Errors in survey based quality evaluation variables in efficiency models of primary care physicians
AbstractEfficiency analyses in the health care sector are often criticised for not incorporating quality variables. The definition of quality of primary health care has many aspects, and it is inevitably also a question of the patientsâ perception of the services received. This paper uses variables derived from patient evaluation surveys as measures of the quality of the production of health care services. It uses statistical tests to judge if such measures have a significant impact on the use of resources in various Data Envelopment Analysis (DEA) models. As the use of survey data implies that the quality variables are measured with error, the assumptions underlying a DEA model are not strictly fulfilled. This paper focuses on ways of correcting for biases that might result from the violation of selected assumptions. Firstly, any selection bias in the patient mix of each physician is controlled for by regressing the patient evaluation responses on the patient characteristics. The corrected quality evaluation variables are entered as outputs in the DEA model, and model specification tests indicate that out of 25 different quality variables, only waiting time has a systematic impact on the efficiency results. Secondly, the effect on the efficiency estimates of the remaining sampling error in the patient sample for each physician is accounted for by constructing confidence intervals based on resampling. Finally, as an alternative approach to including the quality variables in the DEA model, a regression model finds different variables significant, but not always with a trade-of between quality and quantity.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
Bibliographic InfoPaper provided by Oslo University, Department of Economics in its series Memorandum with number 24/2001.
Date of creation: 2001
Date of revision:
Contact details of provider:
Postal: Department of Economics, University of Oslo, P.O Box 1095 Blindern, N-0317 Oslo, Norway
Phone: 22 85 51 27
Fax: 22 85 50 35
Web page: http://www.oekonomi.uio.no/indexe.html
More information through EDIRC
data envelopment analysis;
Other versions of this item:
- Kittelsen, Sverre A.C. & Kjæserud, Guri Galtung & Kvamme, Odd Jarle, 2009. "Errors in Survey Based Quality Evaluation Variables in Efficiency Models of Primary Care Physicians," HERO On line Working Paper Series 2001:12, Oslo University, Health Economics Research Programme.
- C61 - Mathematical and Quantitative Methods - - Mathematical Methods; Programming Models; Mathematical and Simulation Modeling - - - Optimization Techniques; Programming Models; Dynamic Analysis
- D24 - Microeconomics - - Production and Organizations - - - Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity
- I12 - Health, Education, and Welfare - - Health - - - Health Production
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.:
- KNEIP, Alois & PARK, Byeong U. & SIMAR, Léopold, 1996.
"A Note on the Convergence of Nonparametric DEA Efficiency Measures,"
CORE Discussion Papers
1996039, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
- Kneip, A & Park, B-U & Simar, L, 1996. "A Note on the Convergence of Nonparametric DEA Efficiency Measures," Papers 9603, Catholique de Louvain - Institut de statistique.
- Rajiv D. Banker, 1993. "Maximum Likelihood, Consistency and Data Envelopment Analysis: A Statistical Foundation," Management Science, INFORMS, vol. 39(10), pages 1265-1273, October.
- Kittelsen,S.A.C., 1999. "Monte Carlo simulations of DEA efficiency measures and hypothesis tests," Memorandum 09/1999, Oslo University, Department of Economics.
- Léopold Simar & Paul W. Wilson, 1998.
"Sensitivity Analysis of Efficiency Scores: How to Bootstrap in Nonparametric Frontier Models,"
INFORMS, vol. 44(1), pages 49-61, January.
- SIMAR, Léopold & WILSON, Paul, 1995. "Sensitivity Analysis to Efficiency Scores : How to Bootstrap in Nonparametric Frontier Models," CORE Discussion Papers 1995043, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
- Simar, L. & Wilson, P.W., . "Sensitivity analysis of efficiency scores: how to bootstrap in nonparametric frontier models," CORE Discussion Papers RP -1304, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
- SIMAR , Léopold, 1995.
"Aspects of Statistical Analysis in DEA-Type Frontier Models,"
CORE Discussion Papers
1995061, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
- Simar, L., . "Aspects of statistical analysis in DEA-type frontier models," CORE Discussion Papers RP -1226, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
- Banker, Rajiv D., 1984. "Estimating most productive scale size using data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 17(1), pages 35-44, July.
- repec:fth:louvco:9639 is not listed on IDEAS
- A. Charnes & W. W. Cooper & E. Rhodes, 1981. "Evaluating Program and Managerial Efficiency: An Application of Data Envelopment Analysis to Program Follow Through," Management Science, INFORMS, vol. 27(6), pages 668-697, June.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Rhiana Bergh-Seeley).
If references are entirely missing, you can add them using this form.