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How efficient are surgical treatments in Japan? The case of a high-volume Japanese hospital

Author

Listed:
  • Yuichi Watanabe

    (Waseda University)

  • Haruko Noguchi

    (Waseda University)

  • Yoshinori Nakata

    (Teikyo University)

Abstract

Japan’s healthcare expenditures, which are largely publicly funded, have been growing dramatically due to the rapid aging of the population as well as the innovation and diffusion of new medical technologies. Annual costs for surgical treatments are estimated to be approximately USD 20 billion. Using unique longitudinal clinical data at the individual surgeon level, this study aims to estimate the technical efficiency of surgical treatments across surgical specialties in a high-volume Japanese teaching hospital by employing stochastic frontier analysis (SFA) with production frontier models. We simultaneously examine the impacts of potential determinants that are likely to affect inefficiency in operating rooms. Our empirical results show a relatively high average technical efficiency of surgical production, with modest disparity across surgical specialties. We also demonstrate that an increase in the number of operations performed by a surgeon significantly reduces operating room inefficiency, whereas the revision of the fee-for-service schedule for surgical treatments does not have a significant impact on inefficiency. In addition, we find higher technical efficiency among surgeons who perform multiple daily surgeries than those who perform a single operation in a day. We suggest that it is important for hospital management to retain efficient surgeons and physicians and provide efficient healthcare services given the competitive Japanese healthcare market.

Suggested Citation

  • Yuichi Watanabe & Haruko Noguchi & Yoshinori Nakata, 2020. "How efficient are surgical treatments in Japan? The case of a high-volume Japanese hospital," Health Care Management Science, Springer, vol. 23(3), pages 401-413, September.
  • Handle: RePEc:kap:hcarem:v:23:y:2020:i:3:d:10.1007_s10729-020-09507-3
    DOI: 10.1007/s10729-020-09507-3
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    References listed on IDEAS

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    1. William W. Cooper & Lawrence M. Seiford & Joe Zhu (ed.), 2011. "Handbook on Data Envelopment Analysis," International Series in Operations Research and Management Science, Springer, number 978-1-4419-6151-8, September.
    2. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128, October.
    3. Mareike Heimeshoff & Jonas Schreyögg & Lukas Kwietniewski, 2014. "Cost and technical efficiency of physician practices: a stochastic frontier approach using panel data," Health Care Management Science, Springer, vol. 17(2), pages 150-161, June.
    4. Lukas Kwietniewski & Jonas Schreyögg, 2018. "Efficiency of physician specialist groups," Health Care Management Science, Springer, vol. 21(3), pages 409-425, September.
    5. Hayashida, Kenshi & Imanaka, Yuichi, 2005. "Inequity in the price of physician activity across surgical procedures," Health Policy, Elsevier, vol. 74(1), pages 24-38, September.
    6. Norman K Thurston & Anne M. Libby, 2002. "A Production Function For Physician Services Revisited," The Review of Economics and Statistics, MIT Press, vol. 84(1), pages 184-191, February.
    7. Galina Besstremyannaya, 2011. "Managerial performance and cost efficiency of Japanese local public hospitals: A latent class stochastic frontier model," Health Economics, John Wiley & Sons, Ltd., vol. 20(S1), pages 19-34, September.
    8. Kumbhakar,Subal C. & Wang,Hung-Jen & Horncastle,Alan P., 2015. "A Practitioner's Guide to Stochastic Frontier Analysis Using Stata," Cambridge Books, Cambridge University Press, number 9781107029514.
    9. Jon A. Chilingerian & H. David Sherman, 2011. "Health-Care Applications: From Hospitals to Physicians, from Productive Efficiency to Quality Frontiers," International Series in Operations Research & Management Science, in: William W. Cooper & Lawrence M. Seiford & Joe Zhu (ed.), Handbook on Data Envelopment Analysis, chapter 0, pages 445-493, Springer.
    10. Reinhardt, U, 1972. "A Product Function for Physician Services," The Review of Economics and Statistics, MIT Press, vol. 54(1), pages 55-66, February.
    11. Battese, G E & Coelli, T J, 1995. "A Model for Technical Inefficiency Effects in a Stochastic Frontier Production Function for Panel Data," Empirical Economics, Springer, vol. 20(2), pages 325-332.
    12. Greene, William, 2005. "Reconsidering heterogeneity in panel data estimators of the stochastic frontier model," Journal of Econometrics, Elsevier, vol. 126(2), pages 269-303, June.
    13. Steven F. Koch & Jean D. Slabbert, 2012. "Stochastic Frontier Analysis Of Specialist Surgeon Clinics," South African Journal of Economics, Economic Society of South Africa, vol. 80(1), pages 1-15, March.
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