Evaluating the decentralization of public hospitals in Turkey in terms of technical efficiency: data envelopment analysis and Malmquist index

Abstract

PurposeDecree Law No. 663 introduced a decentralized organizational structure and administration pertaining to Turkish public hospitals in November 2011. This study aims to explore the effects of the public hospital unions (PHUs), which were a result of Decree Law No. 663, on the efficiency and productivity of public hospitals.Design/methodology/approachData envelopment analysis (DEA) and DEA-based Malmquist total factor productivity (TFP) index were used from 2011 to 2016. Raw materials and supply expenses, salaries and fringe benefits, other service costs, general administrative expenses, total number of beds, number of specialists, number of residents, number of general practitioners, number of nurses and midwives and other medical officials were used as input variables. Working capital turnover, number of inpatients, number of outpatients and number of surgical operations for Groups A, B and C were used as output variables.FindingsAccording to the DEA scores, the percentage of efficient hospitals showed a declining trend from 2011 to 2016. The TFP results also showed a decreasing trend from 2011 to 2016.Practical implicationsProviding administrative and financial autonomy to public hospital managers may cause efficiency and productivity losses, which is contrary to expectations.Originality/valueThis study is the first to reveal the impact of decentralization of public healthcare providers on their performance levels in Turkey.

The Application of Data Envelopment Analysis to Emergency Departments and Management of Emergency Conditions: A Narrative Review

“…The findings from this model can provide valuable insights into the performance of each rural health clinic. In a related study, Bağcı et al [ 63 ] proposed a time series DEA-based MPI using CRS and VRS models from 2011 to 2016 in rural hospitals in Turkey. As input variables, the study considered the total number of beds, specialists, residents, general practitioners, nurses, and midwives; other medical personnel wages and benefits; other service expenditures; raw materials and supply costs; and overall administrative costs.…”

A non-parametric synthesis measure for board quality: empirical evidence from Indian banks

“…The BD approach has several associated advantages with it in measuring the composite value for any multidimensional phenomenon and has been used in the diversified field to determine the index value (Bernini et al, 2013;F€ are et al, 2019;Oliveira et al, 2020;Sahoo et al, 2017). A few of the major benefits of for opting the BD approach include the ease of interpretation as BD provide a single value for any multidimensional phenomenon (Cherchye et al, 2004), the BD approach assigns objective weights to each attribute while collectively providing an efficiency score (Cherchye et al, 2007), this tool is much appropriate when the sample size is small (Gulati et al, 2020;Sahoo et al, 2017), the BD, like the classical DEA (Ba gcı and Çil Koçyi git, 2023;Tamatam et al, 2019), is unit invariant (Oliveira et al, 2020). Owing to such advantages, the present study chooses the BD approach as the most appropriate technique that can able to measure the strength of the corporate board of Indian banks.…”

“…, 2020; Sahoo et al. , 2017), the BD, like the classical DEA (Bağcı and Çil Koçyiğit, 2023; Tamatam et al. , 2019), is unit invariant (Oliveira et al.…”

Kamu Ağız ve Diş Sağlığı Merkezlerinin Malmquist Indeksi ile Finansal Performansının Değerlendirilmesi (Financial Performance Evaluation of Public Oral and Dental Health Centers with Malmquist Index)

“…2011 yılında 663 sayılı Sağlık Bakanlığı ve Bağlı Kuruluşlarının Teşkilat ve Görevleri Hakkında KHK ile SB merkez teşkilatında TKHK kurulmuştur (Resmi Gazete, 2011). 2012 yılında, İstanbul'da 6, Ankara'da 3, İzmir'de 2, diğer illerde bir olmak üzere toplamda 89 KHB'i kurulmuş il düzeyinde kamu hastaneleri ile ağız ve diş sağlığı hizmetleri sunan kamu kurumları KHB'lere bağlanmıştır (Bağcı, 2018). Bunun sonucunda SB, doğrudan hizmet sunumunda yer almak yerine, planlayıcı ve denetleyici bir rol üstlenmiştir.…”