This study aimed to evaluate the technical efficiency and change in productivity of 120 public hospitals (établissements publics hospitaliers, EPH) in Algeria over the period 2011-2020, along with the factors influencing this efficiency.

To measure efficiency scores, we used the output-oriented data envelopment analysis (DEA) method, based on the hypothesis of variable returns to scale. We also used the Malmquist index to assess changes in efficiency and productivity over the years, and the Simar-Wilson model to assess the determinants of efficiency.

The average efficiency scores for the study period were 0.788 and 0.710 in the classic DEA and bootstrap DEA models, respectively. Regarding the Malmquist index, we observed a 3% decline in total factor productivity during the study period, but an improvement in technical efficiency of 0.3%. As for the determinants of efficiency, six variables (bed occupancy rate, average length of stay, number of beds per doctor, number of beds per thousand inhabitants, number of doctors per thousand inhabitants, and budget) were significant.

The results show an overall improvement in the technical performance of public hospitals during the study period. However, a decline in total factor productivity was observed over the same period, mainly due to technological change.