IDEAS home Printed from https://ideas.repec.org/a/kap/hcarem/v23y2020i3d10.1007_s10729-020-09507-3.html
   My bibliography  Save this article

How efficient are surgical treatments in Japan? The case of a high-volume Japanese hospital

Author

Listed:
  • Yuichi Watanabe

    (Waseda University)

  • Haruko Noguchi

    (Waseda University)

  • Yoshinori Nakata

    (Teikyo University)

Abstract

Japan’s healthcare expenditures, which are largely publicly funded, have been growing dramatically due to the rapid aging of the population as well as the innovation and diffusion of new medical technologies. Annual costs for surgical treatments are estimated to be approximately USD 20 billion. Using unique longitudinal clinical data at the individual surgeon level, this study aims to estimate the technical efficiency of surgical treatments across surgical specialties in a high-volume Japanese teaching hospital by employing stochastic frontier analysis (SFA) with production frontier models. We simultaneously examine the impacts of potential determinants that are likely to affect inefficiency in operating rooms. Our empirical results show a relatively high average technical efficiency of surgical production, with modest disparity across surgical specialties. We also demonstrate that an increase in the number of operations performed by a surgeon significantly reduces operating room inefficiency, whereas the revision of the fee-for-service schedule for surgical treatments does not have a significant impact on inefficiency. In addition, we find higher technical efficiency among surgeons who perform multiple daily surgeries than those who perform a single operation in a day. We suggest that it is important for hospital management to retain efficient surgeons and physicians and provide efficient healthcare services given the competitive Japanese healthcare market.

Suggested Citation

  • Yuichi Watanabe & Haruko Noguchi & Yoshinori Nakata, 2020. "How efficient are surgical treatments in Japan? The case of a high-volume Japanese hospital," Health Care Management Science, Springer, vol. 23(3), pages 401-413, September.
  • Handle: RePEc:kap:hcarem:v:23:y:2020:i:3:d:10.1007_s10729-020-09507-3
    DOI: 10.1007/s10729-020-09507-3
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10729-020-09507-3
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.

    File URL: https://libkey.io/10.1007/s10729-020-09507-3?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. William W. Cooper & Lawrence M. Seiford & Joe Zhu (ed.), 2011. "Handbook on Data Envelopment Analysis," International Series in Operations Research and Management Science, Springer, number 978-1-4419-6151-8, April.
    2. Mareike Heimeshoff & Jonas Schreyögg & Lukas Kwietniewski, 2014. "Cost and technical efficiency of physician practices: a stochastic frontier approach using panel data," Health Care Management Science, Springer, vol. 17(2), pages 150-161, June.
    3. Hayashida, Kenshi & Imanaka, Yuichi, 2005. "Inequity in the price of physician activity across surgical procedures," Health Policy, Elsevier, vol. 74(1), pages 24-38, September.
    4. Galina Besstremyannaya, 2011. "Managerial performance and cost efficiency of Japanese local public hospitals: A latent class stochastic frontier model," Health Economics, John Wiley & Sons, Ltd., vol. 20(S1), pages 19-34, September.
    5. Jon A. Chilingerian & H. David Sherman, 2011. "Health-Care Applications: From Hospitals to Physicians, from Productive Efficiency to Quality Frontiers," International Series in Operations Research & Management Science, in: William W. Cooper & Lawrence M. Seiford & Joe Zhu (ed.), Handbook on Data Envelopment Analysis, chapter 0, pages 445-493, Springer.
    6. Kumbhakar,Subal C. & Wang,Hung-Jen & Horncastle,Alan P., 2015. "A Practitioner's Guide to Stochastic Frontier Analysis Using Stata," Cambridge Books, Cambridge University Press, number 9781107609464, September.
    7. Battese, G E & Coelli, T J, 1995. "A Model for Technical Inefficiency Effects in a Stochastic Frontier Production Function for Panel Data," Empirical Economics, Springer, vol. 20(2), pages 325-332.
    8. Greene, William, 2005. "Reconsidering heterogeneity in panel data estimators of the stochastic frontier model," Journal of Econometrics, Elsevier, vol. 126(2), pages 269-303, June.
    9. Steven F. Koch & Jean D. Slabbert, 2012. "Stochastic Frontier Analysis Of Specialist Surgeon Clinics," South African Journal of Economics, Economic Society of South Africa, vol. 80(1), pages 1-15, March.
    10. 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.
    11. Lukas Kwietniewski & Jonas Schreyögg, 2018. "Efficiency of physician specialist groups," Health Care Management Science, Springer, vol. 21(3), pages 409-425, September.
    12. Norman K Thurston & Anne M. Libby, 2002. "A Production Function For Physician Services Revisited," The Review of Economics and Statistics, MIT Press, vol. 84(1), pages 184-191, February.
    13. Reinhardt, U, 1972. "A Product Function for Physician Services," The Review of Economics and Statistics, MIT Press, vol. 54(1), pages 55-66, February.
    Full references (including those not matched with items on IDEAS)

    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. Lukas Kwietniewski & Jonas Schreyögg, 2018. "Efficiency of physician specialist groups," Health Care Management Science, Springer, vol. 21(3), pages 409-425, September.
    2. Lukas Kwietniewski & Jonas Schreyögg, 2018. "Profit efficiency of physician practices: a stochastic frontier approach using panel data," Health Care Management Science, Springer, vol. 21(1), pages 76-86, March.
    3. Roberto Colombi & Gianmaria Martini & Giorgio Vittadini, 2017. "Determinants of transient and persistent hospital efficiency: The case of Italy," Health Economics, John Wiley & Sons, Ltd., vol. 26(S2), pages 5-22, September.
    4. Mareike Heimeshoff & Jonas Schreyögg & Lukas Kwietniewski, 2014. "Cost and technical efficiency of physician practices: a stochastic frontier approach using panel data," Health Care Management Science, Springer, vol. 17(2), pages 150-161, June.
    5. Subal C. Kumbhakar & Christopher F. Parmeter & Valentin Zelenyuk, 2022. "Stochastic Frontier Analysis: Foundations and Advances I," Springer Books, in: Subhash C. Ray & Robert G. Chambers & Subal C. Kumbhakar (ed.), Handbook of Production Economics, chapter 8, pages 331-370, Springer.
    6. Keller, Michael, 2020. "Wasted windfalls: Inefficiencies in health care spending in oil rich countries," Resources Policy, Elsevier, vol. 66(C).
    7. Wanglin Ma & Kathryn Bicknell & Alan Renwick, 2019. "Feed use intensification and technical efficiency of dairy farms in New Zealand," Australian Journal of Agricultural and Resource Economics, Australian Agricultural and Resource Economics Society, vol. 63(1), pages 20-38, January.
    8. George Fragkiadakis & Michael Doumpos & Constantin Zopounidis & Christophe Germain, 2016. "Operational and economic efficiency analysis of public hospitals in Greece," Post-Print hal-01414677, HAL.
    9. Ahimbisibwe, Vianny & Zhunusova, Eliza & Kassa, Habtemariam & Günter, Sven, 2024. "Technical efficiency drivers of farmer-led restoration strategies, and how substantial is the unrealised potential for farm output?," Agricultural Systems, Elsevier, vol. 213(C).
    10. Liu, John S. & Lu, Louis Y.Y. & Lu, Wen-Min & Lin, Bruce J.Y., 2013. "A survey of DEA applications," Omega, Elsevier, vol. 41(5), pages 893-902.
    11. Orea, Luis, 2019. "The Econometric Measurement of Firms’ Efficiency," Efficiency Series Papers 2019/02, University of Oviedo, Department of Economics, Oviedo Efficiency Group (OEG).
    12. Gralka, Sabine, 2018. "Stochastic frontier analysis in higher education: A systematic review," CEPIE Working Papers 05/18, Technische Universität Dresden, Center of Public and International Economics (CEPIE).
    13. Nadide YiÄŸiteli, 2023. "Production Losses Due to Technical Inefficiency: A Panel Data Analysis on the Case of BRICS-T Countries," EKOIST Journal of Econometrics and Statistics, Istanbul University, Faculty of Economics, vol. 0(38), pages 53-73, June.
    14. Zuzana FUNGACOVA & Paul-Olivier KLEIN & Laurent WEILL, 2018. "Persistent and Transient Inefficiency: Explaining the Low Efficiency of Chinese Big Banks," Working Papers of LaRGE Research Center 2018-07, Laboratoire de Recherche en Gestion et Economie (LaRGE), Université de Strasbourg.
    15. Martini, Gianmaria & Scotti, Davide & Viola, Domenico & Vittadini, Giorgio, 2020. "Persistent and temporary inefficiency in airport cost function: An application to Italy," Transportation Research Part A: Policy and Practice, Elsevier, vol. 132(C), pages 999-1019.
    16. Carolina Crispin-Fory & Ligia Alba Melo-Becerra & Diego Alexander Restrepo-Tobón & Diego Vásquez-Escobar, 2023. "Eficiencia y solidez financiera de las Instituciones prestadoras de Servicio de Salud (IPS) en Colombia," Borradores de Economia 1248, Banco de la Republica de Colombia.
    17. Ali M. Oumer & Michael Burton & Atakelty Hailu & Amin Mugera, 2020. "Sustainable agricultural intensification practices and cost efficiency in smallholder maize farms: Evidence from Ethiopia," Agricultural Economics, International Association of Agricultural Economists, vol. 51(6), pages 841-856, November.
    18. Iparraguirre, José Luis & Ma, Ruosi, 2015. "Efficiency in the provision of social care for older people. A three-stage Data Envelopment Analysis using self-reported quality of life," Socio-Economic Planning Sciences, Elsevier, vol. 49(C), pages 33-46.
    19. Mocholi-Arce, Manuel & Sala-Garrido, Ramon & Molinos-Senante, Maria & Maziotis, Alexandros, 2021. "Water company productivity change: A disaggregated approach accounting for changes in inputs and outputs," Utilities Policy, Elsevier, vol. 70(C).
    20. Pal, Debdatta & Mitra, Subrata K. & Chatterjee, Somdeep, 2022. "Does “investment climate” affect GDP? Panel data evidence using reduced-form and stochastic frontier analysis," Journal of Business Research, Elsevier, vol. 138(C), pages 301-310.

    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:kap:hcarem:v:23:y:2020:i:3:d:10.1007_s10729-020-09507-3. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    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.