IDEAS home Printed from https://ideas.repec.org/p/iim/iimawp/wp01744.html
   My bibliography  Save this paper

Hospital Efficiency: An Empirical Analysis of District and Grant-in-Aid Hospitals in Gujarat

Author

Listed:
  • Reuben Elan
  • Verma Bharat Bhushan
  • Bhat Ramesh

Abstract

This study focuses on analysing the hospital efficiency of district level government hospitals and grant-in-aid hospitals in Gujarat. The study makes an attempt to provide an overview of the general status of the health care services provided by hospitals in the state of Gujarat in terms of their technical and allocative efficiency. One of the two thrusts behind addressing the issue of efficiency was to take stock of the state of healthcare services (in terms of efficiency) provided by grant-in-aid hospitals and district hospitals in Gujarat. The motivation behind addressing the efficiency issue is to provide empirical analysis of governments policy to provide grants to not-for-profit making institutions which in turn provide hospital care in the state. The study addresses the issue whether grant-in-aid hospitals are relatively more efficient than public hospitals. This comparison between grant-in-aid hospitals and district hospitals in terms of their efficiency has been of interest to many researchers in countries other than India, and no consensus has been reached so far as to which category is more efficient. The relative efficiency of government and not-for-profit sector has been reviewed in this paper. It is expected that the findings of the study would be useful to evaluate this policy and help policy makers to develop benchmarks in providing the grants to such institutions.

Suggested Citation

  • Reuben Elan & Verma Bharat Bhushan & Bhat Ramesh, 2001. "Hospital Efficiency: An Empirical Analysis of District and Grant-in-Aid Hospitals in Gujarat," IIMA Working Papers WP2001-07-05, Indian Institute of Management Ahmedabad, Research and Publication Department.
    • Handle: RePEc:iim:iimawp:wp01744
    as

    Download full text from publisher

    File URL: https://www.iima.ac.in/sites/default/files/rnpfiles/2001-07-05RameshBhat.pdf
    File Function: English Version
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Banker, Rajiv D. & Thrall, R. M., 1992. "Estimation of returns to scale using data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 62(1), pages 74-84, October.
    2. Lindsay, Cotton M, 1976. "A Theory of Government Enterprise," Journal of Political Economy, University of Chicago Press, vol. 84(5), pages 1061-1077, October.
    3. Per Andersen & Niels Christian Petersen, 1993. "A Procedure for Ranking Efficient Units in Data Envelopment Analysis," Management Science, INFORMS, vol. 39(10), pages 1261-1264, October.
    4. Ray, Subhash C & Desli, Evangelia, 1997. "Productivity Growth, Technical Progress, and Efficiency Change in Industrialized Countries: Comment," American Economic Review, American Economic Association, vol. 87(5), pages 1033-1039, December.
    5. Richard G. Frank, 1988. "Note---On Making the Illustration Illustrative: A Comment on Banker, Conrad and Strauss," Management Science, INFORMS, vol. 34(8), pages 1026-1029, August.
    6. Wagner A. Kamakura, 1988. "Note---A Note on "The Use of Categorical Variables in Data Envelopment Analysis"," Management Science, INFORMS, vol. 34(10), pages 1273-1276, October.
    7. Smith, Peter & Mayston, David, 1987. "Measuring efficiency in the public sector," Omega, Elsevier, vol. 15(3), pages 181-189.
    8. Boaz Golany & Eran Tamir, 1995. "Evaluating Efficiency-Effectiveness-Equality Trade-Offs: A Data Envelopment Analysis Approach," Management Science, INFORMS, vol. 41(7), pages 1172-1184, July.
    9. C. Lovell & Shawna Grosskopf & Eduardo Ley & Jesús Pastor & Diego Prior & Philippe Eeckaut, 1994. "Linear programming approaches to the measurement and analysis of productive efficiency," TOP: An Official Journal of the Spanish Society of Statistics and Operations Research, Springer;Sociedad de Estadística e Investigación Operativa, vol. 2(2), pages 175-248, December.
    10. Chang, Kuo-Ping & Guh, Yeah-Yuh, 1991. "Linear production functions and the data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 52(2), pages 215-223, May.
    11. 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.
    12. Boussofiane, A. & Dyson, R. G. & Thanassoulis, E., 1991. "Applied data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 52(1), pages 1-15, May.
    13. Olesen, O. B., 1995. "Some unsolved problems in data envelopment analysis: A survey," International Journal of Production Economics, Elsevier, vol. 39(1-2), pages 5-36, April.
    14. Zuckerman, Stephen & Hadley, Jack & Iezzoni, Lisa, 1994. "Measuring hospital efficiency with frontier cost functions," Journal of Health Economics, Elsevier, vol. 13(3), pages 255-280, October.
    15. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
    16. Valdmanis, Vivian, 1992. "Sensitivity analysis for DEA models : An empirical example using public vs. NFP hospitals," Journal of Public Economics, Elsevier, vol. 48(2), pages 185-205, July.
    17. Charnes, A. & Neralic, L., 1990. "Sensitivity analysis of the additive model in data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 48(3), pages 332-341, October.
    18. Boyd, Gale & Fare, Rolf, 1984. "Measuring the efficiency of decision making units: A comment," European Journal of Operational Research, Elsevier, vol. 15(3), pages 331-332, March.
    19. Caves, Douglas W & Christensen, Laurits R & Diewert, W Erwin, 1982. "The Economic Theory of Index Numbers and the Measurement of Input, Output, and Productivity," Econometrica, Econometric Society, vol. 50(6), pages 1393-1414, November.
    20. Seiford, Lawrence M. & Thrall, Robert M., 1990. "Recent developments in DEA : The mathematical programming approach to frontier analysis," Journal of Econometrics, Elsevier, vol. 46(1-2), pages 7-38.
    21. Bjurek, Hans & Hjalmarsson, Lennart & Forsund, Finn R., 1990. "Deterministic parametric and nonparametric estimation of efficiency in service production : A comparison," Journal of Econometrics, Elsevier, vol. 46(1-2), pages 213-227.
    22. Charnes, A. & Cooper, W. W. & Golany, B. & Seiford, L. & Stutz, J., 1985. "Foundations of data envelopment analysis for Pareto-Koopmans efficient empirical production functions," Journal of Econometrics, Elsevier, vol. 30(1-2), pages 91-107.
    23. El-Mahgary, Sami & Lahdelma, Risto, 1995. "Data envelopment analysis: Visualizing the results," European Journal of Operational Research, Elsevier, vol. 83(3), pages 700-710, June.
    24. Paul L. Joskow, 1980. "The Effects of Competition and Regulation on Hospital Bed Supply and the Reservation Quality of the Hospital," Bell Journal of Economics, The RAND Corporation, vol. 11(2), pages 421-447, Autumn.
    25. Chilingerian, Jon A., 1995. "Evaluating physician efficiency in hospitals: A multivariate analysis of best practices," European Journal of Operational Research, Elsevier, vol. 80(3), pages 548-574, February.
    26. Newhouse, Joseph P., 1994. "Frontier estimation: How useful a tool for health economics?," Journal of Health Economics, Elsevier, vol. 13(3), pages 317-322, October.
    27. Sengupta, Jati K., 1990. "Transformations in stochastic DEA models," Journal of Econometrics, Elsevier, vol. 46(1-2), pages 109-123.
    28. Grosskopf, S. & Valdmanis, V., 1987. "Measuring hospital performance : A non-parametric approach," Journal of Health Economics, Elsevier, vol. 6(2), pages 89-107, June.
    29. Rajiv D. Banker, 1993. "Maximum Likelihood, Consistency and Data Envelopment Analysis: A Statistical Foundation," Management Science, INFORMS, vol. 39(10), pages 1265-1273, October.
    30. Cook, Wade D. & Kress, Moshe & Seiford, Lawrence M., 1992. "Prioritization models for frontier decision making units in DEA," European Journal of Operational Research, Elsevier, vol. 59(2), pages 319-323, June.
    31. Ali, Agha Iqbal & Lerme, Catherine S. & Seiford, Lawrence M., 1995. "Components of efficiency evaluation in data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 80(3), pages 462-473, February.
    32. Golany, B & Roll, Y, 1989. "An application procedure for DEA," Omega, Elsevier, vol. 17(3), pages 237-250.
    33. Thanassoulis, E. & Dyson, R. G., 1992. "Estimating preferred target input-output levels using data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 56(1), pages 80-97, January.
    34. Chalos, Peter & Cherian, Joseph, 1995. "An application of data envelopment analysis to public sector performance measurement and accountability," Journal of Accounting and Public Policy, Elsevier, vol. 14(2), pages 143-160.
    35. Wade D. Cook & Moshe Kress, 1990. "A Data Envelopment Model for Aggregating Preference Rankings," Management Science, INFORMS, vol. 36(11), pages 1302-1310, November.
    36. Cook, Wade D. & Kress, Moshe, 1994. "A multiple-criteria composite index model for quantitative and qualitative data," European Journal of Operational Research, Elsevier, vol. 78(3), pages 367-379, November.
    37. Chirikos, Thomas N. & Sear, Alan M., 1994. "Technical efficiency and the competitive behavior of hospitals," Socio-Economic Planning Sciences, Elsevier, vol. 28(4), pages 219-227, December.
    38. John J. Rousseau & John H. Semple, 1993. "Notes: Categorical Outputs in Data Envelopment Analysis," Management Science, INFORMS, vol. 39(3), pages 384-386, March.
    39. 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.
    40. Kao, Chiang, 1994. "Efficiency improvement in data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 73(3), pages 487-494, March.
    41. Boaz Golany, 1988. "Note---A Note on Including Ordinal Relations Among Multipliers in Data Envelopment Analysis," Management Science, INFORMS, vol. 34(8), pages 1029-1033, August.
    42. Doyle, J & Green, R, 1993. "Data envelopment analysis and multiple criteria decision making," Omega, Elsevier, vol. 21(6), pages 713-715, November.
    43. Ray, Subhash C., 1988. "Data envelopment analysis, nondiscretionary inputs and efficiency: an alternative interpretation," Socio-Economic Planning Sciences, Elsevier, vol. 22(4), pages 167-176.
    44. Wei, Q. L. & Sun, Bruce & Xiao, Z. J., 1995. "Measuring technical progress with data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 80(3), pages 691-702, February.
    45. R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, vol. 30(9), pages 1078-1092, September.
    46. Thanassoulis, E. & Boussofiane, A. & Dyson, R. G., 1995. "Exploring output quality targets in the provision of perinatal care in England using data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 80(3), pages 588-607, February.
    47. Toshiyuki Sueyoshi, 1995. "Production analysis in different time periods: An application of data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 86(2), pages 216-230, October.
    48. Ali, Agha Iqbal, 1993. "Streamlined computation for data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 64(1), pages 61-67, January.
    49. Rajiv D. Banker & Richard C. Morey, 1986. "The Use of Categorical Variables in Data Envelopment Analysis," Management Science, INFORMS, vol. 32(12), pages 1613-1627, December.
    50. Becker, Edmund R & Sloan, Frank A, 1985. "Hospital Ownership and Performance," Economic Inquiry, Western Economic Association International, vol. 23(1), pages 21-36, January.
    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. Rajasulochana, Subramania Raju & Chen, Po-Chi, 2019. "Efficiency and Productivity changes in the presence of undesirable outcomes in Emergency Obstetric and Newborn Care," Journal of Policy Modeling, Elsevier, vol. 41(5), pages 905-925.
    2. Babak Daneshvar Rouyendegh & Asil Oztekin & Joseph Ekong & Ali Dag, 2019. "Measuring the efficiency of hospitals: a fully-ranking DEA–FAHP approach," Annals of Operations Research, Springer, vol. 278(1), pages 361-378, July.
    3. Bhat Ramesh & Singh, Amarjit & Maheshwari, Sunil Kumar & Saha Somen, 2006. "Maternal Health Financing – Issues and Options: A Study of Chiranjeevi Yojana in Gujarat," IIMA Working Papers WP2006-08-03, Indian Institute of Management Ahmedabad, Research and Publication Department.

    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. Lampe, Hannes W. & Hilgers, Dennis, 2015. "Trajectories of efficiency measurement: A bibliometric analysis of DEA and SFA," European Journal of Operational Research, Elsevier, vol. 240(1), pages 1-21.
    2. 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.
    3. Mai, Nhat Chi, 2015. "Efficiency of the banking system in Vietnam under financial liberalization," OSF Preprints qsf6d, Center for Open Science.
    4. Luis R. Murillo‐Zamorano, 2004. "Economic Efficiency and Frontier Techniques," Journal of Economic Surveys, Wiley Blackwell, vol. 18(1), pages 33-77, February.
    5. Cook, Wade D. & Seiford, Larry M., 2009. "Data envelopment analysis (DEA) - Thirty years on," European Journal of Operational Research, Elsevier, vol. 192(1), pages 1-17, January.
    6. Beatriz Gonzalez Lopez-Valcarcel & Patricia Barber Perez, 1996. "Changes in the efficiency of spanish public hospitals after the introduction of program-contracts," Investigaciones Economicas, Fundación SEPI, vol. 20(3), pages 377-402, September.
    7. 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.
    8. Adler, Nicole & Friedman, Lea & Sinuany-Stern, Zilla, 2002. "Review of ranking methods in the data envelopment analysis context," European Journal of Operational Research, Elsevier, vol. 140(2), pages 249-265, July.
    9. Forsund, Finn R. & Sarafoglou, Nikias, 2005. "The tale of two research communities: The diffusion of research on productive efficiency," International Journal of Production Economics, Elsevier, vol. 98(1), pages 17-40, October.
    10. Kyuseok Lee & Kyuwan Choi, 2010. "Cross redundancy and sensitivity in DEA models," Journal of Productivity Analysis, Springer, vol. 34(2), pages 151-165, October.
    11. Valentin Zelenyuk, 2019. "Data Envelopment Analysis and Business Analytics: The Big Data Challenges and Some Solutions," CEPA Working Papers Series WP072019, School of Economics, University of Queensland, Australia.
    12. Puig-Junoy, Jaume, 2000. "Partitioning input cost efficiency into its allocative and technical components: an empirical DEA application to hospitals," Socio-Economic Planning Sciences, Elsevier, vol. 34(3), pages 199-218, September.
    13. Karkazis, John & Thanassoulis, Emmanuel, 1998. "Assessing the effectiveness of regional development policies in Northern Greece using data envelopment analysis," Socio-Economic Planning Sciences, Elsevier, vol. 32(2), pages 123-137, June.
    14. Harald Dyckhoff & Katrin Allen, 1999. "Theoretische Begründung einer Effizienzanalyse mittels Data Envelopment Analysis (DEA)," Schmalenbach Journal of Business Research, Springer, vol. 51(5), pages 411-436, May.
    15. Ramanathan, Ramakrishnan & Ramanathan, Usha & Bentley, Yongmei, 2018. "The debate on flexibility of environmental regulations, innovation capabilities and financial performance – A novel use of DEA," Omega, Elsevier, vol. 75(C), pages 131-138.
    16. Guilhermina Rego & Rui Nunes & José Costa, 2010. "The challenge of corporatisation: the experience of Portuguese public hospitals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(4), pages 367-381, August.
    17. Emmanuel Thanassoulis & Maria Da Conceicao & A. Silva Portela, 2002. "School Outcomes: Sharing the Responsibility Between Pupil and School1," Education Economics, Taylor & Francis Journals, vol. 10(2), pages 183-207.
    18. Bozec, Richard & Dia, Mohamed, 2007. "Board structure and firm technical efficiency: Evidence from Canadian state-owned enterprises," European Journal of Operational Research, Elsevier, vol. 177(3), pages 1734-1750, March.
    19. Li, Susan X., 1998. "Stochastic models and variable returns to scales in data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 104(3), pages 532-548, February.
    20. Kuosmanen, Timo & Post, Thierry & Scholtes, Stefan, 2007. "Non-parametric tests of productive efficiency with errors-in-variables," Journal of Econometrics, Elsevier, vol. 136(1), pages 131-162, January.

    More about this item

    Statistics

    Access and download statistics

    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:iim:iimawp:wp01744. 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: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/eciimin.html .

    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.