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Performance of French intensive care units: A directional distance function approach at the patient level

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  • Dervaux, B.
  • Leleu, H.
  • Minvielle, E.
  • Valdmanis, V.
  • Aegerter, P.
  • Guidet, B.

Abstract

By using a novel adaptation of the free-disposable hull analysis of productivity, we assess the medical and technical efficiency of patient care in 25 Parisian intensive care units (ICUs) during 2000. The robust free disposable hull (RFDH) as defined by [Cazals et al., 2002. Nonparametric frontier estimation: a robust approach. Journal of Econometrics 106, 1-25] reduces the impact outliers may have on findings by employing Monte-Carlo techniques and repeated sample selection. Among our key findings, there was no overall significant correlation between medical and technical efficiencies for all the ICUs, therefore performing well in one does not guarantee good performance in the other. We also found that over 80% of inefficiency is concentrated in less than 20% of the sampled patients.

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  • Dervaux, B. & Leleu, H. & Minvielle, E. & Valdmanis, V. & Aegerter, P. & Guidet, B., 2009. "Performance of French intensive care units: A directional distance function approach at the patient level," International Journal of Production Economics, Elsevier, vol. 120(2), pages 585-594, August.
    • Handle: RePEc:eee:proeco:v:120:y:2009:i:2:p:585-594
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    2. Jaume Puig‐Junoy, 1998. "Technical efficiency in the clinical management of critically ill patients," Health Economics, John Wiley & Sons, Ltd., vol. 7(3), pages 263-277, May.
    3. E. Minvielle & B. Dervaux & A. Retbi & P. Aegerter & A. Boumendil & M.C. Jars-Guincestre & A. Tenaillon & B. Guidet, 2005. "Culture, organization, and management in intensive care: construction and validation of a multidimensional questionnaire," Post-Print hal-00200377, HAL.
    4. 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.
    5. Cazals, Catherine & Florens, Jean-Pierre & Simar, Leopold, 2002. "Nonparametric frontier estimation: a robust approach," Journal of Econometrics, Elsevier, vol. 106(1), pages 1-25, January.
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    3. Ke Wang & Yujiao Xian & Chia-Yen Lee & Yi-Ming Wei & Zhimin Huang, 2019. "On selecting directions for directional distance functions in a non-parametric framework: a review," Annals of Operations Research, Springer, vol. 278(1), pages 43-76, July.
    4. Boussemart, Jean-Philippe & Crainich, David & Leleu, Hervé, 2015. "A decomposition of profit loss under output price uncertainty," European Journal of Operational Research, Elsevier, vol. 243(3), pages 1016-1027.
    5. Diogo Cunha Ferreira & Alexandre Morais Nunes & Rui Cunha Marques, 2020. "Operational efficiency vs clinical safety, care appropriateness, timeliness, and access to health care," Journal of Productivity Analysis, Springer, vol. 53(3), pages 355-375, June.
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    8. Thanassoulis, Emmanuel & Silva Portela, Maria C.A. & Graveney, Mike, 2014. "Using DEA to estimate potential savings at GP units at medical specialty level," Socio-Economic Planning Sciences, Elsevier, vol. 48(1), pages 38-48.
    9. Tsekouras, Kostas & Papathanassopoulos, Fotis & Kounetas, Kostas & Pappous, Giorgos, 2010. "Does the adoption of new technology boost productive efficiency in the public sector? The case of ICUs system," International Journal of Production Economics, Elsevier, vol. 128(1), pages 427-433, November.
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    11. Gitto, Simone & Mancuso, Paolo, 2012. "Bootstrapping the Malmquist indexes for Italian airports," International Journal of Production Economics, Elsevier, vol. 135(1), pages 403-411.
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    13. Mahlberg, Bernhard & Sahoo, Biresh K., 2011. "Radial and non-radial decompositions of Luenberger productivity indicator with an illustrative application," International Journal of Production Economics, Elsevier, vol. 131(2), pages 721-726, June.
    14. Jean-Philippe Boussemart & David Crainich & Hervé Leleu, 2012. "A decomposition of profit inefficiency into price expectation error, preferences towards risk and technical inefficiency," Working Papers 2012-ECO-04, IESEG School of Management.
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