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The measurement of efficiency and productivity of health care delivery

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Author Info
Bruce Hollingsworth (Centre for Health Economics, Faculty of Business and Economics, Monash University, Melbourne, Australia)

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Abstract

The measurement of efficiency and productivity of health service delivery has become a small industry. This is a review of 317 published papers on frontier efficiency measurement. The techniques used are mainly based on non-parametric data envelopment analysis, but there is increasing use of parametric techniques, such as stochastic frontier analysis. Applications to hospitals and other health care organizations and areas are reviewed and summarised, and some meta-type analysis undertaken. Cautious conclusions are that public provision may be potentially more efficient than private, in certain settings. The paper also considers conceptualizations of efficiency, and points to dangers and opportunities in generating such information. Finally, some criteria for assessing the use and usefulness of efficiency studies are established, with a view to helping both researchers and those assessing whether or not to act upon published results. Copyright © 2008 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1391
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Publisher Info
Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 17 (2008)
Issue (Month): 10 ()
Pages: 1107-1128
Download reference. The following formats are available: HTML (with abstract), plain text (with abstract), BibTeX, RIS (EndNote, RefMan, ProCite), ReDIF
Handle: RePEc:wly:hlthec:v:17:y:2008:i:10:p:1107-1128

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Wagner, Janet M. & Shimshak, Daniel G. & Novak, Michael A., 2003. "Advances in physician profiling: the use of DEA," Socio-Economic Planning Sciences, Elsevier, vol. 37(2), pages 141-163, June. [Downloadable!] (restricted)
  2. Suthathip Yaisawarng & James F. Burgess, 2006. "Performance-based budgeting in the public sector: an illustration from the VA health care system," Health Economics, John Wiley & Sons, Ltd., vol. 15(3), pages 295-310. [Downloadable!]
  3. Grosskopf, Shawna & Margaritis, Dimitri & Valdmanis, Vivian, 2004. "Competitive effects on teaching hospitals," European Journal of Operational Research, Elsevier, vol. 154(2), pages 515-525, April. [Downloadable!] (restricted)
  4. Gary Ferrier & Michael Rosko & Vivian Valdmanis, 2006. "Analysis of uncompensated hospital care using a DEA model of output congestion," Health Care Management Science, Springer, vol. 9(2), pages 181-188, May. [Downloadable!] (restricted)
  5. Anthony J. Culyer, 2006. "The bogus conflict between efficiency and vertical equity," Health Economics, John Wiley & Sons, Ltd., vol. 15(11), pages 1155-1158. [Downloadable!]
  6. Benoît Dervaux & Gary D. Ferrier & Hervé Leleu & Vivian Valdmanis, 2004. "Comparing French and US hospital technologies: a directional input distance function approach," Applied Economics, Taylor and Francis Journals, vol. 36(10), pages 1065-1081, June. [Downloadable!] (restricted)
  7. Juha Laine & Miika Linna & Unto Häkkinen & Anja Noro, 2005. "Measuring the productive efficiency and clinical quality of institutional long-term care for the elderly," Health Economics, John Wiley & Sons, Ltd., vol. 14(3), pages 245-256. [Downloadable!]
  8. Bruce Hollingsworth & Andrew Street, 2006. "The market for efficiency analysis of health care organisations," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1055-1059. [Downloadable!]
  9. António Afonso & Miguel St. Aubyn, 2005. "Non-parametric approaches to education and health efficiency in OECD countries," Journal of Applied Economics, Universidad del CEMA, vol. 0, pages 227-246, November. [Downloadable!]
  10. Mehdi Farsi & Massimo Filippini, 2004. "An Empirical Analysis of Cost Efficiency in Non-profit and Public Nursing Homes," Annals of Public and Cooperative Economics, Blackwell Publishing, vol. 75(3), pages 339-365, 09. [Downloadable!] (restricted)
  11. Maniadakis, Nikolaos & Thanassoulis, Emmanuel, 2004. "A cost Malmquist productivity index," European Journal of Operational Research, Elsevier, vol. 154(2), pages 396-409, April. [Downloadable!] (restricted)
  12. Kontodimopoulos, Nick & Niakas, Dimitris, 2005. "Efficiency measurement of hemodialysis units in Greece with data envelopment analysis," Health Policy, Elsevier, vol. 71(2), pages 195-204, February. [Downloadable!] (restricted)
  13. Brenda Gannon, 2005. "Testing for Variation in Technical Efficiency of Hospitals in Ireland," The Economic and Social Review, Economic and Social Studies, vol. 36(3), pages 273-294. [Downloadable!]
  14. Butler, Timothy W. & Li, Ling, 2005. "The utility of returns to scale in DEA programming: An analysis of Michigan rural hospitals," European Journal of Operational Research, Elsevier, vol. 161(2), pages 469-477, March. [Downloadable!] (restricted)
  15. Gannon, Brenda, 2005. "Testing for Variation in Technical Efficiency of Hospitals in Ireland," Papers HRBWP20, Economic and Social Research Institute (ESRI). [Downloadable!]
  16. Bruce Hollingsworth & P.J. Dawson & N. Maniadakis, 1999. "Efficiency measurement of health care: a review of non‐parametric methods and applications," Health Care Management Science, Springer, vol. 2(3), pages 161-172, July. [Downloadable!] (restricted)
  17. Chen, Andrew & Hwang, Yuhchang & Shao, Benjamin, 2005. "Measurement and sources of overall and input inefficiencies: Evidences and implications in hospital services," European Journal of Operational Research, Elsevier, vol. 161(2), pages 447-468, March. [Downloadable!] (restricted)
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  1. Annika Herr & Hendrik Schmitz & Boris Augurzky, 2009. "This paper investigates cost and profit efficiency of German hospitals. More specifically, it deals with the question how hospital efficiency varies with ownership, patient structure and other exogeno," Ruhr Economic Papers 0132, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen. [Downloadable!]
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