What Counts in Nursing Homes’ Quality and Efficiency? Results From Data Envelopment Analysis in Italy

Abstract

Purpose: Economic resource constrains in public spending budget in a country, such as Italy, with an ageing population with high incidence of chronic diseases calls for better strategies to improve measuring quality and efficiency in nursing homes (NHs). This paper analyses the efficiency of 40 NHs based in Tuscany considering not only structural characteristics but also quality of care, including residents, relatives and staff satisfaction. Methodology: We run a classic data envelopment analysis (DEA) on data gathered by the NHs’ regional performance evaluation system. We include as inputs the number of total work hours as labour and the daily cost for services as economic resources. As outputs we include measures for quality of care (number of falls, urinary infections and antidepressants), satisfaction (residents, relatives and professionals) and quality of life (days of recreational activities). We run a multivariate regression to analyse the determinants of previously obtained efficiency scores considering factors such as: institutional (ownership), managerial (training) and clinical (patient’s severity). Findings: Results find 35% efficient NHs. Moreover, management and the managerial factor (staff trained in end-of-life support) are predictors of the efficiency score. Originality: Our study uses satisfaction (residents, relatives and professionals) measures as proxy for quality output in the DEA model and measures related to staff management (eg training) as predictors of the efficiency scores.

Total Factor Productivity Change of Long-Term Care System in Selected Oecd Countries

“…Further, this service is provided to a person in need, in a majority of cases an elderly, consequently, quality measures form the second group of variables additionally used in research (e.g. Kooreman, 1994;Garavaglia, Lettieri, Agasisti & Lopez, 2010;Chang & Yang, 2010;Barsanti, Bunea & Colombini, 2021). Finally, a growing number of LTC institutions are being established as any other for-profit business project and in that sense, financial indicators form the third group of variables that are the less often (solely) used in efficiency studies of the LTC sector (e.g.…”

“…Kleinsorge & Karney, 1992;Garavaglia et al, 2010;Olivares-Tirado & Tamiya, 2014;Veloso, Vaz & Alves, 2017;Stals, Tsaurkubule, Konstante & Alksnis, 2020;Vrabková & Vaňková, 2021;Višić & Kordić, 2021). As stated, some of the aforementioned studies use just one type of variable, some combine two types, while for example, Zhang, Zeng and Fang (2019) and Barsanti et al (2021) use all three groups of variables -those common in health-sector focused studies, qualitative and financial variables.…”

Il vissuto degli operatori e l'emergenza Covid-19 nelle Residenze Sanitarie Assistenziali

“…Inoltre, si è verifi cata una diffusa disponibilità dei diversi professionisti a coprire i turni dei colleghi mancanti. L'organizzazione e la flessibilità dei turni di lavoro rappresentano un tema particolarmente sensibile in tale contesto, sentito dagli operatori come non necessariamente legato ai momenti di stress come la pandemia (Barsanti et al, 2019(Barsanti et al, , 2021.…”

Efficiency evaluation of surgical nursing wards based on data envelopment analysis

“…Previous studies have attempted to assess the efficiency of nursing resources; however, they focused on the efficiency of nursing resources in intensive care units (Antunes et al, 2021) and nursing homes (Barsanti et al, 2021)…”

“…Previous studies have attempted to assess the efficiency of nursing resources; however, they focused on the efficiency of nursing resources in intensive care units (Antunes et al, 2021) and nursing homes (Barsanti et al, 2021), which include different evaluation items and indicators from hospital settings. Based on previous research on nursing management, this study employed a DEA model to evaluate current nursing resource allocation efficiency in public hospitals in China and examine the potential causes of low efficiency in surgical wards.…”