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Measuring efficiency in clinical departments

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  • 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.

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  • 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
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    1. 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.
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    7. 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.
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    2. 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.
    3. 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).
    4. 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).
    5. 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.
    6. 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.
    7. Claudio Pinto, 2014. "Efficiency comparison for directly managed public hospitals for different geographical area in Italy," Working papers 5, Società Italiana di Economia Pubblica.
    8. 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.

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