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Exploring the use of DEA for formative evaluation in primary diabetes care: An application to compare English practices

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  • C A F Amado

    (University of Algarve, Campus de Gambelas)

  • R G Dyson

    (University of Warwick)

Abstract

Primary care is currently at the heart of the UK National Health Service policy. Primary care trusts have the crucial role of improving the efficiency and equity in primary care delivery. However, few studies have focused on performance assessment in primary care provision. In this paper, we examine the role of data envelopment analysis (DEA) in helping decision makers to understand and improve the performance of primary care practices. We discuss the results from a study of 14 practices in England in terms of their delivery of diabetes services. In order to take into account the multiple values that underlie public services provision, we have considered several different perspectives for evaluation. These were: technical, allocative and cost efficiency, clinical and patient-focused effectiveness, and equity. The approach adopted involved a deep engagement with the practices. The purpose was to understand the structures and processes supporting effective practice using DEA in a formative role rather than the more usual summative role with a large data set. This approach is in the tradition of the developmental engagement approach of operational research.

Suggested Citation

  • 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.
    • Handle: RePEc:pal:jorsoc:v:60:y:2009:i:11:d:10.1057_jors.2008.160
    DOI: 10.1057/jors.2008.160
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    References listed on IDEAS

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    Cited by:

    1. Rita Bastião & Nuno de Sousa Pereira, 2020. "Performance in the Delivery of Primary Health Care Services: A Longitudinal Analysis," CEF.UP Working Papers 2002, Universidade do Porto, Faculdade de Economia do Porto.
    2. 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.
    3. Victor V. Podinovski & Wan Rohaida Wan Husain, 2017. "The hybrid returns-to-scale model and its extension by production trade-offs: an application to the efficiency assessment of public universities in Malaysia," Annals of Operations Research, Springer, vol. 250(1), pages 65-84, March.
    4. Margit Sommersguter-Reichmann, 2022. "Health care quality in nonparametric efficiency studies: a review," 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. 30(1), pages 67-131, March.
    5. Amado, Carla A.F. & Santos, Sérgio P. & Marques, Pedro M., 2012. "Integrating the Data Envelopment Analysis and the Balanced Scorecard approaches for enhanced performance assessment," Omega, Elsevier, vol. 40(3), pages 390-403.
    6. Luis Murillo-Zamorano & Carmelo Petraglia, 2011. "Technical efficiency in primary health care: does quality matter?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(2), pages 115-125, April.
    7. Førsund, Finn R., 2017. "Measuring effectiveness of production in the public sector," Omega, Elsevier, vol. 73(C), pages 93-103.
    8. 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.
    9. Panagiotis Ravanos & Giannis Karagiannis, 2023. "On VEA, production trade-offs and weights restrictions," Journal of the Operational Research Society, Taylor & Francis Journals, vol. 74(10), pages 2081-2093, October.
    10. Cordero, José Manuel & Alonso-Morán, Edurne & Nuño-Solinis, Roberto & Orueta, Juan F. & Arce, Regina Sauto, 2015. "Efficiency assessment of primary care providers: A conditional nonparametric approach," European Journal of Operational Research, Elsevier, vol. 240(1), pages 235-244.
    11. Kalinichenko, Olena & Amado, Carla A.F. & Santos, Sérgio P., 2022. "Exploring the potential of Data Envelopment Analysis for enhancing pay-for-performance programme design in primary health care," European Journal of Operational Research, Elsevier, vol. 298(3), pages 1084-1100.
    12. Olena Kalinichenko & Carla A. F. Amado & Sérgio P. Santos, 2013. "Performance Assessment in Primary Health Care: A Systematic Literature Review," CEFAGE-UE Working Papers 2013_03, University of Evora, CEFAGE-UE (Portugal).
    13. R G Dyson & E A Shale, 2010. "Data envelopment analysis, operational research and uncertainty," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 61(1), pages 25-34, January.
    14. Marcos Pereira Estellita Lins & Sergio Orlando Antoun Netto & Maria Stella Castro Lobo, 2019. "Multimethodology applied to the evaluation of Healthcare in Brazilian municipalities," Health Care Management Science, Springer, vol. 22(2), pages 197-214, June.
    15. Thanassoulis, Emmanuel & Silva Portela, Maria C.A. & Graveney, Mike, 2012. "Estimating the scope for savings in referrals and drug prescription costs in the general Practice units of a UK primary care trust," European Journal of Operational Research, Elsevier, vol. 221(2), pages 432-444.
    16. Podinovski, Victor V. & Bouzdine-Chameeva, Tatiana, 2016. "On single-stage DEA models with weight restrictions," European Journal of Operational Research, Elsevier, vol. 248(3), pages 1044-1050.
    17. Thorsen, Maggie & McGarvey, Ronald & Thorsen, Andreas, 2020. "Diabetes management at community health centers: Examining associations with patient and regional characteristics, efficiency, and staffing patterns," Social Science & Medicine, Elsevier, vol. 255(C).

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