title: Are vaccination sites in Bangladesh scale efficient?
abstract: OBJECTIVE
  The overall aim of this study is to discern whether and to what degree vaccination sites exhibit constant returns to scale.
  
  
  METHODS
  Data Envelopment Analysis is used to compare all the facilities in the sample in terms of input costs used to produce multiple outputs. The application considers the Expanded Program on Immunization (EPI), which operated in Dhaka City, Bangladesh, during 1999.
  
  
  RESULTS
  A preponderance of EPI sites were determined to be operating at increasing returns to scale.
  
  
  CONCLUSIONS
  Our findings question the applicability of cost-effectiveness analyses that assume constant returns to scale.
authors.affiliation: Health Economics and Financing Program, Department of Public Health and Policy, London School of Hygiene and Tropical Medicine, UK. vivian.valdmanis@lshtm.ac.uk
authors.forename: Vivian
authors.initials: V
authors.lastname: Valdmanis
authors.forename: Damian
authors.initials: D
authors.lastname: Walker
authors.forename: Julia
authors.initials: J
authors.lastname: Fox-Rushby
mesh_terms: D001459:Bangladesh; D003695:Delivery of Health Care / Q000191:economics* / Q000458:organization & administration; D003906:Developing Countries; D017598:Efficiency, Organizational / Q000191:economics*; D017048:Health Care Costs; D017589:Immunization Programs / Q000458:organization & administration*; D015397:Program Evaluation / Q000191:economics