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Technical efficiency in the clinical management of critically ill patients

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Author Info
Jaume Puig-Junoy (Department of Economics and Business, Pompeu Fabra University (UPF), Barcelona, Spain)
Abstract

The purpose of this paper is to obtain empirical measures of performance in the management of critical patients treated in intensive care units (ICUs) and to evaluate the factors associated with performance, in a two stage approach. In the first stage, this paper uses an extended version of Data Envelopment Analysis (non-discretionary and categorical variables, and weight constraints under consideration) to obtain measures of technical efficiency in the treatment of 993 critical care patients in intensive care units in Catalonia (Spain) in 1991-92. The model incorporates accurate individual measures of illness severity from Mortality Probability Models (MPM II0) and quality outcome measures in the input-output set to obtain non-biased efficiency measures. In the second stage, a loglinear regression model is applied to test a number of hypothesis about the role of different environmental factors-such as ownership, market structure, dimension, internal organization, diagnostic, mortality risk, etc.-to explain differences in the efficiency scores. © 1998 John Wiley & Sons, Ltd.

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Publisher Info
Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 7 (1998)
Issue (Month): 3 ()
Pages: 263-277
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Handle: RePEc:wly:hlthec:v:7:y:1998:i:3:p:263-277

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

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  1. Finn R. Førsund, 2001. "Categorical variables in DEA," ICER Working Papers 06-2001, ICER - International Centre for Economic Research. [Downloadable!]
  2. Gian Paolo Barbetta & Gilberto Turati & Angelo Zago, 2004. "Behavioral Differences Between Public and Private Not-For-Profit Hospitals in the Italian National Health Service," Working Papers 12, Università di Verona, Dipartimento di Scienze economiche. [Downloadable!]
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  3. Daniel Becker, 2008. "Public-Sector Efficiency and Interjurisdictional Competition - an Empirical Investigation," Thuenen-Series of Applied Economic Theory 101, University of Rostock, Institute of Economics, Germany. [Downloadable!]
  4. Berta, P & Callea, G & Martini, G & Vittadini, G, 2009. "The effects of upcoding, cream skimming and readmissions on the Italian hospitals efficiency: a population–based investigation," MPRA Paper 17671, University Library of Munich, Germany. [Downloadable!]
  5. Simon Eckermann & Tim Coelli, 2008. "Including quality attributes in a model of health care efficiency: A net benefit approach," CEPA Working Papers Series WP032008, School of Economics, University of Queensland, Australia. [Downloadable!]
  6. Pierre Ouellette & Valérie Vierstraete, 2008. "Malmquist indexes with quasi-fixed inputs: An application to school districts in Québec," Cahiers de recherche 08-25, Departement d'Economique de la Faculte d'administration à l'Universite de Sherbrooke. [Downloadable!]
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