Efficiency and Productivity of Public Hospitals in Serbia Using DEA-Malmquist Model and Tobit Regression Model, 2015–2019

Medarević, Aleksandar; Vukovic, Dejana

doi:10.3390/ijerph182312475

Cited by 25 publications

(20 citation statements)

References 69 publications

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“…Therefore, it is reasonable and necessary to use the improved three-stage DEA method when measuring the efficiency of public hospitals for accurate results. The results for efficiency indicated that the mean efficiency score of public hospitals in Guangdong was 0.891, which was higher than that in Palestine (0.853) [ 32 ], Serbia (0.782) [ 45 ], Turkey (0.724) [ 69 ], Saudi Arabia (0.76) [ 50 ], Jordan (0.547) [ 70 ], and Iran (0.873) [ 71 ] and lower than that in Spain (1.016) [ 72 ], Wuhan, China (0.899) [ 73 ], and Taiwan, China (0.973) [ 74 ]. Only 38.1% of cities were found to be efficient in 2020.…”

Section: Discussionmentioning

confidence: 99%

“…The number of healthcare institutions and beds were commonly chosen to represent capital investment [ 33 , 42 , 46 – 49 ]. Regarding labor variables, health workers [ 13 , 17 , 42 , 44 – 47 , 50 ], health technical workers [ 30 , 33 , 36 , 42 , 45 , 48 , 49 ], physicians [ 28 – 30 , 36 , 41 , 43 – 45 , 50 ], and nurses [ 17 , 28 , 30 , 36 , 41 , 42 , 44 , 45 ] were often regarded as types of labor investment. In the selection of output indicators, there are two main categories of expected and undesirable outputs.…”

Section: Introductionmentioning

confidence: 99%

“…For data availability issues, most studies opt for expected indicators when conducting analysis. The number of outpatient visits or outpatient and emergency visits [13,28,30,36,41,42,[44][45][46][47][48][49]51], inpatient visits or discharged visits [28, 29, 36, 41-44, 46-48, 51] and revenue [17,33] are usually regarded as expected outputs, and infection incidence or infectious patients and patient or population mortality [36,50,52] are regarded as undesirable outputs. Kohl S and Schoenfelder J et al pointed out that it is of great importance to distinguish between absolute and relative data to prevent biased conclusions [40].…”

Section: Introductionmentioning

confidence: 99%

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Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China

Fan

et al. 2022

Int J Equity Health

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Background To better meet people’s growing demand for medical and health services, 21 cities in Guangdong Province were involved in the reform of public hospitals in 2017. This paper evaluates the equity and efficiency of public hospitals’ health resource allocation in Guangdong Province and explores ways to change the current situation. Methods Data were collected from the Guangdong Health Statistical Yearbook 2016–2020 and Guangdong Statistical Yearbook 2017–2021. The Gini coefficient (G), Theil index (T), and health resource density index (HRDI) were used to measure the equity of health resource allocation. An improved three-stage DEA method was applied in efficiency evaluation. The entropy weight method was employed to calculate the weight of different indicators to obtain a comprehensive indicator representing the overall volume of health resources in each city. A two-dimensional matrix was drawn between the HRDI of the comprehensive indicator and efficiency and the per capita government financial subsidies and efficiency to observe the coordination of equity and efficiency across regions. Results From 2016 to 2020, the G of public hospital, bed, and health technician allocation by population remained below 0.2, while that by geographical area ranged from 0.4 to 0.6; the G of government financial subsidies by population was above 0.4, while that by geographical area was greater than 0.7. The results for T showed that inequality mainly comes from intraregional differences, and the Pearl River Delta contributes most to the overall differences. Although the HRDI of the Pearl River Delta is far greater than that of other regions, obvious differences exist across cities in the region. Only 38.1% of cities were found to be efficient in 2020. The Pearl River Delta was in the first quadrant, and the other three regions were in the third quadrant, accounting for a large proportion. Conclusion The equity of government financial subsidies allocation was the worst, and there were distinct regional differences in the geographical distribution of health resources. The development of healthcare within the Pearl River Delta was highly unbalanced. The development of healthcare was uneven between the Pearl River Delta, eastern, western, and mountainous regions. In addition, most cities in the eastern, western, and mountainous regions bore the dual pressures of relatively insufficient health resources and inefficiency.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China

Fan

et al. 2022

Int J Equity Health

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“…The DEA model measured relative efficiency by comparing and evaluating multi-input and multioutput DMUs, but it did not capture the key factors affecting efficiency. Thus, having calculated the efficiency score, we regressed environmental and managerial factors as the explanatory variables on the OTE to investigate the reasons for inefficiencies in medical institutions at various levels ( 41 ). In our study, we took into account the independence, availability, and comprehensiveness of data with the research focus.…”

Section: Methodsmentioning

confidence: 99%

Levels, trends, and determinants of effectiveness on the hierarchical medical system in China: Data envelopment analysis and bootstrapping truncated regression analysis

Hou

Tao

Hou

et al. 2022

Front. Public Health

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BackgroundThe hierarchical medical system (HMS) refers to the classification of treatment according to disease priorities based on severity and difficulty to promote the fairness of medical services for residents, which is regarded as the key to the success of medical reform in China.MethodsIn the past decade of “New Medical Reform,” the efficiency of HMS, including secondary and tertiary hospitals and primary healthcare centers (PHCs), was measured horizontally and vertically by employing the combination of an output-oriented superefficiency slack-based model-data envelopment analysis (SE-SBM-DEA) model with the Malmquist total factor productivity index (MTFP). In the second stage, the overall technical efficiency (OTE) scores were regressed against a set of environmental characteristics and several managerial factors through bootstrapping truncated regression.ResultsOn average, the OTE score in tertiary hospitals was 0.93, which was higher than that in secondary hospitals and PHCs (0.9 and 0.92, respectively). In terms of trend, the OTE of tertiary hospitals declined at first and then increased. The opposite was true of secondary hospitals, in which the APC of the OTE was 10.82 and −3.11% in early and late 2012, respectively. The PHCs generally showed a fluctuating downward trend. In the aspects of productivity, all institutions showed a downturn by an annual average rate of 2.73, 0.51, and 2.70%, respectively. There was a significant negative relationship between the ratio of outpatients to inpatients and tertiary hospitals. Additionally, the medical technical personnel per 1,000 population negatively affected PHCs. In contrast, the GDP per capita had a significantly positive effect on tertiary hospitals, and the number of beds per 1,000 population positively influenced PHCs.ConclusionThe efficiency of medical institutions at various levels in HMS was unbalanced and took the form of an “inverted pyramid.” Multilateral factors influence the efficiency of HMS, and to address it, multi-intervention packages focusing on sinking high-quality medical resources and improving healthcare capacity, and guiding hierarchical medical practice should be adopted.

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“…DEA is a deterministic and non-parametric efficiency evaluation method proposed by Charnes et al [ 58 ]. Compared with the stochastic or parametric efficiency measurement method, DEA does not need to set the specific form of production function and does not contain random error [ 59 ]. The relative efficiency of DMUs is evaluated based on the degree of deviation from the frontier of DEA, and it shows strong objectivity.…”

Section: Methodsmentioning

confidence: 99%

Environmental Regulation, Financial Pressure and Industrial Ecological Efficiency of Resource-Based Cities in China: Spatiotemporal Characteristics and Impact Mechanism

Hou

Yin

Chen

2022

IJERPH

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A resource-based city is a type of city characterized by the exploitation and processing of natural resources as the leading industry in the region. Such cities provide essential resources for China’s economic development and support long-term rapid economic growth. However, resource-based cities (RBCs) face challenges, including resource depletion, economic recession, environmental pollution, and ecological damage, to which not enough attention has been paid. In the context of China’s increased focus on environmental protection and the economy, improving industrial ecological efficiency of RBCs has become ever more important. In the present study, the Super-SBM model was used to measure the industrial ecological efficiency of 114 RBCs in China from 2003 to 2016. The results show that during the study period, the industrial ecological efficiency of RBCs in China improved significantly, particularly in the central and western regions. The results from a Tobit model show that appropriate environmental regulation and financial pressure have a positive impact on the industrial ecological efficiency of RBCs. However, when faced with the dual pressures of environmental regulation and financial difficulty, improvement in industrial ecological efficiency was inhibited. The impact of environmental regulation and financial pressure on industrial ecological efficiency of cities in different regions and development stages and with different resource types shows heterogeneity. In accordance with the study findings, differentiated measures and suggestions are proposed to improve the industrial ecological efficiency of RBCs.

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Efficiency and Productivity of Public Hospitals in Serbia Using DEA-Malmquist Model and Tobit Regression Model, 2015–2019

Cited by 25 publications

References 69 publications

Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China

Equity and efficiency of public hospitals’ health resource allocation in Guangdong Province, China

Levels, trends, and determinants of effectiveness on the hierarchical medical system in China: Data envelopment analysis and bootstrapping truncated regression analysis

Environmental Regulation, Financial Pressure and Industrial Ecological Efficiency of Resource-Based Cities in China: Spatiotemporal Characteristics and Impact Mechanism

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