Performance evaluation of emergency department physicians using robust value‐based additive efficiency model

Abstract

We propose a novel variant of the value-based additive data envelopment analysis model. It conducts a comprehensive robustness analysis of efficiency outcomes for all feasible input and output weights using mathematical programming and the Monte Carlo simulation. We also introduce the original procedures for selecting a common vector of weights and an approach for investigating the stability of results in a multiscenario setting. The presented framework is applied to evaluate the performance of emergency department physicians using data from the Children's Hospital of Eastern Ontario in Ottawa. Our focus is on the physicians' performance when dealing with groups of patients' complaints related to abdominal pain and constipation, fever, extremity injury, head injury, and laceration/puncture. The obtained results emphasize the strong dependence of the physicians' performances on the selected weight vectors. However, they prove helpful in pointing out overall good performers who can serve as universal benchmarks or niche performers being markedly better in providing care to a given complaint group. They also offer a basis for developing an improvement plan for the underperforming physicians, identifying the priorities for a practice-oriented model, and recognizing the most challenging patients' complaints.

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

“…Labijak-Kowalska et al [ 90 ] conducted an extensive investigation into the resilience of efficiency results concerning various input and output weights. They achieved this by applying mathematical programming and the Monte Carlo simulation.…”

Exact and stochastic methods for robustness analysis in the context of Imprecise Data Envelopment Analysis

“…Their analysis may lead to selecting the most preferred solution to be implemented in practice. Finally, we develop the methods for robustness analysis in the context of value-based DEA (see Gouveia et al 2008;Labijak-Kowalska et al 2023). This model is based on concepts from Multiple Criteria Decision Analysis, allowing the incorporation of managerial preferences on different levels.…”

Robust Additive Value-Based Efficiency Analysis with a Hierarchical Structure of Inputs and Outputs

“…The proposed framework is inspired by [23], being adapted to the multiple-level hierarchy value-based efficiency analysis. The formulations of dedicated procedures and types of considered results are similar to those considered in [24]. However, we admit the stakeholders studying the stability of efficiency outcomes in each hierarchy node instead of forcing them to consider all inputs and outputs simultaneously.…”