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Evaluation of efficiency in Colombian hospitals: An analysis for the post-reform period

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  • Giménez, Víctor
  • Prieto, William
  • Prior, Diego
  • Tortosa-Ausina, Emili

Abstract

In this study we analyze the performance of 602 level 1 Colombian hospitals for the period 2009–2013. The analysis is carried out from both static and temporal perspectives in order to evaluate the evolution of total factor productivity (change in hospital performance) and its components throughout the period. The study also explores a question relevant not only to the Colombian health system, but to many others around the world, of whether primary care centers excessively refer patients to high-level hospitals, thereby negatively affecting the quality, efficiency, and effectiveness of all healthcare service provision. The results demonstrated that adjusted production (service provision) and levels of quality and referrals to higher-level hospitals could be improved, on average, by 44%. This increase in health service provision levels and their quality can be achieved by reducing personnel expenditure (by an average of 22%), expenditure on medicines (by 20%), and purchasing expenses (by 11%). The temporal analysis shows that total factor productivity (hospital performance change) worsened by 1% during the period, mainly due to the technological backlash experienced despite a slightly positive evolution in efficiency.

Suggested Citation

  • Giménez, Víctor & Prieto, William & Prior, Diego & Tortosa-Ausina, Emili, 2019. "Evaluation of efficiency in Colombian hospitals: An analysis for the post-reform period," Socio-Economic Planning Sciences, Elsevier, vol. 65(C), pages 20-35.
    • Handle: RePEc:eee:soceps:v:65:y:2019:i:c:p:20-35
    DOI: 10.1016/j.seps.2018.02.002
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    Cited by:

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    2. Zhensheng Chen & Xueli Chen & Xiaoqing Gan & Kaixuan Bai & Tomas Baležentis & Lixin Cui, 2020. "Technical Efficiency of Regional Public Hospitals in China Based on the Three-Stage DEA," IJERPH, MDPI, vol. 17(24), pages 1-17, December.
    3. 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.
    4. José M. Cordero & Agustín García-García & Enrique Lau-Cortés & Cristina Polo, 2021. "Efficiency and Productivity Change of Public Hospitals in Panama: Do Management Schemes Matter?," IJERPH, MDPI, vol. 18(16), pages 1-21, August.
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    More about this item

    Keywords

    Hospitals; Efficiency; Quality; Bad outputs; Global Malmquist-Luenberger index;
    All these keywords.

    JEL classification:

    • C61 - Mathematical and Quantitative Methods - - Mathematical Methods; Programming Models; Mathematical and Simulation Modeling - - - Optimization Techniques; Programming Models; Dynamic Analysis
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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