IDEAS home Printed from https://ideas.repec.org/a/kap/hcarem/v24y2021i3d10.1007_s10729-021-09552-6.html
   My bibliography  Save this article

Using data envelopment analysis and the bootstrap method to evaluate organ transplantation efficiency in Brazil

Author

Listed:
  • Alexandre Marinho

    (Rio de Janeiro State University)

  • Claudia Affonso Silva Araújo

    (Federal University of Rio de Janeiro
    Fundação Getulio Vargas’s Sao Paulo School of Business Administration -FGV/EAESP)

Abstract

Brazil has the most extensive public program for organ transplantation in the world, and the Brazilian National Health System (SUS) provides full coverage of all costs involved in organ donation, transplants, and post-transplant. Despite the relevance of the subject and the shortage of organs for transplants, transplantation process efficiency assessments are still uncommon in Brazil and abroad. This study aims to evaluate the efficiency of the Brazilian states and the Federal District in transforming potential organ donors into actual donations. We applied data envelopment analysis (DEA) in conjunction with the bootstrap technique, using organ transplantation data from 2018. The bootstrap methods applied (bootstrap technique, the bootstrap-biased scores of efficiency, and the bootstrap bias–corrected scores of efficiency) allow to obtain a confidence interval for DEA scores and provide greater robustness to studies based on DEA methodology. The bootstrap bias–corrected model indicates that there is significant room for improvement in terms of converting potential donors into actual donors. The mean corrected score is 0.55, signalizing that altogether the Brazilian states could maximize in 45% the number of transplanted organs without necessarily increasing the pool of potential donors. The study provides insights into the Brazilian processes of organ donation and transplantation, helping to identify locations in need of resource allocation improvements. Given the scarcity of studies with a joint application of DEA and bootstrap techniques in this crucial health activity, we also intend to methodologically contribute to this type of benchmark analysis, emphasizing the importance of considering measurement errors, randomness, and bias at DEA models.

Suggested Citation

  • Alexandre Marinho & Claudia Affonso Silva Araújo, 2021. "Using data envelopment analysis and the bootstrap method to evaluate organ transplantation efficiency in Brazil," Health Care Management Science, Springer, vol. 24(3), pages 569-581, September.
    • Handle: RePEc:kap:hcarem:v:24:y:2021:i:3:d:10.1007_s10729-021-09552-6
    DOI: 10.1007/s10729-021-09552-6
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1007/s10729-021-09552-6
    File Function: Abstract
    Download Restriction: Access to the full text of the articles in this series is restricted.
    File URL: https://libkey.io/10.1007/s10729-021-09552-6?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Marina Martins Siqueira & Claudia Affonso Silva Araujo, 2018. "Efficiency of Brazilian public services of kidney transplantation: Benchmarking Brazilian states via data envelopment analysis," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(4), pages 1067-1087, October.
    2. Wilson, Paul W., 2018. "Dimension reduction in nonparametric models of production," European Journal of Operational Research, Elsevier, vol. 267(1), pages 349-367.
    3. 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.
    4. Alois Kneip & Léopold Simar & Paul W. Wilson, 2016. "Testing Hypotheses in Nonparametric Models of Production," Journal of Business & Economic Statistics, Taylor & Francis Journals, vol. 34(3), pages 435-456, July.
    5. Léopold Simar & Paul W. Wilson, 2020. "Hypothesis testing in nonparametric models of production using multiple sample splits," Journal of Productivity Analysis, Springer, vol. 53(3), pages 287-303, June.
    6. 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.
    7. Cláudia Araújo & Carlos Barros & Peter Wanke, 2014. "Efficiency determinants and capacity issues in Brazilian for-profit hospitals," Health Care Management Science, Springer, vol. 17(2), pages 126-138, June.
    8. Kneip, Alois & Simar, Léopold & Wilson, Paul W., 2015. "When Bias Kills The Variance: Central Limit Theorems For Dea And Fdh Efficiency Scores," Econometric Theory, Cambridge University Press, vol. 31(2), pages 394-422, April.
    9. Simar, Leopold & Wilson, Paul W., 2007. "Estimation and inference in two-stage, semi-parametric models of production processes," Journal of Econometrics, Elsevier, vol. 136(1), pages 31-64, January.
    10. Misiunas, Nicholas & Oztekin, Asil & Chen, Yao & Chandra, Kavitha, 2016. "DEANN: A healthcare analytic methodology of data envelopment analysis and artificial neural networks for the prediction of organ recipient functional status," Omega, Elsevier, vol. 58(C), pages 46-54.
    11. Claudia A. S. Araújo & Elaine Tavares & Eduardo Raupp de Vargas & Eduardo Rocha, 2015. "Developing learning capabilities through a quality management program," The Service Industries Journal, Taylor & Francis Journals, vol. 35(9), pages 483-498, June.
    12. 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.
    13. Léopold Simar & Paul W. Wilson, 1998. "Sensitivity Analysis of Efficiency Scores: How to Bootstrap in Nonparametric Frontier Models," Management Science, INFORMS, vol. 44(1), pages 49-61, January.
    14. Khushalani, Jaya & Ozcan, Yasar A., 2017. "Are hospitals producing quality care efficiently? An analysis using Dynamic Network Data Envelopment Analysis (DEA)," Socio-Economic Planning Sciences, Elsevier, vol. 60(C), pages 15-23.
    15. Seiford, Lawrence M. & Thrall, Robert M., 1990. "Recent developments in DEA : The mathematical programming approach to frontier analysis," Journal of Econometrics, Elsevier, vol. 46(1-2), pages 7-38.
    16. Erika Laranjeira & Helena Szrek, 2016. "Going beyond life expectancy in assessments of health systems’ performance: life expectancy adjusted by perceived health status," International Journal of Health Economics and Management, Springer, vol. 16(2), pages 133-161, June.
    17. James Langabeer & Yasar Ozcan, 2009. "The economics of cancer care: longitudinal changes in provider efficiency," Health Care Management Science, Springer, vol. 12(2), pages 192-200, June.
    18. Sahar Ahmadvand & Mir Saman Pishvaee, 2018. "An efficient method for kidney allocation problem: a credibility-based fuzzy common weights data envelopment analysis approach," Health Care Management Science, Springer, vol. 21(4), pages 587-603, December.
    19. 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.
    20. Peter Bogetoft & Lars Otto, 2011. "Benchmarking with DEA, SFA, and R," International Series in Operations Research and Management Science, Springer, number 978-1-4419-7961-2, September.
    21. Palazzolo, Jennifer R. & Ozcan, Yasar A., 2018. "Do the most efficient accountable care organizations earn shared savings?," Socio-Economic Planning Sciences, Elsevier, vol. 63(C), pages 12-17.
    22. 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.
    23. 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.
    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. Márcia N. F. Manoel & Sérgio P. Santos & Carla A. F. Amado, 2023. "Assessing the impact of COVID-19 on the performance of organ transplant services using data envelopment analysis," Health Care Management Science, Springer, vol. 26(2), pages 217-237, June.

    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. Sebastian Kohl & Jan Schoenfelder & Andreas Fügener & Jens O. Brunner, 2019. "The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals," Health Care Management Science, Springer, vol. 22(2), pages 245-286, June.
    2. Valentin Zelenyuk, 2019. "Data Envelopment Analysis and Business Analytics: The Big Data Challenges and Some Solutions," CEPA Working Papers Series WP072019, School of Economics, University of Queensland, Australia.
    3. Ferreira, D.C. & Marques, R.C., 2019. "Do quality and access to hospital services impact on their technical efficiency?," Omega, Elsevier, vol. 86(C), pages 218-236.
    4. Annika Maren Schneider & Eva-Maria Oppel & Jonas Schreyögg, 2020. "Investigating the link between medical urgency and hospital efficiency – Insights from the German hospital market," Health Care Management Science, Springer, vol. 23(4), pages 649-660, December.
    5. Sommersguter-Reichmann, Margit & Stepan, Adolf, 2015. "The interplay between regulation and efficiency: Evidence from the Austrian hospital inpatient sector," Socio-Economic Planning Sciences, Elsevier, vol. 52(C), pages 10-21.
    6. Mansour Zarrin & Jan Schoenfelder & Jens O. Brunner, 2022. "Homogeneity and Best Practice Analyses in Hospital Performance Management: An Analytical Framework," Health Care Management Science, Springer, vol. 25(3), pages 406-425, September.
    7. Diogo Cunha Ferreira & Alexandre Morais Nunes & Rui Cunha Marques, 2020. "Operational efficiency vs clinical safety, care appropriateness, timeliness, and access to health care," Journal of Productivity Analysis, Springer, vol. 53(3), pages 355-375, June.
    8. Nguyen, Bao Hoang & Simar, Léopold & Zelenyuk, Valentin, 2022. "Data sharpening for improving central limit theorem approximations for data envelopment analysis–type efficiency estimators," European Journal of Operational Research, Elsevier, vol. 303(3), pages 1469-1480.
    9. Angeliki Flokou & Vassilis Aletras & Dimitris Niakas, 2017. "Decomposition of potential efficiency gains from hospital mergers in Greece," Health Care Management Science, Springer, vol. 20(4), pages 467-484, December.
    10. Guangshun Qiao & Zhan-ao Wang, 2021. "Vertical integration vs. specialization: a nonparametric conditional efficiency estimate for the global semiconductor industry," Journal of Productivity Analysis, Springer, vol. 56(2), pages 139-150, December.
    11. Diogo Cunha Ferreira & Rui Cunha Marques, 2020. "A step forward on order-α robust nonparametric method: inclusion of weight restrictions, convexity and non-variable returns to scale," Operational Research, Springer, vol. 20(2), pages 1011-1046, June.
    12. Caitlin T. O’Loughlin & Paul W. Wilson, 2021. "Benchmarking the performance of US Municipalities," Empirical Economics, Springer, vol. 60(6), pages 2665-2700, June.
    13. Lisciandra, Maurizio & Milani, Riccardo & Millemaci, Emanuele, 2022. "A corruption risk indicator for public procurement," European Journal of Political Economy, Elsevier, vol. 73(C).
    14. Varabyova, Yauheniya & Schreyögg, Jonas, 2013. "International comparisons of the technical efficiency of the hospital sector: Panel data analysis of OECD countries using parametric and non-parametric approaches," Health Policy, Elsevier, vol. 112(1), pages 70-79.
    15. Rita Bastião & Nuno de Sousa Pereira, 2020. "Performance in the Delivery of Primary Health Care Services: A Longitudinal Analysis," CEF.UP Working Papers 2002, Universidade do Porto, Faculdade de Economia do Porto.
    16. Bao Hoang Nguyen & Valentin Zelenyuk, 2021. "Aggregate efficiency of industry and its groups: the case of Queensland public hospitals," Empirical Economics, Springer, vol. 60(6), pages 2795-2836, June.
    17. Bao Hoang Nguyen & Léopold Simar & Valentin Zelenyuk, 2021. "Data Sharpening for improving CLT approximations for DEA-type efficiency estimators," CEPA Working Papers Series WP142021, School of Economics, University of Queensland, Australia.
    18. José Solana‐Ibáñez & Manuel Caravaca‐Garratón, 2021. "Stakeholder engagement and corporate social reputation: The influence of exogenous factors on efficiency performance (stakeholder engagement and exogenous factors): Stakeholder engagement and exogenou," Corporate Social Responsibility and Environmental Management, John Wiley & Sons, vol. 28(6), pages 1891-1905, November.
    19. Ronald G. McGarvey & Andreas Thorsen & Maggie L. Thorsen & Rohith Madhi Reddy, 2019. "Measuring efficiency of community health centers: a multi-model approach considering quality of care and heterogeneous operating environments," Health Care Management Science, Springer, vol. 22(3), pages 489-511, September.
    20. Yauheniya Varabyova & Carl Rudolf Blankart & Aleksandra Torbica & Jonas Schreyögg, 2017. "Comparing the Efficiency of Hospitals in Italy and Germany: Nonparametric Conditional Approach Based on Partial Frontier," Health Care Management Science, Springer, vol. 20(3), pages 379-394, September.

    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:kap:hcarem:v:24:y:2021:i:3:d:10.1007_s10729-021-09552-6. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    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.