Evaluation of Efficiency in Primary Health Care Centres: An Application of Data Envelopment Analysis

García, F. J. Zufía; Servós, Carmen Marcuello; Serrano, D.; Urbina, Olga

doi:10.1111/1468-0408.00074

Cited by 33 publications

(20 citation statements)

References 10 publications

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“…it can be used to determine whether returns to scales are locally increasing or decreasing [58,59]; 3. Using ratios adjusted for the DMUs size as input-output data rather than absolute numbers, which removes any information about the size of DMUs [34,49,55].…”

Section: Discussionmentioning

confidence: 99%

“…Largely, DEA has been used to measure the relative efficiency of a wide range of activities provided by different PC centers or districts within national/regional PC systems [21][22][23][24][25][26][27][28][29][30][31][32][33][34][35][36]. In a large number of studies DEA has also been used to compare PC providers in delivering specific activities (e.g.…”

Section: General Descriptionmentioning

confidence: 99%

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Primary Care Efficiency Measurement Using Data Envelopment Analysis: A Systematic Review

et al. 2014

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There is a gap between the demand and supply of efficiency analyses within primary care (PC), despite the threatening financial sustainability of health care systems. This paper provides a systematic literature review on PC efficiency analysis using Data Envelopment Analysis (DEA). We reviewed 39 DEA applications in PC, to understand how methodological frameworks impact results and influence the information provided to decision makers. Studies were combined using qualitative narrative synthesis. This paper reports data for each efficiency analysis on the: 1) evaluation context; 2) model specifications; 3) application of methods to test the robustness of findings; 4) presentation of results. Even though a consistent number of analyses aim to support policymakers and practice managers in improving the efficiency of their PC organizations, the results indicate that DEA--at least when applied to PC--is a methodology still in progress; it needs to be further advanced to meet the complexity that characterizes the production of PC outcomes. Future studies are needed to fill some gaps in this particular domain of research, such as on the standardization of methodologies and the improvement of outcome research in PC. Most importantly, further studies should include extensive uncertainty analyses and be based on good evidence-based rationales. We suggest a number of considerations to academics and researchers to foster the utility of efficiency measurement for the decision making purposes in PC.

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Section: Discussionmentioning

confidence: 99%

Section: General Descriptionmentioning

confidence: 99%

Primary Care Efficiency Measurement Using Data Envelopment Analysis: A Systematic Review

et al. 2014

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“…However, the concept of quality is difficult to define, since it encompasses technical aspects reflecting the capacity of medical staff to diagnose and treat medical problems, but also patients´ perceptions about the service delivered (Donabedian, 1980;Campbell et al, 2000). Therefore, in the short list of studies using a nonparametric framework to incorporate quality measures into the efficiency analysis it is possible to detect a variety of indicators as proxies to this concept (Salinas-Jiménez and Smith, 1996;García et al, 1999;Rosenman and Friesner, 2004;Amado and Santos, 2009). …”

Section: Literature Reviewmentioning

confidence: 99%

Efficiency assessment of primary care providers: A conditional nonparametric approach

Ferrera

Alonso-Morán

Nuño-Solinís

et al. 2015

European Journal of Operational Research

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This paper uses a fully nonparametric approach to estimate efficiency measures for primary care units incorporating the effect of environmental factors. This methodology allows us to account for different types of variables (continuous and discrete) regarding the main characteristics of patients served by those providers. In addition, we use an extension of this nonparametric approach to deal with the presence of undesirable outputs in data, represented by the number of readmissions and hospitalization rates of ambulatory care sensitive condition (ASCS). The empirical results of our application show that all the exogenous variables considered have a significant and negative effect on efficiency estimates.

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“…This introduces further difficulty into the analysis, and indeed there have been only a few studies taking this line, such as Salinas-Jiménez and Smith (1996), García et al (1999), and, more recently, Rosenman and Friesner (2004).…”

Section: Introductionmentioning

confidence: 99%

Technical efficiency in primary health care: does quality matter?

Zamorano

Petraglia

2010

Eur J Health Econ

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The accuracy required in the measurement of output is an issue that has as yet still not been satisfactorily addressed in empirical research on efficiency in primary health care. We exploit information retrieved from a newly constructed database (APEX06) for the Spanish region of Extremadura. The richness of our dataset allows us to consider original synthetic measures of output that take into account both the quantity and the quality of services provided by 85 primary care centres (PCCs) in 2006. We provide evidence that neglecting the issue of properly accounting for the quality of health services can lead to misleading results. Our main finding is that adjusting output for quality influences efficiency analysis in three senses. First, inefficiency now explains relatively more of the deviation from the potential output. Second, the average technical efficiency in the sector is lower, while its dispersion among PCCs is significantly higher. And third, the efficiency ranking of the PCCs is also affected.

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Evaluation of Efficiency in Primary Health Care Centres: An Application of Data Envelopment Analysis

Cited by 33 publications

References 10 publications

Primary Care Efficiency Measurement Using Data Envelopment Analysis: A Systematic Review

Primary Care Efficiency Measurement Using Data Envelopment Analysis: A Systematic Review

Efficiency assessment of primary care providers: A conditional nonparametric approach

Technical efficiency in primary health care: does quality matter?

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