Assessment of the impact of public hospital associations (PHAs) on the efficiency of hospitals under the ministry of health in Turkey with data envelopment analysis

Şahin, Bayram; İlgün, Gülnur

doi:10.1007/s10729-018-9463-5

Cited by 23 publications

(21 citation statements)

References 18 publications

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“…This phenomenon, in some extent, is suggestive of the regional inequity of the distribution of MCH resources and health utilization, that well-developed regions have more experienced experts and advanced equipments than that in underdevelopment regions. An approach may be helpful to improve the quality of health care services in MCHHs in underdeveloped regions, by sharing training activities in developed regions [35]. It may be useful to improve the quality of medical care in the economic backward areas in a sustainable manner, that medical personnel return to work after a period of receiving the technical training from tertiary hospitals in developed regions.…”

Section: Discussionmentioning

confidence: 99%

Equity and efficiency of maternal and child health resources allocation in Hunan Province, China

Minyuan

Luo

Wang

et al. 2020

BMC Health Serv Res

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Background: A reasonable allocation of health resources is often characterized by equity and high efficiency. This study aims to evaluate the equity and efficiency of maternal and child health (MCH) resources allocation in Hunan Province, China. Methods: Data related to MCH resources and services was obtained from the Hunan maternal and child health information reporting and management system. The Gini coefficient and data envelopment analysis (DEA) were employed to evaluate the equity and efficiency of MCH resources allocation, respectively. Results:The MCH resources allocation in terms of demographic dimension were in a preferred equity status with the Gini values all less than 0.3, and the Gini values for each MCH resources' allocation in terms of the geographical dimension ranged from 0.1298 to 0.4256, with the highest values in the number of midwives and medical equipment (≥ CNY 10,000), which exceeds 0.4, indicating an alert of inequity. More than 40% regions in Hunan were found to be relatively inefficient with decreased return to scale in the allocation of MCH resources, indicating those inefficient regions were using more inputs than needed to obtain the current output levels. Conclusions:The equity of MCH resources by population size is superior by geographic area and the disproportionate distribution of the number of medical equipment (≥ CNY 10,000) and midwives between different regions was the main source of inequity. Policy-makers need to consider the geographical accessibility of health resources among different regions to ensure people in different regions could get access to available health services. More than 40% of regions in Hunan were found to be inefficient, with using more health resources than needed to produce the current amount of health services. Further investigations on factors affecting the efficiency of MCH resources allocation is still needed to guide regional health plans-making and resource allocation.

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Section: Discussionmentioning

confidence: 99%

Equity and efficiency of maternal and child health resources allocation in Hunan Province, China

Minyuan

Luo

Wang

et al. 2020

BMC Health Serv Res

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“…It is known that there are many studies examining the efficiency of hospitals in Turkey (Bilsel and Davutyan, 2014;Sulku, 2011b;Şahin et al, 2011;Bal and Bilge, 2013;G€ ok and Sezen, 2013;Kaçak et al, 2014;G€ ok and Altında g, 2015;€ Ozgen Narcı et al, 2015;Yi git, 2016;Şahin and _ Ilg€ un, 2019). However, it is seen that most of these studies cover the period before 2010 and are descriptive studies.…”

Section: Rq1mentioning

confidence: 99%

Determining the factors affecting the technical efficiency scores of public hospitals using different regression methods

Şahin

İlgün

Sönmez

2021

BIJ

Self Cite

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PurposeThis study aims to identify the efficiency scores of hospitals affiliated to the Ministry of Health in Turkey between the years of 2010–2015 at provincial level and to reveal the factors that affect the efficiency scores.Design/methodology/approachThe two-stage data envelopment analysis (DEA) method was used to achieve the study purpose. In the first stage, DEA method based on input-oriented Charnes–Cooper–Rhodes (CCR) model was performed to calculate the efficiency scores of public hospitals at the provincial level between 2010 and 2015, and in the second stage, Tobit regression and linear regression analyses were used to identify whether the efficiency scores of provinces are affected by the input, output and control variables.FindingsUpon the analysis, the average efficiency scores of 81 provinces by years were found to vary between 0.79 and 0.89. According to both regression analyses, all of the input and output variables were found to have significant effects on the efficiency scores of provinces while only the population of province among the control variables was identified as the factor with an effect on the efficiency scores of provinces (p < 0.05).Practical implicationsThe results of this study are thought to guide health policymakers and managers in terms of both determining efficient and inefficient hospitals at the provincial level and revealing which variables should be taken into account in order to increase efficiency.Originality/valueThe study differs from previous studies on the efficiency of hospitals. First, although previous studies were generally descriptive studies to determine the efficiency level of hospitals, this study is an analytical study that tries also to show the factors affecting the efficiency of hospitals. In addition, while examining the effect of input and output variables on efficiency scores, control variables were also included in the study.

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“…The relationship with previous research is as follows. First, unlike Sahin and İlgün 11 and Jiang et al, 12 , the formulation of reform plans based on discretion to some extent did signi cantly affect e ciency values. In addition, the current study also suggests that public hospitals have soft budget constraints, consistent with Nozao.…”

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confidence: 90%

Management Reform at the Discretion of Public Hospitals in Japan

Miura

Nakata

Murakami

2020

Preprint

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Background: The purpose of this study is to evaluate whether the management reform carried out at the discretion of each public hospital has affected the management efficiency of public hospitals.Methods: This was a retrospective cohort study of public hospitals in Japan. The dependent variable was a technical efficiency score calculated using data envelopment analysis. The independent variable was the presence or absence of a reform plan. Nine control variables were collected in this study; hospital location conditions, nursing standards, transfer to other accounts ratio, disaster base hospital designation, clinical training hospital designation, population under 15 years old, number of hospitals per 1,000 km2, number of beds per 100,000 population, and population density. Univariate and multivariate analysis was performed. A P value < 0.05 was considered statistically significant.Results: There was no significant difference in technical efficiency in univariate analysis and multivariate analysis between public hospitals with and without reform plan.Conclusions: Management efficiency did not improve among public hospitals with management reforms plans. The reason for this lack of improvement is considered to be due to the fact that the management reforms plans were formulated and implemented at each hospital’s discretion.

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Assessment of the impact of public hospital associations (PHAs) on the efficiency of hospitals under the ministry of health in Turkey with data envelopment analysis

Cited by 23 publications

References 18 publications

Equity and efficiency of maternal and child health resources allocation in Hunan Province, China

Equity and efficiency of maternal and child health resources allocation in Hunan Province, China

Determining the factors affecting the technical efficiency scores of public hospitals using different regression methods

Management Reform at the Discretion of Public Hospitals in Japan

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