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Productivity and patient satisfaction in primary care—Conflicting or compatible goals?

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  • Glenngård, Anna Häger

Abstract

Following recent reforms in Swedish primary care, providers are accountable to both citizens and county councils, in their role as payers. Productivity and quality measurement is fundamental for ensuring health care providers accountability to payers and that resources are spent as intended. The purpose was to study productivity and patient satisfaction in Swedish primary care. One measure of productivity capturing volume of visits and one measure capturing individual's judgment about the quality of services in relation to allocated resources was estimated. The potential conflict between the two measures and variation with respect to different factors was analyzed. There was a great variation in both measures of productivity. No conflict between the two measures of productivity was found. Thus, most providers could increase their volume of services without adverse effects for the quality and vice versa. Providers are however faced with different conditions. Traditional productivity measures are not enough to assess whether allocated resources are used according to set priorities and generates value for money. Information about the length and content of visits and the distribution of services produced is also needed, in particular to assess if resources allocated based on expected great needs among certain groups actually benefits those individuals. Effects of services produced are also needed. This is particularly important to assess if resources allocated based on expected great needs among certain groups actually benefits those individuals.

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  • Glenngård, Anna Häger, 2013. "Productivity and patient satisfaction in primary care—Conflicting or compatible goals?," Health Policy, Elsevier, vol. 111(2), pages 157-165.
  • Handle: RePEc:eee:hepoli:v:111:y:2013:i:2:p:157-165
    DOI: 10.1016/j.healthpol.2013.04.012
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    1. Esmeralda Ramalho & Joaquim Ramalho & Pedro Henriques, 2010. "Fractional regression models for second stage DEA efficiency analyses," Journal of Productivity Analysis, Springer, vol. 34(3), pages 239-255, December.
    2. 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.
    3. Carol Propper, 2013. "Competition, Incentives and the English NHS," ifo DICE Report, ifo Institute - Leibniz Institute for Economic Research at the University of Munich, vol. 11(01), pages 16-20, April.
    4. Simar, Leopold & Wilson, Paul W., 2007. "Estimation and inference in two-stage, semi-parametric models of production processes," Journal of Econometrics, Elsevier, vol. 136(1), pages 31-64, January.
    5. Glenngård, Anna H. & Anell, Anders & Beckman, Anders, 2011. "Choice of primary care provider: Results from a population survey in three Swedish counties," Health Policy, Elsevier, vol. 103(1), pages 31-37.
    6. David M. Cutler, 2002. "Equality, Efficiency, and Market Fundamentals: The Dynamics of International Medical-Care Reform," Journal of Economic Literature, American Economic Association, vol. 40(3), pages 881-906, September.
    7. Reid, R. & MacWilliam, L. & Roos, N.P. & Bogdanovich, B. & Black, C., 1999. "Measuring Morbidity in Populations: Performance of the John Hopkins Adjusted Clinical Group (ACG) Case-Mix Adjustment System in Manitoba," Centre for Health Services and Policy Research 99:9, University of British Columbia - Centre for Health Services and Policy Research..
    8. Scott, Anthony, 2000. "Economics of general practice," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 22, pages 1175-1200, Elsevier.
    9. McDonald, John, 2009. "Using least squares and tobit in second stage DEA efficiency analyses," European Journal of Operational Research, Elsevier, vol. 197(2), pages 792-798, September.
    10. Smith, Peter C. & Anell, Anders & Busse, Reinhard & Crivelli, Luca & Healy, Judith & Lindahl, Anne Karin & Westert, Gert & Kene, Tobechukwu, 2012. "Leadership and governance in seven developed health systems," Health Policy, Elsevier, vol. 106(1), pages 37-49.
    11. Le Grand, Julian, 2009. "Choice and competition in publicly funded health care," Health Economics, Policy and Law, Cambridge University Press, vol. 4(4), pages 479-488, October.
    12. Bevan, Gwyn & Helderman, Jan-Kees & Wilsford, David, 2010. "Changing choices in health care: implications for equity, efficiency and cost," Health Economics, Policy and Law, Cambridge University Press, vol. 5(03), pages 251-267, July.
    13. Cutler, David, 2002. "Equality, Efficiency, and Market Fundamentals: The Dynamics of International Medical Care Reform," Scholarly Articles 2640584, Harvard University Department of Economics.
    14. Anell, Anders, 2011. "Choice and privatisation in Swedish primary care," Health Economics, Policy and Law, Cambridge University Press, vol. 6(4), pages 549-569, October.
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