IDEAS home Printed from https://ideas.repec.org/p/ven/wpaper/2006_13.html
   My bibliography  Save this paper

Measuring Hospital Efficiency through Data Envelopment Analysis when Policy-makers� Preferences Matter. An Application to a sample of Italian NHS hospitals

Author

Listed:
  • Dino Rizzi

    (Department of Economics, University Of Venice Ca� Foscari)

  • Vincenzo Rebba

    (Department of Economics - University of Padova)

Abstract

In this paper we show how both the choice of specific constraints on input and output weights (in accordance with health care policy-makers� preferences) and the consideration of exogenous variables outside the control of hospital management (and linked to past policy-makers� decisions) can affect the measurement of hospital technical efficiency using the Data Envelopment Analysis (DEA). Considering these issues, the DEA method is applied to measure the efficiency of 85 (public and private) hospitals in Veneto, a Northern region of Italy. The empirical analysis allows us to verify the role of weight restrictions and of demand in measuring the efficiency of hospitals operating within a National Health Service (NHS). We find that the imposition of a lower bound on the virtual weight of acute care discharges weighted by case-mix (in order to consider policy-maker objectives) reduces average hospital efficiency. Moreover, we show that, in many cases, low efficiency scores are attributable to external factors, which are not fully controlled by the hospital management; especially for public hospitals low total efficiency scores can be mainly explained by past policy-makers� decisions on the size of the hospitals or their role within the regional health care service. Finally, non-profit private hospitals exhibit a higher total inefficiency while both non-profit and for-profit hospitals are characterised by higher levels of scale inefficiency than public ones.

Suggested Citation

  • Dino Rizzi & Vincenzo Rebba, 2006. "Measuring Hospital Efficiency through Data Envelopment Analysis when Policy-makers� Preferences Matter. An Application to a sample of Italian NHS hospitals," Working Papers 2006_13, Department of Economics, University of Venice "Ca' Foscari".
    • Handle: RePEc:ven:wpaper:2006_13
    as

    Download full text from publisher

    File URL: https://www.unive.it/web/fileadmin/user_upload/dipartimenti/DEC/doc/Pubblicazioni_scientifiche/working_papers/2006/WP_DSE_Rebba_Rizzi_13_06.pdf
    File Function: First version, 2006
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Bruce Hollingsworth & P.J. Dawson & N. Maniadakis, 1999. "Efficiency measurement of health care: a review of non‐parametric methods and applications," Health Care Management Science, Springer, vol. 2(3), pages 161-172, July.
    2. Rajiv D. Banker & Robert F. Conrad & Robert P. Strauss, 1986. "A Comparative Application of Data Envelopment Analysis and Translog Methods: An Illustrative Study of Hospital Production," Management Science, INFORMS, vol. 32(1), pages 30-44, January.
    3. 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.
    4. R. Allen & A. Athanassopoulos & R.G. Dyson & E. Thanassoulis, 1997. "Weights restrictions and value judgements in Data Envelopment Analysis: Evolution, development and future directions," Annals of Operations Research, Springer, vol. 73(0), pages 13-34, October.
    5. Juan Ventura & Eduardo GonzáLez & Ana Cárcaba, 2004. "Efficiency and Program‐Contract Bargaining in Spanish Public Hospitals," Annals of Public and Cooperative Economics, Wiley Blackwell, vol. 75(4), pages 549-573, December.
    6. Puig-Junoy, Jaume, 2000. "Partitioning input cost efficiency into its allocative and technical components: an empirical DEA application to hospitals," Socio-Economic Planning Sciences, Elsevier, vol. 34(3), pages 199-218, September.
    7. Liam O'Neill, 1998. "Multifactor efficiency in Data Envelopment Analysis with an application to urban hospitals," Health Care Management Science, Springer, vol. 1(1), pages 19-27, September.
    8. L. Steinmann & P. Zweifel, 2003. "On the (in)efficiency of Swiss hospitals," Applied Economics, Taylor & Francis Journals, vol. 35(3), pages 361-370.
    9. 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.
    10. Francisco Pedraja-Chaparro & Javier Salinas-Jimenez & Peter Smith, 1997. "On the Role of Weight Restrictions in Data Envelopment Analysis," Journal of Productivity Analysis, Springer, vol. 8(2), pages 215-230, May.
    11. Jon Chilingerian & H. David Sherman, 1997. "DEA and primary care physician report cards: Deriving preferred practice cones from managed care service concepts and operating strategies," Annals of Operations Research, Springer, vol. 73(0), pages 35-66, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Abhijit Das & Rashmi Banga & Dinesh Kumar, 2011. "Global Economic Crisis : Impact and Restructuring of the Services Sector in India," Trade Working Papers 23225, East Asian Bureau of Economic Research.
    2. Ng, Ying Chu, 2011. "The productive efficiency of Chinese hospitals," China Economic Review, Elsevier, vol. 22(3), pages 428-439, September.
    3. Joanicjusz Nazarko & Marta Komuda & Katarzyna Kuźmicz & Elżbieta Szubzda & Joanna Urban, 2008. "The DEA method in public sector institutions efficiency analysis on the basis of higher education institutions," Operations Research and Decisions, Wroclaw University of Science and Technology, Faculty of Management, vol. 18(4), pages 89-105.
    4. PINTO, Claudio, 2013. "Complexity of Treatment, and Changes in Efficiency and Productivity for Directly Managed Italian Hospitals," CELPE Discussion Papers 124, CELPE - CEnter for Labor and Political Economics, University of Salerno, Italy.

    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. O'Neill, Liam & Rauner, Marion & Heidenberger, Kurt & Kraus, Markus, 2008. "A cross-national comparison and taxonomy of DEA-based hospital efficiency studies," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 158-189, September.
    2. González, Eduardo & García, Vicente, 2006. "Using Value Efficiency Analysis (VEA) to Measure Productivity Efficiency in Primary Health Care," Efficiency Series Papers 2006/04, University of Oviedo, Department of Economics, Oviedo Efficiency Group (OEG).
    3. Korhonen, Pekka & Tainio, Risto & Wallenius, Jyrki, 2001. "Value efficiency analysis of academic research," European Journal of Operational Research, Elsevier, vol. 130(1), pages 121-132, April.
    4. 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.
    5. Eduardo González & Ana Cárcaba & Juan Ventura, 2011. "Quality Of Life Ranking Of Spanish Municipalities," Revista de Economia Aplicada, Universidad de Zaragoza, Departamento de Estructura Economica y Economia Publica, vol. 19(2), pages 123-148, Autumn.
    6. Zarrin, Mansour & Brunner, Jens O., 2023. "Analyzing the accuracy of variable returns to scale data envelopment analysis models," European Journal of Operational Research, Elsevier, vol. 308(3), pages 1286-1301.
    7. Halme, Merja & Korhonen, Pekka, 2000. "Restricting weights in value efficiency analysis," European Journal of Operational Research, Elsevier, vol. 126(1), pages 175-188, October.
    8. Akkan, Can & Karadayi, Melis Almula & Ekinci, Yeliz & Ülengin, Füsun & Uray, Nimet & Karaosmanoğlu, Elif, 2020. "Efficiency analysis of emergency departments in metropolitan areas," Socio-Economic Planning Sciences, Elsevier, vol. 69(C).
    9. Kuosmanen, Timo & Kortelainen, Mika, 2007. "Valuing environmental factors in cost-benefit analysis using data envelopment analysis," Ecological Economics, Elsevier, vol. 62(1), pages 56-65, April.
    10. Emrouznejad, Ali & De Witte, Kristof, 2010. "COOPER-framework: A unified process for non-parametric projects," European Journal of Operational Research, Elsevier, vol. 207(3), pages 1573-1586, December.
    11. Luis R. Murillo‐Zamorano, 2004. "Economic Efficiency and Frontier Techniques," Journal of Economic Surveys, Wiley Blackwell, vol. 18(1), pages 33-77, February.
    12. Silva, Rodrigo Cesar & Milioni, Armando Zeferino, 2012. "The Adjusted Spherical Frontier Model with weight restrictions," European Journal of Operational Research, Elsevier, vol. 220(3), pages 729-735.
    13. F. Hosseinzadeh Lotfi & A. Noora & G. Jahanshahloo & J. Jablonsky & M. Mozaffari & J. Gerami, 2009. "An MOLP based procedure for finding efficient units in DEA models," 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. 17(1), pages 1-11, March.
    14. Lins, Marcos Pereira Estellita & Sollero, Maria Karla Vervloet & Caloba, Guilherme Marques & da Silva, Angela Cristina Moreira, 2007. "Integrating the regulatory and utility firm perspectives, when measuring the efficiency of electricity distribution," European Journal of Operational Research, Elsevier, vol. 181(3), pages 1413-1424, September.
    15. 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.
    16. Heikki Loikkanen & Ilkka Susiluoton, 2000. "Cost Efficiency of Finnish Municipalities in Basic Service Provision 1994-2002," Regional and Urban Modeling 283600056, EcoMod.
    17. Finn Førsund, 2013. "Weight restrictions in DEA: misplaced emphasis?," Journal of Productivity Analysis, Springer, vol. 40(3), pages 271-283, December.
    18. Miryam Daoud Marrakchi & Hédi Essid, 2019. "Efficiency Assessment of Tunisian Public hospitals Using Data Envelopment Analysis (DEA)," Working Papers 1291, Economic Research Forum, revised 2019.
    19. Estellita Lins, M.P. & Moreira da Silva, A.C. & Lovell, C.A.K., 2007. "Avoiding infeasibility in DEA models with weight restrictions," European Journal of Operational Research, Elsevier, vol. 181(2), pages 956-966, September.
    20. Pinar Guven Uslu & Thuy Pham Linh, 2008. "Effects of Changes in Public Policy on Efficiency and Productivity of General Hospitals in Vietnam," Working Paper series, University of East Anglia, Centre for Competition Policy (CCP) 2008-30, Centre for Competition Policy, University of East Anglia, Norwich, UK..

    More about this item

    Keywords

    Hospital performance; Technical efficiency; Data envelopment analysis; NationalHealth Service;
    All these keywords.

    JEL classification:

    • D24 - Microeconomics - - Production and Organizations - - - Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

    Statistics

    Access and download statistics

    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:ven:wpaper:2006_13. 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: Sassano Sonia (email available below). General contact details of provider: https://edirc.repec.org/data/dsvenit.html .

    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.