IDEAS home Printed from https://ideas.repec.org/a/wsi/ijitdm/v18y2019i03ns0219622018500165.html
   My bibliography  Save this article

Performance Evaluation for Taiwanese Hospitals by Multi-Activity Network Data Envelopment Analysis

Author

Listed:
  • Bo Hsiao

    (Department of Information Management, Chang Jung Christian University, Tainan, Taiwan)

  • Li-Hsueh Chen

    (Department of Transportation Science, National Taiwan Ocean University, No. 2 Pei-Ning Road, Keelung City 20224, Taiwan)

Abstract

This study proposes an alternative method for evaluating the overall performance of hospitals in Taiwan. Specifically, three types of hospital activities, medical, pharmaceutical, and rehabilitation, are classified and connected using the parallel method. To bridge the difference between the performance evaluation methods adopted in hospitals and the evaluation method adopted by traditional enterprises, each activity is divided into two serial-type connected processes, which are the production and service processes. This study analyzes the performance of the six processes in three types of activities of three levels of hospitals, namely medical centers, regional hospitals, and district hospitals, by using multi-activity network data envelopment analysis (MNDEA) in Taiwan in 2012. The average overall efficiency was 0.41, while the average estimated efficiency for medical, pharmaceutical, and rehabilitation activities was 0.62, 0.34, and 0.27, respectively. At the hospital level, the average efficiency for medical centers, regional hospitals, and district hospitals was 0.59, 0.49, and 0.35, respectively. The production processes of medical and rehabilitation activities in Taiwan have higher average efficiency than their service processes, while the production processes of pharmaceutical activity have lower average efficiency than its service processes. These results provide a reference for upgrading the operation and management strategies for all hospitals in the country.

Suggested Citation

  • Bo Hsiao & Li-Hsueh Chen, 2019. "Performance Evaluation for Taiwanese Hospitals by Multi-Activity Network Data Envelopment Analysis," International Journal of Information Technology & Decision Making (IJITDM), World Scientific Publishing Co. Pte. Ltd., vol. 18(03), pages 1009-1043, May.
  • Handle: RePEc:wsi:ijitdm:v:18:y:2019:i:03:n:s0219622018500165
    DOI: 10.1142/S0219622018500165
    as

    Download full text from publisher

    File URL: http://www.worldscientific.com/doi/abs/10.1142/S0219622018500165
    Download Restriction: Access to full text is restricted to subscribers

    File URL: https://libkey.io/10.1142/S0219622018500165?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. Ng, Ying Chu, 2011. "The productive efficiency of Chinese hospitals," China Economic Review, Elsevier, vol. 22(3), pages 428-439, September.
    2. Guo, Chuanyin & Abbasi Shureshjani, Roohollah & Foroughi, Ali Asghar & Zhu, Joe, 2017. "Decomposition weights and overall efficiency in two-stage additive network DEA," European Journal of Operational Research, Elsevier, vol. 257(3), pages 896-906.
    3. Fare, Rolf & Grosskopf, Shawna & Noh, Dong-Woon & Weber, William, 2005. "Characteristics of a polluting technology: theory and practice," Journal of Econometrics, Elsevier, vol. 126(2), pages 469-492, June.
    4. Eyob Zere, 2000. "Hospital Efficiency in Sub-Saharan Africa: Evidence from South Africa," WIDER Working Paper Series wp-2000-187, World Institute for Development Economic Research (UNU-WIDER).
    5. 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.
    6. Jeffrey E. Harris, 1977. "The Internal Organization of Hospitals: Some Economic Implications," Bell Journal of Economics, The RAND Corporation, vol. 8(2), pages 467-482, Autumn.
    7. Juan Du & Justin Wang & Yao Chen & Shin-Yi Chou & Joe Zhu, 2014. "Incorporating health outcomes in Pennsylvania hospital efficiency: an additive super-efficiency DEA approach," Annals of Operations Research, Springer, vol. 221(1), pages 161-172, October.
    8. Chiu, Ching-Ren & Chiu, Yung-Ho & Chen, Yu-Chuan & Fang, Chen-Ling, 2016. "Exploring the source of metafrontier inefficiency for various bank types in the two-stage network system with undesirable output," Pacific-Basin Finance Journal, Elsevier, vol. 36(C), pages 1-13.
    9. Kao, Chiang, 2014. "Network data envelopment analysis: A review," European Journal of Operational Research, Elsevier, vol. 239(1), pages 1-16.
    10. Tsai, P. F. & Mar Molinero, C., 2002. "A variable returns to scale data envelopment analysis model for the joint determination of efficiencies with an example of the UK health service," European Journal of Operational Research, Elsevier, vol. 141(1), pages 21-38, August.
    11. Chang, Shyr-Juh & Hsiao, Hsing-Chin & Huang, Li-Hua & Chang, Hsihui, 2011. "Taiwan quality indicator project and hospital productivity growth," Omega, Elsevier, vol. 39(1), pages 14-22, January.
    12. Yu, Ming-Miin & Lin, Erwin T.J., 2008. "Efficiency and effectiveness in railway performance using a multi-activity network DEA model," Omega, Elsevier, vol. 36(6), pages 1005-1017, December.
    13. Grosskopf, Shawna & Margaritis, Dimitri & Valdmanis, Vivian, 2001. "The effects of teaching on hospital productivity," Socio-Economic Planning Sciences, Elsevier, vol. 35(3), pages 189-204, September.
    14. 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.
    15. Magnus Tambour & Niklas Zethraeus, 1998. "Bootstrap confidence intervals for cost‐effectiveness ratios: some simulation results," Health Economics, John Wiley & Sons, Ltd., vol. 7(2), pages 143-147, March.
    16. Po-Chi Chen, 2012. "Measurement of technical efficiency in farrow-to-finish swine production using multi-activity network data envelopment analysis: evidence from Taiwan," Journal of Productivity Analysis, Springer, vol. 38(3), pages 319-331, December.
    17. Tone, Kaoru & Tsutsui, Miki, 2009. "Network DEA: A slacks-based measure approach," European Journal of Operational Research, Elsevier, vol. 197(1), pages 243-252, August.
    18. N. Maniadakis & N. Kotsopoulos & P. Prezerakos & J. Yfantopoulos, 2008. "Measuring Intra-Hospital Clinic Efficiency and Productivity: Application to a Greek University General Hospital," European Research Studies Journal, European Research Studies Journal, vol. 0(1-2), pages 95-110.
    19. Ming-Miin Yu & Bo Hsiao, 2016. "Measuring the technology gap and logistics performance of individual countries by using a meta-DEA--AR model," Maritime Policy & Management, Taylor & Francis Journals, vol. 43(1), pages 98-120, January.
    20. Fare, Rolf & Grosskopf, Shawna, 2004. "Modeling undesirable factors in efficiency evaluation: Comment," European Journal of Operational Research, Elsevier, vol. 157(1), pages 242-245, August.
    21. Annika Herr, 2008. "Cost and technical efficiency of German hospitals: does ownership matter?," Health Economics, John Wiley & Sons, Ltd., vol. 17(9), pages 1057-1071, September.
    22. Yu, Ming-Miin & Chen, Li-Hsueh & Hsiao, Bo, 2016. "Dynamic performance assessment of bus transit with the multi-activity network structure," Omega, Elsevier, vol. 60(C), pages 15-25.
    23. Fare, Rolf, et al, 1989. "Multilateral Productivity Comparisons When Some Outputs Are Undesirable: A Nonparametric Approach," The Review of Economics and Statistics, MIT Press, vol. 71(1), pages 90-98, February.
    24. Chang, Hsi-Hui, 1998. "Determinants of Hospital Efficiency: the Case of Central Government-owned Hospitals in Taiwan," Omega, Elsevier, vol. 26(2), pages 307-317, April.
    25. Miika Linna, 1998. "Measuring hospital cost efficiency with panel data models," Health Economics, John Wiley & Sons, Ltd., vol. 7(5), pages 415-427, August.
    26. Hiroyuki Kawaguchi & Kaoru Tone & Miki Tsutsui, 2014. "Estimation of the efficiency of Japanese hospitals using a dynamic and network data envelopment analysis model," Health Care Management Science, Springer, vol. 17(2), pages 101-112, June.
    27. Wang, Chun-Hsien & Lu, Yung-Hsiang & Huang, Chin-Wei & Lee, Jun-Yen, 2013. "R&D, productivity, and market value: An empirical study from high-technology firms," Omega, Elsevier, vol. 41(1), pages 143-155.
    28. Ouellette, Pierre & Vierstraete, Valerie, 2004. "Technological change and efficiency in the presence of quasi-fixed inputs: A DEA application to the hospital sector," European Journal of Operational Research, Elsevier, vol. 154(3), pages 755-763, May.
    29. Yu, Ming-Miin & Fan, Chih-Ku, 2009. "Measuring the performance of multimode bus transit: A mixed structure network DEA model," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 45(3), pages 501-515, May.
    30. Grosskopf, S. & Valdmanis, V., 1987. "Measuring hospital performance : A non-parametric approach," Journal of Health Economics, Elsevier, vol. 6(2), pages 89-107, June.
    31. Zere, E., 2000. "Hospital Efficiency in Sub-Saharan Africa. Evidence from South Africa," Research Paper 187, World Institute for Development Economics Research.
    32. Christopher O’Donnell & D. Rao & George Battese, 2008. "Metafrontier frameworks for the study of firm-level efficiencies and technology ratios," Empirical Economics, Springer, vol. 34(2), pages 231-255, March.
    33. James F. Burgess, Jr. & Paul W. Wilson, 1996. "Hospital Ownership and Technical Inefficiency," Management Science, INFORMS, vol. 42(1), pages 110-123, January.
    34. Chowdhury, Hedayet & Zelenyuk, Valentin & Laporte, Audrey & Wodchis, Walter P., 2014. "Analysis of productivity, efficiency and technological changes in hospital services in Ontario: How does case-mix matter?," International Journal of Production Economics, Elsevier, vol. 150(C), pages 74-82.
    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. Svetlana V. Ratner & Artem M. Shaposhnikov & Andrey V. Lychev, 2023. "Network DEA and Its Applications (2017–2022): A Systematic Literature Review," Mathematics, MDPI, vol. 11(9), pages 1-24, May.
    2. Mustafa Kemal Yilmaz & Ali Osman Kusakci & Ekrem Tatoglu & Orkun Icten & Feyzullah Yetgin, 2019. "Performance Evaluation of Real Estate Investment Trusts using a Hybridized Interval Type-2 Fuzzy AHP-DEA Approach: The Case of Borsa Istanbul," International Journal of Information Technology & Decision Making (IJITDM), World Scientific Publishing Co. Pte. Ltd., vol. 18(06), pages 1785-1820, November.

    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. Bao Hoang Nguyen & Robin C. Sickles & Valentin Zelenyuk, 2021. "What do we know from the vast literature on efficiency and productivity in healthcare? A Systematic Review and Bibliometric Analysis," CEPA Working Papers Series WP092021, School of Economics, University of Queensland, Australia.
    2. Ho, Foo Nin & Huang, Chin-wei, 2020. "The interdependencies of marketing capabilities and operations efficiency in hospitals," Journal of Business Research, Elsevier, vol. 113(C), pages 337-347.
    3. O'Neill, Liam & Rauner, Marion & Heidenberger, Kurt & Kraus, Markus, 2008. "A cross-national comparison and taxonomy of DEA-based hospital efficiency studies," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 158-189, September.
    4. 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.
    5. Kao, Chiang, 2014. "Network data envelopment analysis: A review," European Journal of Operational Research, Elsevier, vol. 239(1), pages 1-16.
    6. Yu, Ming-Miin & Chen, Li-Hsueh & Hsiao, Bo, 2016. "Dynamic performance assessment of bus transit with the multi-activity network structure," Omega, Elsevier, vol. 60(C), pages 15-25.
    7. José M. Cordero & Agustín García-García & Enrique Lau-Cortés & Cristina Polo, 2021. "Efficiency and Productivity Change of Public Hospitals in Panama: Do Management Schemes Matter?," IJERPH, MDPI, vol. 18(16), pages 1-21, August.
    8. Chen, Chih Cheng, 2017. "Measuring departmental and overall regional performance: applying the multi-activity DEA model to Taiwan׳s cities/counties," Omega, Elsevier, vol. 67(C), pages 60-80.
    9. See, Kok Fong & Ng, Ying Chu, 2021. "Do hospital reform and ownership matter to Shenzhen hospitals in China? A productivity analysis," Economic Analysis and Policy, Elsevier, vol. 72(C), pages 145-155.
    10. Kuan-Chen Chen & Hong-Ming Chen & Li-Nien Chien & Ming-Miin Yu, 2019. "Productivity growth and quality changes of hospitals in Taiwan: does ownership matter?," Health Care Management Science, Springer, vol. 22(3), pages 451-461, September.
    11. Hainan Guo & Yang Zhao & Tie Niu & Kwok-Leung Tsui, 2017. "Hong Kong Hospital Authority resource efficiency evaluation: Via a novel DEA-Malmquist model and Tobit regression model," PLOS ONE, Public Library of Science, vol. 12(9), pages 1-24, September.
    12. Akkan, Can & Karadayi, Melis Almula & Ekinci, Yeliz & Ülengin, Füsun & Uray, Nimet & Karaosmanoğlu, Elif, 2020. "Efficiency analysis of emergency departments in metropolitan areas," Socio-Economic Planning Sciences, Elsevier, vol. 69(C).
    13. Thomas Czypionka & Markus Kraus & Susanne Mayer & Gerald Röhrling, 2014. "Efficiency, ownership, and financing of hospitals: The case of Austria," Health Care Management Science, Springer, vol. 17(4), pages 331-347, December.
    14. Juan Piedra-Peña & Diego Prior, 2023. "Analyzing the effect of health reforms on the efficiency of Ecuadorian public hospitals," International Journal of Health Economics and Management, Springer, vol. 23(3), pages 361-392, September.
    15. Yusi Cheng & Xuejie Bai & Yung‐Ho Chiu, 2023. "Performance evaluation for health‐care sectors using a dynamic network data envelopment analysis approach," Managerial and Decision Economics, John Wiley & Sons, Ltd., vol. 44(4), pages 2237-2253, June.
    16. Chao, Shih-Liang & Yu, Ming-Miin & Hsieh, Wei-Fan, 2018. "Evaluating the efficiency of major container shipping companies: A framework of dynamic network DEA with shared inputs," Transportation Research Part A: Policy and Practice, Elsevier, vol. 117(C), pages 44-57.
    17. Rize Jing & Tingting Xu & Xiaozhen Lai & Elham Mahmoudi & Hai Fang, 2019. "Technical Efficiency of Public and Private Hospitals in Beijing, China: A Comparative Study," IJERPH, MDPI, vol. 17(1), pages 1-18, December.
    18. 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.
    19. Kao, Chiang, 2017. "Efficiency measurement and frontier projection identification for general two-stage systems in data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 261(2), pages 679-689.
    20. Zhang, Linyan & Chen, Kun, 2019. "Hierarchical network systems: An application to high-technology industry in China," Omega, Elsevier, vol. 82(C), pages 118-131.

    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:wsi:ijitdm:v:18:y:2019:i:03:n:s0219622018500165. 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: Tai Tone Lim (email available below). General contact details of provider: http://www.worldscinet.com/ijitdm/ijitdm.shtml .

    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.