Evaluating the efficiency of one stop crisis centres in managing domestic violence cases

Abstract

Introduction: As domestic violence (DV) poses a critical threat to public health worldwide, this prompts the need for efficient and effective intervention. In Malaysia, although One Stop Crisis Centres (OSCCs) have been offering multisectoral services to DV victims for many decades, an evaluation of the efficiency of these centres has yet to be conducted. This study aimed to assess the efficiency and effectiveness of three Malaysian OSCCs using a two-stage Data Envelopment Analysis (DEA) approach.

Materials and methods: A total of 153 adult DV victims were recruited from OSCCs in Sarawak General Hospital, Universiti Malaya Medical Centre, and Hospital Universiti Sains Malaysia. The inputs included the number of doctors, nurses, and other personnel whereas the outputs were total response time and service quality, measured via a validated 35-item OSCC-Qual instrument. Stage 1 employed an inputoriented Banker, Charnes, and Cooper (BCC) DEA model to determine how efficiently OSCCs managed resources to minimize response times. Stage 2 used an output-oriented BCC model to evaluate the centre's ability to maximize service quality.

Results: The social workers unit recorded notably long mean response times across three centres. Correlation analysis revealed a strong negative association between the number of personnel and the multisectoral coordination dimension of service quality. While most units showed high pure technical efficiency in the input-oriented DEA, scale inefficiencies were shown to be common in all centres. Pure technical efficiency measures how well resources are utilized regardless of scale, whereas scale efficiency assesses whether an organization operates at its optimal size (neither too large nor too small). In the output-oriented model, all centres similarly demonstrated good pure technical efficiency but continued to grapple with scale inefficiencies, especially at Sarawak General Hospital and Hospital Universiti Sains Malaysia.

Conclusion: These findings highlight the importance of optimizing operational scale in OSCCs. Tailoring resource allocation and strengthening coordination among multidisciplinary teams could reduce response times and improve care for DV victims.