IDEAS home Printed from https://ideas.repec.org/a/kap/hcarem/v26y2023i1d10.1007_s10729-022-09620-5.html
   My bibliography  Save this article

A mixed-integer slacks-based measure data envelopment analysis for efficiency measuring of German university hospitals

Author

Listed:
  • Mansour Zarrin

    (University of Augsburg)

Abstract

Standard Data Envelopment Analysis (DEA) models consider continuous-valued and known input and output statuses for measures. This paper proposes an extended Slacks-Based Measure (SBM) DEA model to accommodate flexible (a measure that can play the role of input and output) and integer measures simultaneously. A flexible measure’s most appropriate role (designation) is determined by maximizing the technical efficiency of each unit. The main advantage of the proposed model is that all inputs, outputs, and flexible measures can be expressed in integer values without inflation of efficiency scores since they are directly calculated by modifying input and output inefficiencies. Furthermore, we illustrate and examine the application of the proposed models with 28 university hospitals in Germany. We investigate the differences and common properties of the proposed models with the literature to shed light on both teaching and general inefficiencies. Results of inefficiency decomposition indicate that “Third-party funding income” that university hospitals receive from the research-granting agencies dominates the other inefficiencies sources. The study of the efficiency scores is then followed up with a second-stage regression analysis based on efficiency scores and environmental factors. The result of the regression analysis confirms the conclusion derived from the inefficiency decomposition analysis.

Suggested Citation

  • Mansour Zarrin, 2023. "A mixed-integer slacks-based measure data envelopment analysis for efficiency measuring of German university hospitals," Health Care Management Science, Springer, vol. 26(1), pages 138-160, March.
    • Handle: RePEc:kap:hcarem:v:26:y:2023:i:1:d:10.1007_s10729-022-09620-5
    DOI: 10.1007/s10729-022-09620-5
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10729-022-09620-5
    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/s10729-022-09620-5?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. Grosskopf, Shawna & Margaritis, Dimitri & Valdmanis, Vivian, 2004. "Competitive effects on teaching hospitals," European Journal of Operational Research, Elsevier, vol. 154(2), pages 515-525, April.
    2. Toloo, Mehdi, 2009. "On classifying inputs and outputs in DEA: A revised model," European Journal of Operational Research, Elsevier, vol. 198(1), pages 358-360, October.
    3. Per Andersen & Niels Christian Petersen, 1993. "A Procedure for Ranking Efficient Units in Data Envelopment Analysis," Management Science, INFORMS, vol. 39(10), pages 1261-1264, October.
    4. Kazemi Matin, Reza & Kuosmanen, Timo, 2009. "Theory of integer-valued data envelopment analysis under alternative returns to scale axioms," Omega, Elsevier, vol. 37(5), pages 988-995, October.
    5. Henry Tulkens, 2006. "On FDH Efficiency Analysis: Some Methodological Issues and Applications to Retail Banking, Courts and Urban Transit," Springer Books, in: Parkash Chander & Jacques Drèze & C. Knox Lovell & Jack Mintz (ed.), Public goods, environmental externalities and fiscal competition, chapter 0, pages 311-342, Springer.
    6. 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.
    7. Kuosmanen, Timo & Matin, Reza Kazemi, 2009. "Theory of integer-valued data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 192(2), pages 658-667, January.
    8. Timo Kuosmanen & Abolfazl Keshvari & Reza Kazemi Matin, 2015. "Discrete and Integer Valued Inputs and Outputs in Data Envelopment Analysis," International Series in Operations Research & Management Science, in: Joe Zhu (ed.), Data Envelopment Analysis, edition 127, chapter 4, pages 67-103, Springer.
    9. 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.
    10. Francisco Javier Santos Arteaga & Debora Di Caprio & David Cucchiari & Josep M Campistol & Federico Oppenheimer & Fritz Diekmann & Ignacio Revuelta, 2021. "Modeling patients as decision making units: evaluating the efficiency of kidney transplantation through data envelopment analysis," Health Care Management Science, Springer, vol. 24(1), pages 55-71, March.
    11. Yasar Ozcan & Marcos Lins & Maria Lobo & Angela da Silva & Roberto Fiszman & Basilio Pereira, 2010. "Evaluating the performance of Brazilian university hospitals," Annals of Operations Research, Springer, vol. 178(1), pages 247-261, July.
    12. 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.
    13. Beasley, J. E., 1990. "Comparing university departments," Omega, Elsevier, vol. 18(2), pages 171-183.
    14. Annika Maren Schneider & Eva-Maria Oppel & Jonas Schreyögg, 2020. "Investigating the link between medical urgency and hospital efficiency – Insights from the German hospital market," Health Care Management Science, Springer, vol. 23(4), pages 649-660, December.
    15. Toloo, Mehdi & Ebrahimi, Bohlool & Amin, Gholam R., 2021. "New data envelopment analysis models for classifying flexible measures: The role of non-Archimedean epsilon," European Journal of Operational Research, Elsevier, vol. 292(3), pages 1037-1050.
    16. Du, Juan & Chen, Chien-Ming & Chen, Yao & Cook, Wade D. & Zhu, Joe, 2012. "Additive super-efficiency in integer-valued data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 218(1), pages 186-192.
    17. 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.
    18. G. Tohidi & F. Matroud, 2017. "A new non-oriented model for classifying flexible measures in DEA," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 68(9), pages 1019-1029, September.
    19. Mansour Zarrin & Jan Schoenfelder & Jens O. Brunner, 2022. "Homogeneity and Best Practice Analyses in Hospital Performance Management: An Analytical Framework," Health Care Management Science, Springer, vol. 25(3), pages 406-425, September.
    20. Tone, Kaoru, 2001. "A slacks-based measure of efficiency in data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 130(3), pages 498-509, May.
    21. Cook, Wade D. & Zhu, Joe, 2007. "Classifying inputs and outputs in data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 180(2), pages 692-699, July.
    22. Mojtaba Ghiyasi & Wade D. Cook, 2021. "Classifying dual role variables in DEA: The case of VRS," Journal of the Operational Research Society, Taylor & Francis Journals, vol. 72(5), pages 1183-1190, May.
    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. Dinesh R. Pai & Fatma Pakdil & Nasibeh Azadeh-Fard, 2024. "Applications of data envelopment analysis in acute care hospitals: a systematic literature review, 1984–2022," Health Care Management Science, Springer, vol. 27(2), pages 284-312, June.
    2. Du, Juan & Chen, Chien-Ming & Chen, Yao & Cook, Wade D. & Zhu, Joe, 2012. "Additive super-efficiency in integer-valued data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 218(1), pages 186-192.
    3. Cook, Wade D. & Seiford, Larry M., 2009. "Data envelopment analysis (DEA) - Thirty years on," European Journal of Operational Research, Elsevier, vol. 192(1), pages 1-17, January.
    4. Tavana, Madjid & Izadikhah, Mohammad & Toloo, Mehdi & Roostaee, Razieh, 2021. "A new non-radial directional distance model for data envelopment analysis problems with negative and flexible measures," Omega, Elsevier, vol. 102(C).
    5. 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.
    6. Mansour Zarrin & Jan Schoenfelder & Jens O. Brunner, 2022. "Homogeneity and Best Practice Analyses in Hospital Performance Management: An Analytical Framework," Health Care Management Science, Springer, vol. 25(3), pages 406-425, September.
    7. Toloo, Mehdi & Ebrahimi, Bohlool & Amin, Gholam R., 2021. "New data envelopment analysis models for classifying flexible measures: The role of non-Archimedean epsilon," European Journal of Operational Research, Elsevier, vol. 292(3), pages 1037-1050.
    8. Taleb, Mushtaq & Khalid, Ruzelan & Ramli, Razamin & Ghasemi, Mohammad Reza & Ignatius, Joshua, 2022. "An integrated bi-objective data envelopment analysis model for measuring returns to scale," European Journal of Operational Research, Elsevier, vol. 296(3), pages 967-979.
    9. Mehdi Toloo & Mona Barat & Atefeh Masoumzadeh, 2015. "Selective measures in data envelopment analysis," Annals of Operations Research, Springer, vol. 226(1), pages 623-642, March.
    10. Mahmoudi, Reza & Emrouznejad, Ali & Shetab-Boushehri, Seyyed-Nader & Hejazi, Seyed Reza, 2020. "The origins, development and future directions of data envelopment analysis approach in transportation systems," Socio-Economic Planning Sciences, Elsevier, vol. 69(C).
    11. Yi Qu & Xiao Lyu & Wenlong Peng & Zongfei Xin, 2021. "How to Evaluate the Green Utilization Efficiency of Cultivated Land in a Farming Household? A Case Study of Shandong Province, China," Land, MDPI, vol. 10(8), pages 1-18, July.
    12. Mushtaq Taleb & Ruzelan Khalid & Ali Emrouznejad & Razamin Ramli, 2023. "Environmental efficiency under weak disposability: an improved super efficiency data envelopment analysis model with application for assessment of port operations considering NetZero," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 25(7), pages 6627-6656, July.
    13. Sanjeet Singh & Prabhat Ranjan, 2018. "Efficiency analysis of non-homogeneous parallel sub-unit systems for the performance measurement of higher education," Annals of Operations Research, Springer, vol. 269(1), pages 641-666, October.
    14. Mehdi Toloo & Mona Barat, 2015. "On considering dual-role factor in supplier selection problem," Mathematical Methods of Operations Research, Springer;Gesellschaft für Operations Research (GOR);Nederlands Genootschap voor Besliskunde (NGB), vol. 82(1), pages 107-122, August.
    15. da Cruz, Nuno Ferreira & Marques, Rui Cunha, 2014. "Revisiting the determinants of local government performance," Omega, Elsevier, vol. 44(C), pages 91-103.
    16. Lampe, Hannes W. & Hilgers, Dennis, 2015. "Trajectories of efficiency measurement: A bibliometric analysis of DEA and SFA," European Journal of Operational Research, Elsevier, vol. 240(1), pages 1-21.
    17. Shih-Heng Yu & Chia-Wei Hsu, 2020. "A unified extension of super-efficiency in additive data envelopment analysis with integer-valued inputs and outputs: an application to a municipal bus system," Annals of Operations Research, Springer, vol. 287(1), pages 515-535, April.
    18. Jie Wu & Zhixiang Zhou, 2015. "A mixed-objective integer DEA model," Annals of Operations Research, Springer, vol. 228(1), pages 81-95, May.
    19. Sepideh Abolghasem & Mehdi Toloo & Santiago Amézquita, 2019. "Cross-efficiency evaluation in the presence of flexible measures with an application to healthcare systems," Health Care Management Science, Springer, vol. 22(3), pages 512-533, September.
    20. An, Qingxian & Tao, Xiangyang & Chen, Xiaohong, 2023. "Nested frontier-based best practice regulation under asymmetric information in a principal–agent framework," European Journal of Operational Research, Elsevier, vol. 306(1), pages 269-285.

    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:26:y:2023:i:1:d:10.1007_s10729-022-09620-5. 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.