Scale, efficiency and organization in Norwegian psychiatric outpatient clinics for children
AbstractIn this paper, the authors examine the scale, efficiency and organization of Norwegian psychiatric outpatient clinics for children. Their question is whether there is room for improved performance in these clinics, and how much? Assuming that about 5 per cent of the Norwegian population under 18 years sometimes is in need of specialist psychiatric care, it is clear that this group will suffer when we know that psychiatric services were delivered to only 2.1 per cent of the whole Norwegian population (data from 1998). Based on a relatively low number of registered consultations per therapist (1,1 per therapist day) the ministry has stipulated that productivity can increase with as much as 50 per cent. Access to services can be improved by increasing capacity, but also by increasing the utilization of the existing capacity. With an Data Envelopment Analysis (DEA) the authors estimate a best-practice production frontier. The potential for efficiency improvement is measured as the difference between actual and best-practice performance, while allowing for trade-offs between different staff groups and different mixes of service production. Based on 135 observations for the years 1997 to 1999, the DEA tests lead to a model with two inputs, two outputs and variable returns to scale. The outputs are number of hours spent on direct and indirect interventions, while neither the number of interventions nor the number of patients where found to be significant. The inputs are the number of university-educated staff and other staff, but disaggregating the latter group was not significant. The analysis show that a average of estimated clinic efficiencies is 71%. Mean estimated productivity is 64%, but many large clinics have considerably lower performance due mainly to scale inefficiency.
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Bibliographic InfoPaper provided by Oslo University, Health Economics Research Programme in its series HERO On line Working Paper Series with number 2001:8.
Length: 29 pages
Date of creation: 30 Jun 2009
Date of revision:
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Health Care; Productivity; Data Envelopment Analysis;
Find related papers by JEL classification:
- 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
This paper has been announced in the following NEP Reports:
- NEP-ALL-2009-07-11 (All new papers)
- NEP-EFF-2009-07-11 (Efficiency & Productivity)
- NEP-HEA-2009-07-11 (Health Economics)
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