IDEAS home Printed from https://ideas.repec.org/p/yor/hectdg/07-08.html
   My bibliography  Save this paper

Measuring efficiency in health care: an application to out of hours primary care services in the island of Ireland

Author

Listed:
  • Grace Lordan

Abstract

This paper is a cross border study that explores isolating the efficiency component and measuring its overall contribution to productivity in the case of out of hours (OOH) primary care services operating on the Island of Ireland. Out of hours GP care is supplied throughout the Island of Ireland by OOH co-operatives. Although Northern Ireland (NI) and the Republic of Ireland (ROI) have their own individual health systems the OOH organisations themselves are relatively homogenous in structure. The data for this study has been gathered and collated by the author and relates to six of twelve co-operatives operating in ROI and five of the seven co-operatives in NI. The primary aim of this paper is to estimate efficiency for these organisations using stochastic frontier analysis (SFA) SFA was chosen as the method for analysis as it allows distinction between ‘noise’ effects and efficiency effects. This paper outlines the means that SFA methodology can be used to derive sensible and robust efficiency estimates for OOH primary care organizations operating on the Island of Ireland. The paper also examines the sensitivity of these estimates to the choice of functional form for the health production function, the choice of error distribution for the efficiency terms and the means in which heterogeneity is incorporated into the analysis. Individual efficiency estimates, rankings, cross border rankings and comparisons are reported to allow recommendations to be made on how these organizations can improve their production process.

Suggested Citation

  • Grace Lordan, 2007. "Measuring efficiency in health care: an application to out of hours primary care services in the island of Ireland," Health, Econometrics and Data Group (HEDG) Working Papers 07/08, HEDG, c/o Department of Economics, University of York.
    • Handle: RePEc:yor:hectdg:07/08
    as

    Download full text from publisher

    File URL: https://www.york.ac.uk/media/economics/documents/herc/wp/07_08.pdf
    File Function: Main text
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Robert Rosenman & Daniel Friesner, 2004. "Scope and scale inefficiencies in physician practices," Health Economics, John Wiley & Sons, Ltd., vol. 13(11), pages 1091-1116, November.
    2. Meeusen, Wim & van den Broeck, Julien, 1977. "Efficiency Estimation from Cobb-Douglas Production Functions with Composed Error," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 18(2), pages 435-444, June.
    3. Schmidt, Peter & Sickles, Robin C, 1984. "Production Frontiers and Panel Data," Journal of Business & Economic Statistics, American Statistical Association, vol. 2(4), pages 367-374, October.
    4. Settlage, Daniel M. & Dixon, Bruce L. & Thomsen, Michael R., 2000. "A Comparison Of Various Frontier Estimation Methods Under Differing Data Generation Assumptions," Staff Papers 15773, University of Arkansas, Department of Agricultural Economics and Agribusiness.
    5. Vuong, Quang H, 1989. "Likelihood Ratio Tests for Model Selection and Non-nested Hypotheses," Econometrica, Econometric Society, vol. 57(2), pages 307-333, March.
    6. Jondrow, James & Knox Lovell, C. A. & Materov, Ivan S. & Schmidt, Peter, 1982. "On the estimation of technical inefficiency in the stochastic frontier production function model," Journal of Econometrics, Elsevier, vol. 19(2-3), pages 233-238, August.
    7. Grace Lordan, 2007. "What determines a patient’s treatment? Evidence from out of hours primary care co-op data in the Republic of Ireland," Health Care Management Science, Springer, vol. 10(3), pages 283-292, September.
    8. Greene, William H., 1980. "On the estimation of a flexible frontier production model," Journal of Econometrics, Elsevier, vol. 13(1), pages 101-115, May.
    9. Stevenson, Rodney E., 1980. "Likelihood functions for generalized stochastic frontier estimation," Journal of Econometrics, Elsevier, vol. 13(1), pages 57-66, May.
    10. Aigner, Dennis & Lovell, C. A. Knox & Schmidt, Peter, 1977. "Formulation and estimation of stochastic frontier production function models," Journal of Econometrics, Elsevier, vol. 6(1), pages 21-37, July.
    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. Sickles, Robin C. & Song, Wonho & Zelenyuk, Valentin, 2018. "Econometric Analysis of Productivity: Theory and Implementation in R," Working Papers 18-008, Rice University, Department of Economics.
    2. Massimo Del Gatto & Adriana Di Liberto & Carmelo Petraglia, 2011. "Measuring Productivity," Journal of Economic Surveys, Wiley Blackwell, vol. 25(5), pages 952-1008, December.
    3. Julio Peña & Julio Aguirre & René Cerca D'amico, 2004. "Pesca demersal en Chile: eficiencia técnica y escalas de operación," Revista de Analisis Economico – Economic Analysis Review, Universidad Alberto Hurtado/School of Economics and Business, vol. 19(1), pages 119-160, June.
    4. Luis R. Murillo‐Zamorano, 2004. "Economic Efficiency and Frontier Techniques," Journal of Economic Surveys, Wiley Blackwell, vol. 18(1), pages 33-77, February.
    5. Coelli, Tim J., 1995. "Recent Developments In Frontier Modelling And Efficiency Measurement," Australian Journal of Agricultural Economics, Australian Agricultural and Resource Economics Society, vol. 39(3), pages 1-27, December.
    6. Mustafa U. Karakaplan & Levent Kutlu, 2019. "School district consolidation policies: endogenous cost inefficiency and saving reversals," Empirical Economics, Springer, vol. 56(5), pages 1729-1768, May.
    7. Resti, Andrea, 1997. "Evaluating the cost-efficiency of the Italian Banking System: What can be learned from the joint application of parametric and non-parametric techniques," Journal of Banking & Finance, Elsevier, vol. 21(2), pages 221-250, February.
    8. Levent Kutlu & Shasha Liu & Robin C. Sickles, 2022. "Cost, Revenue, and Profit Function Estimates," Springer Books, in: Subhash C. Ray & Robert G. Chambers & Subal C. Kumbhakar (ed.), Handbook of Production Economics, chapter 16, pages 641-679, Springer.
    9. Wang, Wei Siang & Schmidt, Peter, 2009. "On the distribution of estimated technical efficiency in stochastic frontier models," Journal of Econometrics, Elsevier, vol. 148(1), pages 36-45, January.
    10. Philippe Gagnepain & Marc Ivaldi, 2002. "Stochastic Frontiers and Asymmetric Information Models," Journal of Productivity Analysis, Springer, vol. 18(2), pages 145-159, September.
    11. Yoro Diallo & Sébastien Marchand & Etienne Espagne, 2019. "Impacts of extreme events on technical efficiency in Vietnamese agriculture," CIRED Working Papers halshs-02080285, HAL.
    12. Dairo Estrada & Poldy Osorio, 2004. "Effects of Financial Capital on Colombian Banking Efficiency," Revista ESPE - Ensayos sobre Política Económica, Banco de la Republica de Colombia, vol. 22(47), pages 162-201, December.
    13. Vangelis Tzouvelekas & Konstantinos Giannakas & Peter Midmore & Konstantinos Mattas, 1997. "Technical efficiency measures for olive-growing farms in Crete, Greece," International Advances in Economic Research, Springer;International Atlantic Economic Society, vol. 3(2), pages 154-169, May.
    14. Orea, Luis, 2019. "The Econometric Measurement of Firms’ Efficiency," Efficiency Series Papers 2019/02, University of Oviedo, Department of Economics, Oviedo Efficiency Group (OEG).
    15. Sakouvogui Kekoura & Shaik Saleem & Doetkott Curt & Magel Rhonda, 2021. "Sensitivity analysis of stochastic frontier analysis models," Monte Carlo Methods and Applications, De Gruyter, vol. 27(1), pages 71-90, March.
    16. Etienne ESPAGNE & Yoro DIALLO & Sébastien MARCHAND, 2019. "Impacts of Extreme Climate Events on Technical Efficiency in Vietnamese Agriculture," Working Paper c1221ee7-5311-4af0-b1b4-3, Agence française de développement.
    17. Horrace, William C. & Rothbart, Michah W. & Yang, Yi, 2022. "Technical efficiency of public middle schools in New York City," Economics of Education Review, Elsevier, vol. 86(C).
    18. Canay, Iván, 2002. "Eficiencia y Productividad en Distribuidoras Eléctricas: Repaso de la Metodología y Aplicación," UADE Textos de Discusión 35_2002, Instituto de Economía, Universidad Argentina de la Empresa.
    19. Gian Carlo Scarsi, 1999. "Local Electricity Distribution in Italy: Comparative Efficiency Analysis and Methodological Cross-Checking," Working Papers 1999.16, Fondazione Eni Enrico Mattei.
    20. Eduardo Fé & Richard Hofler, 2013. "Count data stochastic frontier models, with an application to the patents–R&D relationship," Journal of Productivity Analysis, Springer, vol. 39(3), pages 271-284, June.

    More about this item

    Keywords

    Primary Care; Out of Hours; Efficiency; Stochastic Production Frontiers.;
    All these keywords.

    NEP fields

    This paper has been announced in the following NEP Reports:

    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:yor:hectdg:07/08. 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: Jane Rawlings (email available below). General contact details of provider: https://edirc.repec.org/data/deyoruk.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.