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Integrated k-means clustering with data envelopment analysis of public hospital efficiency

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  • Songul Cinaroglu

    (Hacettepe University)

Abstract

The goal of this study is to integrate k-means clustering with data envelopment analysis to examine technical efficiencies in public hospitals in Turkey. A two-step analysis procedure involving provinces and public hospitals is applied in this study. The first step examines similar provinces in terms of welfare state indicators by using k-means clustering and silhouette (Sil) cluster validity index measures. Then, the efficiencies of public hospitals in different groups of provinces are determined. The data are taken from the Turkish Statistical Institute and the 2017 Public Hospitals Statistical Year Book for eighty-one provinces and 688 public hospitals. Study results show that, relative to similarities of welfare state indicators, there are five province groups (Sil = .58). The number of technically inefficient public hospitals is greater than the number of technically efficient public hospitals in all groups. Study results emphasize that incorporated methodology of k-means clustering with data envelopment analysis is useful to identify efficiencies of public hospitals located in provinces that have similar welfare status.

Suggested Citation

  • Songul Cinaroglu, 2020. "Integrated k-means clustering with data envelopment analysis of public hospital efficiency," Health Care Management Science, Springer, vol. 23(3), pages 325-338, September.
  • Handle: RePEc:kap:hcarem:v:23:y:2020:i:3:d:10.1007_s10729-019-09491-3
    DOI: 10.1007/s10729-019-09491-3
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    1. Cesur, Resul & Güneş, Pınar Mine & Tekin, Erdal & Ulker, Aydogan, 2017. "The value of socialized medicine: The impact of universal primary healthcare provision on mortality rates in Turkey," Journal of Public Economics, Elsevier, vol. 150(C), pages 75-93.
    2. Ismet Sahin & Yasar Ozcan & Hacer Ozgen, 2011. "Assessment of hospital efficiency under health transformation program in Turkey," 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. 19(1), pages 19-37, March.
    3. Ulucan, AydIn & BarIs AtIcI, KazIm, 2010. "Efficiency evaluations with context-dependent and measure-specific data envelopment approaches: An application in a World Bank supported project," Omega, Elsevier, vol. 38(1-2), pages 68-83, February.
    4. Oya Pinar Ardic & H. Evren Damar, 2006. "Financial Sector Deepening and Economic Growth: Evidence From Turkey," Working Papers 2006/19, Bogazici University, Department of Economics.
    5. Louise B. Russell & Gyan Bhanot & Sun-Young Kim & Anushua Sinha, 2018. "Using Cluster Analysis to Group Countries for Cost-effectiveness Analysis: An Application to Sub-Saharan Africa," Medical Decision Making, , vol. 38(2), pages 139-149, February.
    6. Bahar Gedikli & Osman Balaban, 2018. "An evaluation of local policies and actions that address climate change in Turkish metropolitan cities," European Planning Studies, Taylor & Francis Journals, vol. 26(3), pages 458-479, March.
    7. Yasar A. Ozcan, 2014. "Evaluation of Performance in Health Care," International Series in Operations Research & Management Science, in: Health Care Benchmarking and Performance Evaluation, edition 2, chapter 0, pages 3-14, Springer.
    8. G D Ferrier & V G Valdmanis, 2004. "Do mergers improve hospital productivity?," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 55(10), pages 1071-1080, October.
    9. Yasar A. Ozcan & Jaya Khushalani, 2017. "Assessing efficiency of public health and medical care provision in OECD countries after a decade of reform," 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. 25(2), pages 325-343, June.
    10. Hacer Özgen Narcı & Yasar A. Ozcan & İsmet Şahin & Menderes Tarcan & Mustafa Narcı, 2015. "An examination of competition and efficiency for hospital industry in Turkey," Health Care Management Science, Springer, vol. 18(4), pages 407-418, December.
    11. Yasar A. Ozcan, 2014. "Health Care Benchmarking and Performance Evaluation," International Series in Operations Research and Management Science, Springer, edition 2, number 978-1-4899-7472-3, September.
    12. Hakan Kacak & Yasar A. Ozcan & Sahin Kavuncubasi, 2014. "A new examination of hospital performance after healthcare reform in Turkey: sensitivity and quality comparisons," International Journal of Public Policy, Inderscience Enterprises Ltd, vol. 10(4/5), pages 178-194.
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