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Is there a Trade-Off between Quality and Productivity? The Case of Diagnostic Technologies in Portugal

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  • Clara Dismuke
  • Vania Sena

Abstract

The purpose of this paper is twofold: first, we compute quality-adjusted measures of productivity change for the three most important diagnostic technologies (i.e., the Computerised Tomography Scan, Electrocardiogram and Echocardiogram) in the major Portuguese hospitals. We use the Malmquist–Luenberger index, which allows to measure productivity growth while controlling for the quality of the production. Second, using non-parametric tests, we analyse whether the implementation of the Prospective Payment System may have had a positive impact on the movements of productivity over time. The results show that the PPS has helped hospitals to use these tools more efficiently and to improve their effectiveness. Copyright Kluwer Academic Publishers 2001

Suggested Citation

  • Clara Dismuke & Vania Sena, 2001. "Is there a Trade-Off between Quality and Productivity? The Case of Diagnostic Technologies in Portugal," Annals of Operations Research, Springer, vol. 107(1), pages 101-116, October.
    • Handle: RePEc:spr:annopr:v:107:y:2001:i:1:p:101-116:10.1023/a:1014946914816
    DOI: 10.1023/A:1014946914816
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    Cited by:

    1. Pan Wanbin & Huang Lei & Zhao Linlin, 2017. "An Integrated DEA Model Allowing Decomposition of Eco-Efficiency: A Case Study of China," Journal of Systems Science and Information, De Gruyter, vol. 5(5), pages 473-488, October.
    2. Juan Aparicio & Jose Manuel Cordero & Carlos Díaz-Caro, 2020. "Efficiency and productivity change of regional tax offices in Spain: an empirical study using Malmquist–Luenberger and Luenberger indices," Empirical Economics, Springer, vol. 59(3), pages 1403-1434, September.
    3. Diogo Cunha Ferreira & Alexandre Morais Nunes & Rui Cunha Marques, 2020. "Operational efficiency vs clinical safety, care appropriateness, timeliness, and access to health care," Journal of Productivity Analysis, Springer, vol. 53(3), pages 355-375, June.
    4. Anne Hvenegaard & Jacob Arendt & Andrew Street & Dorte Gyrd-Hansen, 2011. "Exploring the relationship between costs and quality: Does the joint evaluation of costs and quality alter the ranking of Danish hospital departments?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(6), pages 541-551, December.
    5. 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.
    6. Paola Dongili & Angelo Zago, 2005. "Bad loans and efficiency in Italian Banks," Working Papers 28/2005, University of Verona, Department of Economics.
    7. Ferreira, D.C. & Marques, R.C., 2019. "Do quality and access to hospital services impact on their technical efficiency?," Omega, Elsevier, vol. 86(C), pages 218-236.
    8. Murat Bilsel & Nurhan Davutyan, 2014. "Hospital efficiency with risk adjusted mortality as undesirable output: the Turkish case," Annals of Operations Research, Springer, vol. 221(1), pages 73-88, October.
    9. Chih-Ching Yang, 2014. "An enhanced DEA model for decomposition of technical efficiency in banking," Annals of Operations Research, Springer, vol. 214(1), pages 167-185, March.
    10. Angelo Zago, 2004. "Quality Production and Quality Indicators in Intermediate Products," Working Papers 16/2004, University of Verona, Department of Economics.
    11. Yauheniya Varabyova & Jonas Schreyögg, 2018. "Integrating quality into the nonparametric analysis of efficiency: a simulation comparison of popular methods," Annals of Operations Research, Springer, vol. 261(1), pages 365-392, February.
    12. Stefan Meyer, 2015. "Payment schemes and cost efficiency: evidence from Swiss public hospitals," International Journal of Health Economics and Management, Springer, vol. 15(1), pages 73-97, March.
    13. Davutyan, Nurhan & Bilsel, Murat & Tarcan, Menderes, 2015. "Migration, Risk-Adjusted Mortality, Varieties of Congestion and Patient Satisfaction in Turkish Provincial General Hospitals," Data Envelopment Analysis Journal, now publishers, vol. 1(2), pages 135-169, July.
    14. Zago, Angelo M., 2002. "Quality Indicators And Intermediate Products: A Non-Parametric Approach," 2002 Annual meeting, July 28-31, Long Beach, CA 19591, American Agricultural Economics Association (New Name 2008: Agricultural and Applied Economics Association).
    15. 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.
    16. Davutyan, Nurhan & Bilsel, Murat & Tarcan, Menderes, 2012. "Risk-Adjusted Mortality, varieties of congestion and patient satisfaction in Turkish provincial general hospitals," MPRA Paper 37437, University Library of Munich, Germany.
    17. Chia-Hsuan Wu & Ching-Cheng Chang & Po-Chi Chen & Ken-Nan Kuo, 2013. "Efficiency and productivity change in Taiwan’s hospitals: a non-radial quality-adjusted measurement," 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. 21(2), pages 431-453, March.
    18. Cavalieri, M. & Guccio, C. & Lisi, D. & Pignataro, G., 2015. "Does the Extent of Per-Case Payment System Affect Hospital Efficiency? Evidence from the Italian NHS," Health, Econometrics and Data Group (HEDG) Working Papers 15/29, HEDG, c/o Department of Economics, University of York.
    19. Gimenez, Victor M. & Martinez, Jose Luis, 2006. "Cost efficiency in the university: A departmental evaluation model," Economics of Education Review, Elsevier, vol. 25(5), pages 543-553, October.
    20. Thyago C. C. Nepomuceno & Cinzia Daraio & Ana Paula C. S. Costa, 2021. "Multicriteria Ranking for the Efficient and Effective Assessment of Police Departments," Sustainability, MDPI, vol. 13(8), pages 1-15, April.
    21. Thanassoulis, Emmanuel & Silva Portela, Maria & Graveney, Mike, 2016. "Identifying the scope for savings at inpatient episode level: An illustration applying DEA to chronic obstructive pulmonary disease," European Journal of Operational Research, Elsevier, vol. 255(2), pages 570-582.

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    Keywords

    DEA; diagnostic technologies;

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