IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v111y2013i2p157-165.html
   My bibliography  Save this article

Productivity and patient satisfaction in primary care—Conflicting or compatible goals?

Author

Listed:
  • Glenngård, Anna Häger

Abstract

Following recent reforms in Swedish primary care, providers are accountable to both citizens and county councils, in their role as payers. Productivity and quality measurement is fundamental for ensuring health care providers accountability to payers and that resources are spent as intended. The purpose was to study productivity and patient satisfaction in Swedish primary care. One measure of productivity capturing volume of visits and one measure capturing individual's judgment about the quality of services in relation to allocated resources was estimated. The potential conflict between the two measures and variation with respect to different factors was analyzed. There was a great variation in both measures of productivity. No conflict between the two measures of productivity was found. Thus, most providers could increase their volume of services without adverse effects for the quality and vice versa. Providers are however faced with different conditions. Traditional productivity measures are not enough to assess whether allocated resources are used according to set priorities and generates value for money. Information about the length and content of visits and the distribution of services produced is also needed, in particular to assess if resources allocated based on expected great needs among certain groups actually benefits those individuals. Effects of services produced are also needed. This is particularly important to assess if resources allocated based on expected great needs among certain groups actually benefits those individuals.

Suggested Citation

  • Glenngård, Anna Häger, 2013. "Productivity and patient satisfaction in primary care—Conflicting or compatible goals?," Health Policy, Elsevier, vol. 111(2), pages 157-165.
  • Handle: RePEc:eee:hepoli:v:111:y:2013:i:2:p:157-165
    DOI: 10.1016/j.healthpol.2013.04.012
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851013001097
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.healthpol.2013.04.012?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    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. Esmeralda Ramalho & Joaquim Ramalho & Pedro Henriques, 2010. "Fractional regression models for second stage DEA efficiency analyses," Journal of Productivity Analysis, Springer, vol. 34(3), pages 239-255, December.
    2. Reid, R. & MacWilliam, L. & Roos, N.P. & Bogdanovich, B. & Black, C., 1999. "Measuring Morbidity in Populations: Performance of the John Hopkins Adjusted Clinical Group (ACG) Case-Mix Adjustment System in Manitoba," Centre for Health Services and Policy Research 99:9, University of British Columbia - Centre for Health Services and Policy Research..
    3. Scott, Anthony, 2000. "Economics of general practice," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 22, pages 1175-1200, Elsevier.
    4. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128, October.
    5. Carol Propper, 2013. "Competition, Incentives and the English NHS," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 11(01), pages 16-20, April.
    6. McDonald, John, 2009. "Using least squares and tobit in second stage DEA efficiency analyses," European Journal of Operational Research, Elsevier, vol. 197(2), pages 792-798, September.
    7. Smith, Peter C. & Anell, Anders & Busse, Reinhard & Crivelli, Luca & Healy, Judith & Lindahl, Anne Karin & Westert, Gert & Kene, Tobechukwu, 2012. "Leadership and governance in seven developed health systems," Health Policy, Elsevier, vol. 106(1), pages 37-49.
    8. Le Grand, Julian, 2009. "Choice and competition in publicly funded health care," Health Economics, Policy and Law, Cambridge University Press, vol. 4(4), pages 479-488, October.
    9. Bevan, Gwyn & Helderman, Jan-Kees & Wilsford, David, 2010. "Changing choices in health care: implications for equity, efficiency and cost," Health Economics, Policy and Law, Cambridge University Press, vol. 5(03), pages 251-267, July.
    10. 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.
    11. Cutler, David, 2002. "Equality, Efficiency, and Market Fundamentals: The Dynamics of International Medical Care Reform," Scholarly Articles 2640584, Harvard University Department of Economics.
    12. Glenngård, Anna H. & Anell, Anders & Beckman, Anders, 2011. "Choice of primary care provider: Results from a population survey in three Swedish counties," Health Policy, Elsevier, vol. 103(1), pages 31-37.
    13. Anell, Anders, 2011. "Choice and privatisation in Swedish primary care," Health Economics, Policy and Law, Cambridge University Press, vol. 6(4), pages 549-569, October.
    14. David M. Cutler, 2002. "Equality, Efficiency, and Market Fundamentals: The Dynamics of International Medical-Care Reform," Journal of Economic Literature, American Economic Association, vol. 40(3), pages 881-906, September.
    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. Sixten Borg & Ulf-G. Gerdtham & Katarina Eeg-Olofsson & Bo Palaszewski & Soffia Gudbjörnsdottir, 2019. "Quality of life in chronic conditions using patient-reported measures and biomarkers: a DEA analysis in type 1 diabetes," Health Economics Review, Springer, vol. 9(1), pages 1-17, December.

    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. Sveréus, Sofia & Kjellsson, Gustav & Rehnberg, Clas, 2018. "Socioeconomic distribution of GP visits following patient choice reform and differences in reimbursement models: Evidence from Sweden," Health Policy, Elsevier, vol. 122(9), pages 949-956.
    2. Martine AUDIBERT & Marlène GUILLON & Jacky MATHONNAT, 2018. "The challenge of improving efficiency of Soum Health Centers in Mongolia," Working Papers P226, FERDI.
    3. Martine Audibert & Marlène Guillon & Jacky Mathonnat, 2018. "The challenge of improving efficiency of Soum Health Centers in Mongolia - What data tell us for Soum Health Centers in five provinces?," Working Papers hal-01795645, HAL.
    4. Martine Audibert & Marlène Guillon & Jacky Mathonnat, 2018. "The challenge of improving efficiency of Soum Health Centers in Mongolia - What data tell us for Soum Health Centers in five provinces?," Post-Print hal-01795645, HAL.
    5. Martine AUDIBERT & Marlène GUILLON & Jacky MATHONNAT, 2018. "The challenge of improving efficiency of Soum Health Centers in Mongolia," Working Papers P226, FERDI.
    6. Galina Besstremyannaya, 2013. "The impact of Japanese hospital financing reform on hospital efficiency: A difference-in-difference approach," The Japanese Economic Review, Japanese Economic Association, vol. 64(3), pages 337-362, September.
    7. Maria EL KHDARI & Babacar SARR, 2018. "Decentralization, spending efficiency and pro-poor outcomes in Morocco," Working Papers 201805, CERDI.
    8. Veronese da Silva, Aline & Costa, Marcelo Azevedo & Lopes-Ahn, Ana Lúcia, 2022. "Accounting multiple environmental variables in DEA energy transmission benchmarking modelling: The 2019 Brazilian case," Socio-Economic Planning Sciences, Elsevier, vol. 80(C).
    9. Berger, Michael & Sommersguter-Reichmann, Margit & Czypionka, Thomas, 2020. "Determinants of soft budget constraints: how public debt affects hospital performance in Austria," LSE Research Online Documents on Economics 116865, London School of Economics and Political Science, LSE Library.
    10. Gutiérrez, Ester & Lozano, Sebastián, 2016. "Efficiency assessment and output maximization possibilities of European small and medium sized airports," Research in Transportation Economics, Elsevier, vol. 56(C), pages 3-14.
    11. Ioannis E. Tsolas, 2020. "Financial Performance Assessment of Construction Firms by Means of RAM-Based Composite Indicators," Mathematics, MDPI, vol. 8(8), pages 1-16, August.
    12. da Silva e Souza, Geraldo & Gomes, Eliane Gonçalves, 2015. "Management of agricultural research centers in Brazil: A DEA application using a dynamic GMM approach," European Journal of Operational Research, Elsevier, vol. 240(3), pages 819-824.
    13. Vengberg, Sofie & Fredriksson, Mio & Winblad, Ulrika, 2019. "Patient choice and provider competition – Quality enhancing drivers in primary care?," Social Science & Medicine, Elsevier, vol. 226(C), pages 217-224.
    14. Laurène PETITFOUR & Xiezhe HUANGFU & Martine AUDIBERT & Jacky MATHONNAT, 2017. "Efficiency of township hospitals in China in the context of the drug policy reform: Progress should not get bogged in midstream - A case study from a survey in Weifang prefecture," Working Papers P185, FERDI.
    15. Tsolas, Ioannis E., 2014. "Precious metal mutual fund performance appraisal using DEA modeling," Resources Policy, Elsevier, vol. 39(C), pages 54-60.
    16. Víctor Chang & Beatriz Tovar, 2022. "Efficiency drivers for the South Pacific West coast port terminals: a two-stage non-convex metafrontier dea approach," Operational Research, Springer, vol. 22(3), pages 2667-2701, July.
    17. Liu, John S. & Lu, Louis Y.Y. & Lu, Wen-Min, 2016. "Research fronts in data envelopment analysis," Omega, Elsevier, vol. 58(C), pages 33-45.
    18. Berger, Michael & Sommersguter-Reichmann, Margit & Czypionka, Thomas, 2020. "Determinants of soft budget constraints: How public debt affects hospital performance in Austria," Social Science & Medicine, Elsevier, vol. 249(C).
    19. Léopold Simar & Paul Wilson, 2011. "Two-stage DEA: caveat emptor," Journal of Productivity Analysis, Springer, vol. 36(2), pages 205-218, October.
    20. Santín, Daniel & Sicilia, Gabriela, 2012. "The educational efficiency drivers in Uruguay: Findings from PISA 2009," MPRA Paper 48420, University Library of Munich, Germany.

    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:hepoli:v:111:y:2013:i:2:p:157-165. 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 or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    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.