IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v87y2008i1p1-7.html
   My bibliography  Save this article

Measuring efficiency in clinical departments

Author

Listed:
  • Magnussen, Jon
  • Nyland, Kari

Abstract

Objectives This paper explores the possibilities and limitations of obtaining and interpreting efficiency measurement on the level of the clinical department. We discuss the limitations of case-mix groupings such as the diagnosis related groups on this level.Methods Hospital costs are allocated to clinical departments and efficiency measured using data envelopment analysis (DEA). Outputs are measured as number of discharges adjusted for case-mix using DRGs. The effect of department vs. hospital on the level of measured efficiency is analysed using a simple fixed effects regression model.Results We find that measured efficiency depends critically on the chosen model specification. Some department types, notably children's departments have systematically lower levels of measured efficiency.Conclusions : Our findings have implications for the monitoring and financing of clinical departments. DRG type instruments should be applied with caution both for monitoring and financing purposes on the departmental level.

Suggested Citation

  • Magnussen, Jon & Nyland, Kari, 2008. "Measuring efficiency in clinical departments," Health Policy, Elsevier, vol. 87(1), pages 1-7, July.
    • Handle: RePEc:eee:hepoli:v:87:y:2008:i:1:p:1-7
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168-8510(07)00209-6
    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. U. -G. Gerdtham & C. Rehnberg & M. Tambour, 1999. "The impact of internal markets on health care efficiency: evidence from health care reforms in Sweden," Applied Economics, Taylor & Francis Journals, vol. 31(8), pages 935-945.
    2. Andrew Street, 2003. "How much confidence should we place in efficiency estimates?," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 895-907, November.
    3. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
    4. Linna, Miika & Hakkinen, Unto & Magnussen, Jon, 2006. "Comparing hospital cost efficiency between Norway and Finland," Health Policy, Elsevier, vol. 77(3), pages 268-278, August.
    5. Hallsteinli, Vidar & Kittelsen, Sverre AC & Magnussen, Jon, 2009. "Scale, efficiency and organization in Norwegian psychiatric outpatient clinics for children," HERO Online Working Paper Series 2001:8, University of Oslo, Health Economics Research Programme.
    6. Léopold Simar & Paul W. Wilson, 1998. "Sensitivity Analysis of Efficiency Scores: How to Bootstrap in Nonparametric Frontier Models," Management Science, INFORMS, vol. 44(1), pages 49-61, January.
    7. R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, vol. 30(9), pages 1078-1092, 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. Sebastian Kohl & Jan Schoenfelder & Andreas Fügener & Jens O. Brunner, 2019. "The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals," Health Care Management Science, Springer, vol. 22(2), pages 245-286, June.
    2. Onder, O. & Cook, W. & Kristal, M., 2022. "Does quality help the financial viability of hospitals? A data envelopment analysis approach," Socio-Economic Planning Sciences, Elsevier, vol. 79(C).
    3. Chowdhury, Hedayet & Zelenyuk, Valentin & Laporte, Audrey & Wodchis, Walter P., 2014. "Analysis of productivity, efficiency and technological changes in hospital services in Ontario: How does case-mix matter?," International Journal of Production Economics, Elsevier, vol. 150(C), pages 74-82.
    4. Miryam Daoud Marrakchi & Hédi Essid, 2019. "Efficiency Assessment of Tunisian Public hospitals Using Data Envelopment Analysis (DEA)," Working Papers 1291, Economic Research Forum, revised 2019.
    5. Halkos, George E. & Tzeremes, Nickolaos G., 2011. "A conditional nonparametric analysis for measuring the efficiency of regional public healthcare delivery: An application to Greek prefectures," Health Policy, Elsevier, vol. 103(1), pages 73-82.
    6. Kao, Chiang & Pang, Rui-Zhi & Liu, Shiang-Tai & Bai, Xue-Jie, 2021. "Most productive types of hospitals: An empirical analysis," Omega, Elsevier, vol. 99(C).
    7. Lorena Androutsou & Michail Kokkinos & Dimitra Latsou & Mary Geitona, 2022. "Assessing the Efficiency and Productivity of the Hospital Clinics on the Island of Rhodes during the COVID-19 Pandemic," IJERPH, MDPI, vol. 19(23), pages 1-12, November.
    8. Claudio Pinto, 2014. "Efficiency comparison for directly managed public hospitals for different geographical area in Italy," Working papers 5, Società Italiana di Economia Pubblica.

    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. Varabyova, Yauheniya & Schreyögg, Jonas, 2013. "International comparisons of the technical efficiency of the hospital sector: Panel data analysis of OECD countries using parametric and non-parametric approaches," Health Policy, Elsevier, vol. 112(1), pages 70-79.
    2. Halsteinli, Vidar & Kittelsen, Sverre A. & Magnussen, Jon, 2010. "Productivity growth in outpatient child and adolescent mental health services: The impact of case-mix adjustment," Social Science & Medicine, Elsevier, vol. 70(3), pages 439-446, February.
    3. Halkos, George E. & Tzeremes, Nickolaos G., 2011. "A conditional nonparametric analysis for measuring the efficiency of regional public healthcare delivery: An application to Greek prefectures," Health Policy, Elsevier, vol. 103(1), pages 73-82.
    4. Sebastian Kohl & Jan Schoenfelder & Andreas Fügener & Jens O. Brunner, 2019. "The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals," Health Care Management Science, Springer, vol. 22(2), pages 245-286, June.
    5. 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.
    6. Franz R. Hahn, 2007. "Determinants of Bank Efficiency in Europe. Assessing Bank Performance Across Markets," WIFO Studies, WIFO, number 31499, June.
    7. H Fukuyama & W L Weber, 2009. "Estimating indirect allocative inefficiency and productivity change," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 60(11), pages 1594-1608, November.
    8. María Victoria Uribe‐Bohorquez & Jennifer Martínez‐Ferrero & Isabel‐María García‐Sánchez, 2019. "Women on boards and efficiency in a business‐orientated environment," Corporate Social Responsibility and Environmental Management, John Wiley & Sons, vol. 26(1), pages 82-96, January.
    9. Alessandra Cepparulo & Gilles Mourre, 2020. "How and How Much? The Growth-Friendliness of Public Spending through the Lens," European Economy - Discussion Papers 132, Directorate General Economic and Financial Affairs (DG ECFIN), European Commission.
    10. Nguyen, Bao Hoang & Simar, Léopold & Zelenyuk, Valentin, 2022. "Data sharpening for improving central limit theorem approximations for data envelopment analysis–type efficiency estimators," European Journal of Operational Research, Elsevier, vol. 303(3), pages 1469-1480.
    11. Santos, Joana & Simões, Pedro & Costa, Álvaro & Cunha Marques, Rui, 2010. "Efficiency of the Portuguese metros. is it different from other European metros?," MPRA Paper 34904, University Library of Munich, Germany.
    12. 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.
    13. Nadia M. Guerrero & Juan Aparicio & Daniel Valero-Carreras, 2022. "Combining Data Envelopment Analysis and Machine Learning," Mathematics, MDPI, vol. 10(6), pages 1-22, March.
    14. Wijesiri, Mahinda & Yaron, Jacob & Meoli, Michele, 2017. "Assessing the financial and outreach efficiency of microfinance institutions: Do age and size matter?," Journal of Multinational Financial Management, Elsevier, vol. 40(C), pages 63-76.
    15. Thanh Ngo & Kan Wai Hong Tsui, 2022. "Estimating the confidence intervals for DEA efficiency scores of Asia-Pacific airlines," Operational Research, Springer, vol. 22(4), pages 3411-3434, September.
    16. Zervopoulos, Panagiotis & Emrouznejad, Ali & Sklavos, Sokratis, 2019. "A Bayesian approach for correcting bias of data envelopment analysis estimators," MPRA Paper 91886, University Library of Munich, Germany.
    17. Andreas Dellnitz & Elmar Reucher & Andreas Kleine, 2021. "Efficiency evaluation in data envelopment analysis using strong defining hyperplanes," OR Spectrum: Quantitative Approaches in Management, Springer;Gesellschaft für Operations Research e.V., vol. 43(2), pages 441-465, June.
    18. Kaffash, Sepideh & Azizi, Roza & Huang, Ying & Zhu, Joe, 2020. "A survey of data envelopment analysis applications in the insurance industry 1993–2018," European Journal of Operational Research, Elsevier, vol. 284(3), pages 801-813.
    19. Changhee Kim & Soo Wook Kim & Hee Jay Kang & Seung-Min Song, 2017. "What Makes Urban Transportation Efficient? Evidence from Subway Transfer Stations in Korea," Sustainability, MDPI, vol. 9(11), pages 1-18, November.
    20. M. Foddi & S. Usai, 2012. "Regional innovation performance in Europe," Working Paper CRENoS 201221, Centre for North South Economic Research, University of Cagliari and Sassari, Sardinia.

    More about this item

    Statistics

    Access and download statistics

    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:87:y:2008:i:1:p:1-7. 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.