Operation Assessment on Ambulance Services: A Case Study of Machakos County, Kenya

Abstract

An efficient ambulance services is an integral component of EMS (Emergency Medical services). This paper attempts to establish a cost-efficient ambulance service appropriate for community critical care transport needs in Kenya on basis of data collected in Machakos County. A descriptive cross-sectional study design was conducted between January and May 2015.  Multistage sampling was carried out to recruit household’s respondents. The technical efficiency scores were computed using Data Envelopment Analysis (DEA) Programme, version 2.1 (DEAP 2.1). The model was based on two inputs (cost incurred on vehicles and medical consumables) and one output (number of kilometres covered monthly by an ambulance). The household survey results demonstrated that all the residents (100%) were aware of free ambulatory services, 30-39 years 31.5% (95% CI ± 4.55) was the dominant population of which majority had 1- 3 children 66.3% (CI± 4.63). It was reported by the majority (78,3%) that the ambulance services were accessible, available and efficient to those who sought them. Between the periods starting March 2014 to May 2015, a total of 12,674 clients were transported by ambulances from the locations to various tires (levels) of hospitals, Majority 24.7% (95% CI; ± 0.75) were in need of emergency obstetric care (EMOC). The annual operational cost was Kshs. 70,328,627 ($717.639); staff salaries accounted for 49% (95% CI ±0.01) of operational cost, overheads costs at 33.5% (95% CI ±0.01) and 1.3% for renting equivalent operation space. The key demand factors were; social-cultural, health-seeking behaviours and political patronage while supply barriers were; transport costs, operational costs and in-efficient signage. Machakos County Government was operating at an average technical efficiency of 90.6% (95% CI ±7.9). In conclusion, Machakos County ambulance services were operating efficiently (technically).