IDEAS home Printed from https://ideas.repec.org/a/eee/proeco/v120y2009i2p585-594.html
   My bibliography  Save this article

Performance of French intensive care units: A directional distance function approach at the patient level

Author

Listed:
  • Dervaux, B.
  • Leleu, H.
  • Minvielle, E.
  • Valdmanis, V.
  • Aegerter, P.
  • Guidet, B.

Abstract

By using a novel adaptation of the free-disposable hull analysis of productivity, we assess the medical and technical efficiency of patient care in 25 Parisian intensive care units (ICUs) during 2000. The robust free disposable hull (RFDH) as defined by [Cazals et al., 2002. Nonparametric frontier estimation: a robust approach. Journal of Econometrics 106, 1-25] reduces the impact outliers may have on findings by employing Monte-Carlo techniques and repeated sample selection. Among our key findings, there was no overall significant correlation between medical and technical efficiencies for all the ICUs, therefore performing well in one does not guarantee good performance in the other. We also found that over 80% of inefficiency is concentrated in less than 20% of the sampled patients.

Suggested Citation

  • Dervaux, B. & Leleu, H. & Minvielle, E. & Valdmanis, V. & Aegerter, P. & Guidet, B., 2009. "Performance of French intensive care units: A directional distance function approach at the patient level," International Journal of Production Economics, Elsevier, vol. 120(2), pages 585-594, August.
    • Handle: RePEc:eee:proeco:v:120:y:2009:i:2:p:585-594
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0925-5273(09)00118-2
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Per Andersen & Niels Christian Petersen, 1993. "A Procedure for Ranking Efficient Units in Data Envelopment Analysis," Management Science, INFORMS, vol. 39(10), pages 1261-1264, October.
    2. E. Minvielle & B. Dervaux & A. Retbi & P. Aegerter & A. Boumendil & M.C. Jars-Guincestre & A. Tenaillon & B. Guidet, 2005. "Culture, organization, and management in intensive care: construction and validation of a multidimensional questionnaire," Post-Print hal-00200377, HAL.
    3. Newhouse, Joseph P., 1994. "Frontier estimation: How useful a tool for health economics?," Journal of Health Economics, Elsevier, vol. 13(3), pages 317-322, October.
    4. Cazals, Catherine & Florens, Jean-Pierre & Simar, Leopold, 2002. "Nonparametric frontier estimation: a robust approach," Journal of Econometrics, Elsevier, vol. 106(1), pages 1-25, January.
    5. Jaume Puig‐Junoy, 1998. "Technical efficiency in the clinical management of critically ill patients," Health Economics, John Wiley & Sons, Ltd., vol. 7(3), pages 263-277, May.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Nikos Chatzistamoulou & Phoebe Koundouri, 2020. "Environmental Efficiency, Productive Performance and Spillover Effects under heterogeneous Environmental Awareness Regimes," DEOS Working Papers 2013, Athens University of Economics and Business.
    2. Diogo Ferreira & Rui Cunha Marques, 2018. "Identifying congestion levels, sources and determinants on intensive care units: the Portuguese case," Health Care Management Science, Springer, vol. 21(3), pages 348-375, September.
    3. Ke Wang & Yujiao Xian & Chia-Yen Lee & Yi-Ming Wei & Zhimin Huang, 2019. "On selecting directions for directional distance functions in a non-parametric framework: a review," Annals of Operations Research, Springer, vol. 278(1), pages 43-76, July.
    4. Boussemart, Jean-Philippe & Crainich, David & Leleu, Hervé, 2015. "A decomposition of profit loss under output price uncertainty," European Journal of Operational Research, Elsevier, vol. 243(3), pages 1016-1027.
    5. Diogo Cunha Ferreira & Alexandre Morais Nunes & Rui Cunha Marques, 2020. "Operational efficiency vs clinical safety, care appropriateness, timeliness, and access to health care," Journal of Productivity Analysis, Springer, vol. 53(3), pages 355-375, June.
    6. Jean-Philippe Boussemart & Herv頌eleu & Vivian Valdmanis, 2015. "A two-stage translog marginal cost pricing approach for Floridian hospital outputs," Applied Economics, Taylor & Francis Journals, vol. 47(38), pages 4116-4127, August.
    7. Fangqing Wei & Junfei Chu & Jiayun Song & Feng Yang, 2019. "A cross-bargaining game approach for direction selection in the directional distance function," OR Spectrum: Quantitative Approaches in Management, Springer;Gesellschaft für Operations Research e.V., vol. 41(3), pages 787-807, September.
    8. Thanassoulis, Emmanuel & Silva Portela, Maria C.A. & Graveney, Mike, 2014. "Using DEA to estimate potential savings at GP units at medical specialty level," Socio-Economic Planning Sciences, Elsevier, vol. 48(1), pages 38-48.
    9. Tsekouras, Kostas & Papathanassopoulos, Fotis & Kounetas, Kostas & Pappous, Giorgos, 2010. "Does the adoption of new technology boost productive efficiency in the public sector? The case of ICUs system," International Journal of Production Economics, Elsevier, vol. 128(1), pages 427-433, November.
    10. Bonasia, Mariangela & Kounetas, Konstantinos & Oreste, Napolitano, 2020. "Assessment of regional productive performance of European health systems under a metatechnology framework," Economic Modelling, Elsevier, vol. 84(C), pages 234-248.
    11. Gitto, Simone & Mancuso, Paolo, 2012. "Bootstrapping the Malmquist indexes for Italian airports," International Journal of Production Economics, Elsevier, vol. 135(1), pages 403-411.
    12. Greta Falavigna & Roberto Ippoliti & Alessandro Manello, 2013. "Hospital organization and performance: a directional distance function approach," Health Care Management Science, Springer, vol. 16(2), pages 139-151, June.
    13. Mahlberg, Bernhard & Sahoo, Biresh K., 2011. "Radial and non-radial decompositions of Luenberger productivity indicator with an illustrative application," International Journal of Production Economics, Elsevier, vol. 131(2), pages 721-726, June.
    14. Jean-Philippe Boussemart & David Crainich & Hervé Leleu, 2012. "A decomposition of profit inefficiency into price expectation error, preferences towards risk and technical inefficiency," Working Papers 2012-ECO-04, IESEG School of Management.
    15. Thanassoulis, Emmanuel & Silva Portela, Maria & Graveney, Mike, 2016. "Identifying the scope for savings at inpatient episode level: An illustration applying DEA to chronic obstructive pulmonary disease," European Journal of Operational Research, Elsevier, vol. 255(2), pages 570-582.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Simon Eckermann & Tim Coelli, 2008. "Including quality attributes in a model of health care efficiency: A net benefit approach," CEPA Working Papers Series WP032008, School of Economics, University of Queensland, Australia.
    2. Kristof De Witte & Rui Marques, 2010. "Designing performance incentives, an international benchmark study in the water sector," Central European Journal of Operations Research, Springer;Slovak Society for Operations Research;Hungarian Operational Research Society;Czech Society for Operations Research;Österr. Gesellschaft für Operations Research (ÖGOR);Slovenian Society Informatika - Section for Operational Research;Croatian Operational Research Society, vol. 18(2), pages 189-220, June.
    3. Gnewuch, Matthias & Wohlrabe, Klaus, 2018. "Super-efficiency of education institutions: an application to economics departments," EconStor Open Access Articles and Book Chapters, ZBW - Leibniz Information Centre for Economics, vol. 26, pages 610-623.
    4. Alda A. Henriques & Milton Fontes & Ana S. Camanho & Giovanna D’Inverno & Pedro Amorim & Jaime Gabriel Silva, 2022. "Performance evaluation of problematic samples: a robust nonparametric approach for wastewater treatment plants," Annals of Operations Research, Springer, vol. 315(1), pages 193-220, August.
    5. Greco, Salvatore & Ishizaka, Alessio & Tasiou, Menelaos & Torrisi, Gianpiero, 2019. "Sigma-Mu efficiency analysis: A methodology for evaluating units through composite indicators," European Journal of Operational Research, Elsevier, vol. 278(3), pages 942-960.
    6. Bornmann, Lutz & Gralka, Sabine & Anegón, Félix de Moya & Wohlrabe, Klaus, 2023. "Efficiency of universities and research-focused institutions worldwide: The introduction of a new input indicator reflecting institutional staff numbers," Journal of Informetrics, Elsevier, vol. 17(2).
    7. Nahra, Tammie A. & Mendez, David & Alexander, Jeffrey A., 2009. "Employing super-efficiency analysis as an alternative to DEA: An application in outpatient substance abuse treatment," European Journal of Operational Research, Elsevier, vol. 196(3), pages 1097-1106, August.
    8. Mustapha D. Ibrahim & Sahand Daneshvar & Mevhibe B. Hocaoğlu & Olasehinde-Williams G. Oluseye, 2019. "An Estimation of the Efficiency and Productivity of Healthcare Systems in Sub-Saharan Africa: Health-Centred Millennium Development Goal-Based Evidence," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 143(1), pages 371-389, May.
    9. K De Witte & E Thanassoulis & G Simpson & G Battisti & A Charlesworth-May, 2010. "Assessing pupil and school performance by non-parametric and parametric techniques," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 61(8), pages 1224-1237, August.
    10. Ramon Sala-Garrido & Manuel Mocholí-Arce & María Molinos-Senante, 2021. "Assessing the Quality of Service of Water Companies: a ‘Benefit of the Doubt’ Composite Indicator," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 155(1), pages 371-387, May.
    11. Rita Bastião & Nuno de Sousa Pereira, 2020. "Performance in the Delivery of Primary Health Care Services: A Longitudinal Analysis," CEF.UP Working Papers 2002, Universidade do Porto, Faculdade de Economia do Porto.
    12. Wilson, Paul W., 2008. "FEAR: A software package for frontier efficiency analysis with R," Socio-Economic Planning Sciences, Elsevier, vol. 42(4), pages 247-254, December.
    13. Emrouznejad, Ali & De Witte, Kristof, 2010. "COOPER-framework: A unified process for non-parametric projects," European Journal of Operational Research, Elsevier, vol. 207(3), pages 1573-1586, December.
    14. Fusco, Elisa & Vidoli, Francesco & Rogge, Nicky, 2020. "Spatial directional robust Benefit of the Doubt approach in presence of undesirable output: An application to Italian waste sector," Omega, Elsevier, vol. 94(C).
    15. Reuben Elan & Verma Bharat Bhushan & Bhat Ramesh, 2001. "Hospital Efficiency: An Empirical Analysis of District and Grant-in-Aid Hospitals in Gujarat," IIMA Working Papers WP2001-07-05, Indian Institute of Management Ahmedabad, Research and Publication Department.
    16. Isabel Narbón-Perpiñá & Kristof De Witte, 2016. "Local governments’ efficiency: A systematic literature review – Part II," Working Papers 2016/21, Economics Department, Universitat Jaume I, Castellón (Spain).
    17. Marcel Clermont & Julia Schaefer, 2019. "Identification of Outliers in Data Envelopment Analysis," Schmalenbach Business Review, Springer;Schmalenbach-Gesellschaft, vol. 71(4), pages 475-496, October.
    18. Bernardino Benito & José Solana & María-Rocío Moreno, 2014. "Explaining efficiency in municipal services providers," Journal of Productivity Analysis, Springer, vol. 42(3), pages 225-239, December.
    19. Panagiotis Ravanos & Giannis Karagiannis, 2021. "A VEA Benefit-of-the-Doubt Model for the HDI," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 155(1), pages 27-46, May.
    20. Simar, Leopold & Wilson, Paul W., 2007. "Estimation and inference in two-stage, semi-parametric models of production processes," Journal of Econometrics, Elsevier, vol. 136(1), pages 31-64, January.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:proeco:v:120:y:2009:i:2:p:585-594. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/locate/ijpe .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.