Technical efficiency in primary health care: does quality matter?
AbstractThe accuracy required in the measurement of output is an issue that has as yet still not been satisfactorily addressed in empirical research on efficiency in primary health care. We exploit information retrieved from a newly constructed database (APEX06) for the Spanish region of Extremadura. The richness of our dataset allows us to consider original synthetic measures of output that take into account both the quantity and the quality of services provided by 85 primary care centres (PCCs) in 2006. We provide evidence that neglecting the issue of properly accounting for the quality of health services can lead to misleading results. Our main finding is that adjusting output for quality influences efficiency analysis in three senses. First, inefficiency now explains relatively more of the deviation from the potential output. Second, the average technical efficiency in the sector is lower, while its dispersion among PCCs is significantly higher. And third, the efficiency ranking of the PCCs is also affected.
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Bibliographic InfoPaper provided by University Library of Munich, Germany in its series MPRA Paper with number 10725.
Date of creation: Sep 2008
Date of revision:
Primary Health Care; Stochastic Frontier Analysis; Technical Efficiency; Quality;
Other versions of this item:
- Luis Murillo-Zamorano & Carmelo Petraglia, 2011. "Technical efficiency in primary health care: does quality matter?," The European Journal of Health Economics, Springer, vol. 12(2), pages 115-125, April.
- C10 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - General
- I10 - Health, Education, and Welfare - - Health - - - General
This paper has been announced in the following NEP Reports:
- NEP-ALL-2008-09-29 (All new papers)
- NEP-EFF-2008-09-29 (Efficiency & Productivity)
- NEP-HEA-2008-09-29 (Health Economics)
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- Amado, Carla Alexandra da Encarnação Filipe & Santos, Sérgio Pereira dos, 2009. "Challenges for performance assessment and improvement in primary health care: The case of the Portuguese health centres," Health Policy, Elsevier, vol. 91(1), pages 43-56, June.
- Luis R. Murillo-Zamorano, 2004. "Economic Efficiency and Frontier Techniques," Journal of Economic Surveys, Wiley Blackwell, vol. 18(1), pages 33-77, 02.
- Battese, George E. & Corra, Greg S., 1977. "Estimation Of A Production Frontier Model: With Application To The Pastoral Zone Of Eastern Australia," Australian Journal of Agricultural Economics, Australian Agricultural and Resource Economics Society, vol. 21(03), December.
- Giuffrida, Antonio & Gravelle, Hugh & Sutton, Matthew, 2000.
"Efficiency and administrative costs in primary care,"
Journal of Health Economics,
Elsevier, vol. 19(6), pages 983-1006, November.
- Antonio Giuffrida & Hugh Gravelle & Matthew Sutton, . "Efficiency and Administrative Costs in Primary Care," Discussion Papers 99/27, Department of Economics, University of York.
- Cervera, Juan Vega & Hernandez, Maria Isabel Sanchez & Mera, Antonio Chamorro & Miranda, Francisco Javier & Murillo, Luis Regino, 2010. "Adapting the Servqual Scale to Primary Health Care Services in Spain," Apas Papers 197, Academic Public Administration Studies Archive - APAS.
- Goni, Salome, 1999. "An analysis of the effectiveness of Spanish primary health care teams," Health Policy, Elsevier, vol. 48(2), pages 107-117, August.
- Battese, George E. & Coelli, Tim J., 1988. "Prediction of firm-level technical efficiencies with a generalized frontier production function and panel data," Journal of Econometrics, Elsevier, vol. 38(3), pages 387-399, July.
- Filipe Amado, Carla Alexandra & Dyson, Robert G., 2008. "On comparing the performance of primary care providers," European Journal of Operational Research, Elsevier, vol. 185(3), pages 915-932, March.
- Battese, G E & Coelli, T J, 1995. "A Model for Technical Inefficiency Effects in a Stochastic Frontier Production Function for Panel Data," Empirical Economics, Springer, vol. 20(2), pages 325-32.
- Jaume Puig-Junoy & Vicente Ort�n, 2004. "Cost efficiency in primary care contracting: a stochastic frontier cost function approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(12), pages 1149-1165.
- Robert Rosenman & Daniel Friesner, 2004. "Scope and scale inefficiencies in physician practices," Health Economics, John Wiley & Sons, Ltd., vol. 13(11), pages 1091-1116.
- Aigner, Dennis & Lovell, C. A. Knox & Schmidt, Peter, 1977. "Formulation and estimation of stochastic frontier production function models," Journal of Econometrics, Elsevier, vol. 6(1), pages 21-37, July.
- Antonio Giuffrida & Hugh Gravelle, 2001.
"Measuring performance in primary care: econometric analysis and DEA,"
Taylor & Francis Journals, vol. 33(2), pages 163-175.
- Antonio Giuffrida and & Hugh Gravelle, . "Measuring Performance in Primary Care: Econometric Analysis and DEA," Discussion Papers 99/36, Department of Economics, University of York.
- Jondrow, James & Knox Lovell, C. A. & Materov, Ivan S. & Schmidt, Peter, 1982. "On the estimation of technical inefficiency in the stochastic frontier production function model," Journal of Econometrics, Elsevier, vol. 19(2-3), pages 233-238, August.
- Yasar Ozcan, 1998. "Physician benchmarking: measuring variation in practice behavior in treatment of otitis media," Health Care Management Science, Springer, vol. 1(1), pages 5-17, September.
- Olena Kalinichenko & Carla A. F. Amado & Sérgio P. Santos, 2013. "Performance Assessment in Primary Health Care: A Systematic Literature Review," CEFAGE-UE Working Papers 2013_03, University of Evora, CEFAGE-UE (Portugal).
- Kim Olsen & Dorte Gyrd-Hansen & Torben Sørensen & Troels Kristensen & Peter Vedsted & Andrew Street, 2013. "Organisational determinants of production and efficiency in general practice: a population-based study," The European Journal of Health Economics, Springer, vol. 14(2), pages 267-276, April.
- John Buckell & Andrew Smith & Roberta Longo & David Holland, 2013. "Health inefficiency and unobservable heterogeneity - empirical evidence from pathology services in the UK National Health Service," Working Papers 1307, Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds.
- Roberta Longo & Claire Hulme & Andrew Smith, 2012. "Measures of Performance in Primary Care - a Review of Efficiency Studies," Working Papers 1203, Academic Unit of Health Economics, Leeds Institute of Health Sciences, University of Leeds.
- Abate, Megersa & Lijesen, Mark & Pels, Eric & Roelevelt, Adriaan, 2013. "The impact of reliability on the productivity of railroad companies," Transportation Research Part E: Logistics and Transportation Review, Elsevier, vol. 51(C), pages 41-49.
- Thanassoulis, Emmanuel & Silva Portela, Maria C.A. & Graveney, Mike, 2012. "Estimating the scope for savings in referrals and drug prescription costs in the general Practice units of a UK primary care trust," European Journal of Operational Research, Elsevier, vol. 221(2), pages 432-444.
- Michiel Bijlsma & Pierre Koning & Victoria Shestalova, 2013. "The Effect of Competition on Process and Outcome Quality of Hospital Care in the Netherlands," De Economist, Springer, vol. 161(2), pages 121-155, June.
- José Cordero Ferrera & Eva Cebada & Luis Murillo Zamorano, 2014. "The effect of quality and socio-demographic variables on efficiency measures in primary health care," The European Journal of Health Economics, Springer, vol. 15(3), pages 289-302, April.
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