Efficiency and quality in health services: a crucial link

Espigares, Jóse Luis Navarro; Torres, Elisa Hernández

doi:10.1080/02642060802712798

Cited by 48 publications

(23 citation statements)

References 31 publications

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“…The performance measurement across the different groups of hospitals is very important for understanding the utilization of scarce resources. It also provides important information for development of healthcare reforms to improve global funding system while simultaneously promoting quality and efficiency (Goldstein et al, 2002;Griffith et al, 2002;Mannion et al, 2005;Villard et al, 2005;Navarro-Espigares and Torres, 2011;Liu et al, 2012;Mauro et. al., 2013) as well as better accountability among healthcare providers.…”

Section: Introductionmentioning

confidence: 99%

Performance of hospital services in Ontario: DEA with truncated regression approach

Chowdhury

Zelenyuk

2016

Omega

125

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In this work, we analyze production performance of hospital services in Ontario (Canada), by investigating its key determinants. Using data for the years 2003 and 2006, we follow the two-stage approach of Simar and Wilson (2007). Specifically, we use Data Envelopment Analysis (DEA) at the first stage to estimate efficiency scores and then use truncated regression estimation with doublebootstrap to test the significance of explanatory variables. We also examine distributions of 2 efficiency across geographic locations, size and teaching status. We find that several organizational factors such as occupancy rate, rate of unit-producing personnel, outpatient-inpatient ratio, case-mix index, geographic locations, size and teaching status are significant determinants of efficiency.

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Section: Introductionmentioning

confidence: 99%

Performance of hospital services in Ontario: DEA with truncated regression approach

Chowdhury

Zelenyuk

2016

Omega

125

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“…In the field of health, studies have focused on 2 types of analysis, according to the subject-object of study. The studies of some authors [33][34][35][36][37][38][39] analyze the efficiency of certain public health institutions such as hospitals and health centers, while other authors 3,[29][30][31]40,41 analyze the efficiency of the health systems of countries.…”

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confidence: 99%

Analysis and determination the efficiency of the European health systems

Moreno‐Enguix

Gómez‐Gallego

Gallego

2017

Health Planning & Management

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The current economic crisis has increased the interest in analyzing the efficiency of health care systems, as their funding is a very important part of the budgets for different countries. In this work determines the efficiency in the health services in European countries applying data envelopment analysis. In addition, the combined application of data envelopment analysis methods and ACP can provide an evaluation of the efficiency with respect to differently oriented productive health systems in the different countries. The results show that models with a lower level of efficiency are those whose input is beds, followed by the models whose input is physicians. Finally, we apply the AD to select a few simple indicators that facilitate control of the level of operational efficiency of a health system.

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“…It has been argued that process indicators should not be included into the efficiency analysis because it is not an output of production process [45]; however, several previous studies included process indicators either to augment the production set [6,11,46] or to explore the relationship with the distribution of inefficiencies in the two-stage analysis [22,23,25]. To shed new light on this discussion we explored whether and how a process indicator enters the production process.…”

Section: Datamentioning

confidence: 99%

Using nonparametric conditional approach to integrate quality into efficiency analysis: empirical evidence from cardiology departments

Varabyova

Blankart

Schreyögg

2016

Health Care Manag Sci

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. In the past decades, hospitals have been facing pressure to increase the efficiency of resource allocation. One way to achieve higher levels of technical efficiency is to treat more patients with the same amount of personnel, which could potentially lead to a trade-off between improving efficiency and maintaining good patient service. The aim of this study is to demonstrate how the nonparametric conditional approach can be used to integrate quality into the analysis of efficiency. The conditional approach allows investigating the mechanism through which quality enters the production process. Generally, an external variable may enter the production process by affecting either the attainable frontier or the distribution of inefficiencies inside the production set. To account for the heterogeneity of hospital services, we focus on a hospital department as the unit of analysis. We use data from 178 departments of interventional cardiology and consider three different measures of quality: patient satisfaction, risk-adjusted mortality, and patient radiation exposure. Our empirical assessment shows that the impact of quality on the production process differs according to the utilized quality measure. Patient satisfaction does not affect the attainable frontier but does have an inverted -shaped effect on the distribution of inefficiencies; risk-adjusted mortality negatively impacts the attainable frontier at high values of mortality but does not impact the distribution of inefficiencies; and patient radiation exposure is not associated with the production process. Our results refute the existence of a clear trade-off between efficiency and quality. The conditional approach can be applied to deal with the complexity of the underlying relationships between efficiency and quality. Terms of use: Documents in

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Efficiency and quality in health services: a crucial link

Cited by 48 publications

References 31 publications

Performance of hospital services in Ontario: DEA with truncated regression approach

Performance of hospital services in Ontario: DEA with truncated regression approach

Analysis and determination the efficiency of the European health systems

Using nonparametric conditional approach to integrate quality into efficiency analysis: empirical evidence from cardiology departments

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