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Technical and cost efficiency of oral health care provision in Finnish health centres

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  • Linna, Miika
  • Nordblad, Anne
  • Koivu, Matti

Abstract

In this study we measured the productive efficiency of public dental health provision across Finland. The analysis was based on data envelopment analysis (DEA) using linear programming. In addition, we investigated various factors explaining the technical and cost efficiency of public dental care using a parametric Tobit model. These analyses revealed substantial variation in productive efficiency between health centres in different municipalities. The level of cost inefficiency was generally between 20% and 30%. Good dental health of the population, high rates of unemployment and high per capita expenditure on primary care in the municipality were associated with technical and cost inefficiency. According to the results, cost efficiency would not be improved by shifting input allocation towards more auxiliary manpower in health centres. Individual efficiency scores were clearly sensitive to the choice of output specification. Changing the unit of output measurement from visit- to patient-based measures affected markedly the ranking of dental health centres. However, the set of exogenous correlates associated to inefficiency was strikingly similar for both types of output specification. More resources are needed if the coverage of public dental care is extended to all age groups. The health centre specific efficiency scores obtained in this study can be used locally to evaluate, design and implement structural changes in the production processes.

Suggested Citation

  • Linna, Miika & Nordblad, Anne & Koivu, Matti, 2003. "Technical and cost efficiency of oral health care provision in Finnish health centres," Social Science & Medicine, Elsevier, vol. 56(2), pages 343-353, January.
    • Handle: RePEc:eee:socmed:v:56:y:2003:i:2:p:343-353
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    Cited by:

    1. Pelone, Ferruccio & Kringos, Dionne Sofia & Valerio, Luca & Romaniello, Alessandro & Lazzari, Agnese & Ricciardi, Walter & de Belvis, Antonio Giulio, 2012. "The measurement of relative efficiency of general practice and the implications for policy makers," Health Policy, Elsevier, vol. 107(2), pages 258-268.
    2. Drake, Leigh & Hall, Maximilian J.B. & Simper, Richard, 2006. "The impact of macroeconomic and regulatory factors on bank efficiency: A non-parametric analysis of Hong Kong's banking system," Journal of Banking & Finance, Elsevier, vol. 30(5), pages 1443-1466, May.
    3. Panagiotis Mitropoulos & Kostas Kounetas & Ioannis Mitropoulos, 2016. "Factors affecting primary health care centers’ economic and production efficiency," Annals of Operations Research, Springer, vol. 247(2), pages 807-822, December.
    4. Leigh M. Drake & Richard Simper, 2005. "The Measurement Of Police Force Efficiency: An Assessment Of U.K. Home Office Policy," Contemporary Economic Policy, Western Economic Association International, vol. 23(4), pages 465-482, October.
    5. Olga Milliken & Rose Anne Devlin & Vicky Barham & William Hogg & Simone Dahrouge & Grant Russell, 2008. "Comparative Efficiency Assessment of Primary Care Models Using Data Envelopment Analysis," Working Papers 0802E, University of Ottawa, Department of Economics.
    6. Kaili Zhong & Lv Chen & Sixiang Cheng & Hongjun Chen & Fei Long, 2020. "The Efficiency of Primary Health Care Institutions in the Counties of Hunan Province, China: Data from 2009 to 2017," IJERPH, MDPI, vol. 17(5), pages 1-15, March.
    7. Nikolaos Oikonomou & Yannis Tountas & Argiris Mariolis & Kyriakos Souliotis & Kostas Athanasakis & John Kyriopoulos, 2016. "Measuring the efficiency of the Greek rural primary health care using a restricted DEA model; the case of southern and western Greece," Health Care Management Science, Springer, vol. 19(4), pages 313-325, December.
    8. C A F Amado & R G Dyson, 2009. "Exploring the use of DEA for formative evaluation in primary diabetes care: An application to compare English practices," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 60(11), pages 1469-1482, November.
    9. 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.
    10. M. C. Gouveia & L. C. Dias & C. H. Antunes & M. A. Mota & E. M. Duarte & E. M. Tenreiro, 2016. "An application of value-based DEA to identify the best practices in primary health care," OR Spectrum: Quantitative Approaches in Management, Springer;Gesellschaft für Operations Research e.V., vol. 38(3), pages 743-767, July.

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