The Open Public Health Journal

ISSN: 1874-9445 ― Volume 14, 2021

An Analytical-Predictive Model for Measuring the Efficiency and Effectiveness of Public Health Services

Neda Vitezić1, *, Antonija Petrlić1
1 University of Rijeka, Faculty of Economics and Business, Ivana Filipovića 4, 51000 Rijeka, Croatia



The main function of public health services is to improve people’s health and therefore, efficiency and effectiveness are constantly a subject of various world-wide research works. Today, in the era of digitalization, when numerous data are created and built, it is much easier to develop and implement a measurement system. It is possible to quickly use a wide variety of accurate and reliable data, aiming to create different measures that will help in the assessment and the decision-making process. For a long time, public health services have been facing a problem of finding an appropriate solution for measuring efficiency and effectiveness.


The aim of this research is to find an appropriate analytical-predictive model for measuring efficiency and effectiveness of public health institutes. Public health is oriented to monitoring, analysis, and evaluation of the health of a population i.e., prevention activities. It is a complex and interdependent process of different realisation of services, programmes, and activities the results of which are sometimes visible only after a long period of time. Therefore, the results of their activities should be evaluated using an appropriate performance measurement system.


The adjusted Balanced Scorecard (BSC) combined with the non-parametric Data Envelopment Analysis (DEA) technique is used to help identify the possibilities for improving the efficiency and effectiveness of public health service activities.


The result of this study is the proposed Analytical-Predictive Model (APE) that uses Balanced Scorecard combined with Data Envelopment Analysis to measure relative and technical efficiency as well as long-term effectiveness. The model used DEA as a benchmark for targets set in each perspective within the BSC. Using the BSC model, we selected the goals and common indicators for all DMUs, and using DEA, we identified relative efficiency of the DMUs. Efficient DMUs are considered a benchmark and used as targets for measuring effectiveness.


This research has confirmed the appropriateness of the combination of BSC and DEA methods for measuring efficiency and effectiveness of public health institutions. To be able to measure and predict the long-term effectiveness of the activities and programmes, we had to combine the realised outputs and the set outcomes. The implementation of the APE model in the institutes of public health will contribute to the improvement of analysis, forecast, and optimisation of all their activities. The model is applicable to other public health institutions.

Keywords: Analytical-predictive model, BSC, DEA, Efficiency, Effectiveness, Public health services.

Article Information

Identifiers and Pagination:

Year: 2020
Volume: 13
First Page: 203
Last Page: 211
Publisher Id: TOPHJ-13-203
DOI: 10.2174/1874944502013010203

Article History:

Received Date: 23/12/2019
Revision Received Date: 27/03/2020
Acceptance Date: 29/03/2020
Electronic publication date: 23/05/2020
Collection year: 2020

© 2020 Vitezić and Petrlić.

open-access license: This is an open access article distributed under the terms of the Creative Commons Attribution 4.0 International Public License (CC-BY 4.0), a copy of which is available at: This license permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

* Address correspondence to this author at the University of Rijeka, Faculty of Economics and Business, Ivana Filipovića 4, 51000 Rijeka, Croatia; Tel: +38551355126; E-mail:

Track Your Manuscript:


"Open access will revolutionize 21st century knowledge work and accelerate the diffusion of ideas and evidence that support just in time learning and the evolution of thinking in a number of disciplines."

Daniel Pesut
(Indiana University School of Nursing, USA)

"It is important that students and researchers from all over the world can have easy access to relevant, high-standard and timely scientific information. This is exactly what Open Access Journals provide and this is the reason why I support this endeavor."

Jacques Descotes
(Centre Antipoison-Centre de Pharmacovigilance, France)

"Publishing research articles is the key for future scientific progress. Open Access publishing is therefore of utmost importance for wider dissemination of information, and will help serving the best interest of the scientific community."

Patrice Talaga
(UCB S.A., Belgium)

"Open access journals are a novel concept in the medical literature. They offer accessible information to a wide variety of individuals, including physicians, medical students, clinical investigators, and the general public. They are an outstanding source of medical and scientific information."

Jeffrey M. Weinberg
(St. Luke's-Roosevelt Hospital Center, USA)

"Open access journals are extremely useful for graduate students, investigators and all other interested persons to read important scientific articles and subscribe scientific journals. Indeed, the research articles span a wide range of area and of high quality. This is specially a must for researchers belonging to institutions with limited library facility and funding to subscribe scientific journals."

Debomoy K. Lahiri
(Indiana University School of Medicine, USA)

"Open access journals represent a major break-through in publishing. They provide easy access to the latest research on a wide variety of issues. Relevant and timely articles are made available in a fraction of the time taken by more conventional publishers. Articles are of uniformly high quality and written by the world's leading authorities."

Robert Looney
(Naval Postgraduate School, USA)

"Open access journals have transformed the way scientific data is published and disseminated: particularly, whilst ensuring a high quality standard and transparency in the editorial process, they have increased the access to the scientific literature by those researchers that have limited library support or that are working on small budgets."

Richard Reithinger
(Westat, USA)

"Not only do open access journals greatly improve the access to high quality information for scientists in the developing world, it also provides extra exposure for our papers."

J. Ferwerda
(University of Oxford, UK)

"Open Access 'Chemistry' Journals allow the dissemination of knowledge at your finger tips without paying for the scientific content."

Sean L. Kitson
(Almac Sciences, Northern Ireland)

"In principle, all scientific journals should have open access, as should be science itself. Open access journals are very helpful for students, researchers and the general public including people from institutions which do not have library or cannot afford to subscribe scientific journals. The articles are high standard and cover a wide area."

Hubert Wolterbeek
(Delft University of Technology, The Netherlands)

"The widest possible diffusion of information is critical for the advancement of science. In this perspective, open access journals are instrumental in fostering researches and achievements."

Alessandro Laviano
(Sapienza - University of Rome, Italy)

"Open access journals are very useful for all scientists as they can have quick information in the different fields of science."

Philippe Hernigou
(Paris University, France)

"There are many scientists who can not afford the rather expensive subscriptions to scientific journals. Open access journals offer a good alternative for free access to good quality scientific information."

Fidel Toldrá
(Instituto de Agroquimica y Tecnologia de Alimentos, Spain)

"Open access journals have become a fundamental tool for students, researchers, patients and the general public. Many people from institutions which do not have library or cannot afford to subscribe scientific journals benefit of them on a daily basis. The articles are among the best and cover most scientific areas."

M. Bendandi
(University Clinic of Navarre, Spain)

"These journals provide researchers with a platform for rapid, open access scientific communication. The articles are of high quality and broad scope."

Peter Chiba
(University of Vienna, Austria)

"Open access journals are probably one of the most important contributions to promote and diffuse science worldwide."

Jaime Sampaio
(University of Trás-os-Montes e Alto Douro, Portugal)

"Open access journals make up a new and rather revolutionary way to scientific publication. This option opens several quite interesting possibilities to disseminate openly and freely new knowledge and even to facilitate interpersonal communication among scientists."

Eduardo A. Castro
(INIFTA, Argentina)

"Open access journals are freely available online throughout the world, for you to read, download, copy, distribute, and use. The articles published in the open access journals are high quality and cover a wide range of fields."

Kenji Hashimoto
(Chiba University, Japan)

"Open Access journals offer an innovative and efficient way of publication for academics and professionals in a wide range of disciplines. The papers published are of high quality after rigorous peer review and they are Indexed in: major international databases. I read Open Access journals to keep abreast of the recent development in my field of study."

Daniel Shek
(Chinese University of Hong Kong, Hong Kong)

"It is a modern trend for publishers to establish open access journals. Researchers, faculty members, and students will be greatly benefited by the new journals of Bentham Science Publishers Ltd. in this category."

Jih Ru Hwu
(National Central University, Taiwan)

Browse Contents

Webmaster Contact:
Copyright © 2021 Bentham Open