IDEAS home Printed from https://ideas.repec.org/a/gam/jijerp/v20y2023i4p3389-d1068970.html
   My bibliography  Save this article

Comparing Hospital Efficiency: An Illustrative Study of Knee and Hip Replacement Surgeries in Spain

Author

Listed:
  • Sophie Gorgemans

    (Department of Business Management and Organization, School of Engineering and Architecture, University of Zaragoza, 50009 Zaragoza, Spain)

  • Micaela Comendeiro-Maaløe

    (Institute for Health Sciences in Aragon (IACS), 50009 Zaragoza, Spain)

  • Manuel Ridao-López

    (Institute for Health Sciences in Aragon (IACS), 50009 Zaragoza, Spain)

  • Enrique Bernal-Delgado

    (Institute for Health Sciences in Aragon (IACS), 50009 Zaragoza, Spain)

Abstract

WHO’s Health Systems Performance Assessment framework suggests monitoring a set of dimensions. This study aims to jointly assess productivity and quality using a treatment-based approach, specifically analyzing knee and hip replacement, two prevalent surgical procedures performed with consolidated technology and run in most acute-care hospitals. Focusing on the analysis of these procedures sets out a novel approach providing clues for hospital management improvements, covering an existing gap in the literature. The Malmquist index under the metafrontier context was used to estimate the productivity in both procedures and its decomposition in terms of efficiency, technical and quality change. A multilevel logistic regression was specified to obtain the in-hospital mortality as a quality factor. All Spanish public acute-care hospitals were classified according to their average severity attended, dividing them into three groups. Our study revealed a decrease in productivity mainly due to a decrease in the technological change. Quality change remained constant during the period with highest variations observed between one period to the next according to the hospital classification. The improvement in the technological gap between different levels was due to an improvement in quality. These results provide new insights of operational efficiency after incorporating the quality dimension, specifically highlighting a decreasing operational performance, confirming that the technological heterogeneity is a critical question when measuring hospital performance.

Suggested Citation

  • Sophie Gorgemans & Micaela Comendeiro-Maaløe & Manuel Ridao-López & Enrique Bernal-Delgado, 2023. "Comparing Hospital Efficiency: An Illustrative Study of Knee and Hip Replacement Surgeries in Spain," IJERPH, MDPI, vol. 20(4), pages 1-12, February.
    • Handle: RePEc:gam:jijerp:v:20:y:2023:i:4:p:3389-:d:1068970
    as

    Download full text from publisher

    File URL: https://www.mdpi.com/1660-4601/20/4/3389/pdf
    Download Restriction: no
    File URL: https://www.mdpi.com/1660-4601/20/4/3389/
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Syam, Siddhartha S. & Côté, Murray J., 2010. "A location-allocation model for service providers with application to not-for-profit health care organizations," Omega, Elsevier, vol. 38(3-4), pages 157-166, June.
    2. 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.
    3. Cabello Granado, Pablo Antonio & Hidalgo Vega, Álvaro, 2014. "Análisis de la eficiencia hospitalaria por Comunidad Autónoma en el ámbito del Sistema Nacional de Salud," INVESTIGACIONES REGIONALES - Journal of REGIONAL RESEARCH, Asociación Española de Ciencia Regional, issue 28, pages 147-158.
    4. Pastor, Jesus T. & Lovell, C.A. Knox, 2005. "A global Malmquist productivity index," Economics Letters, Elsevier, vol. 88(2), pages 266-271, August.
    5. 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.
    6. Fare, R. & Grosskopf, S. & Roos, P., 1995. "Productivity and quality changes in Swedish pharmacies," International Journal of Production Economics, Elsevier, vol. 39(1-2), pages 137-144, April.
    7. Khushalani, Jaya & Ozcan, Yasar A., 2017. "Are hospitals producing quality care efficiently? An analysis using Dynamic Network Data Envelopment Analysis (DEA)," Socio-Economic Planning Sciences, Elsevier, vol. 60(C), pages 15-23.
    8. Shimshak, Daniel G. & Lenard, Melanie L. & Klimberg, Ronald K., 2009. "Incorporating quality into data envelopment analysis of nursing home performance: A case study," Omega, Elsevier, vol. 37(3), pages 672-685, June.
    Full references (including those not matched with items on IDEAS)

    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. Chang, Shyr-Juh & Hsiao, Hsing-Chin & Huang, Li-Hua & Chang, Hsihui, 2011. "Taiwan quality indicator project and hospital productivity growth," Omega, Elsevier, vol. 39(1), pages 14-22, January.
    2. Ferreira, D.C. & Marques, R.C., 2019. "Do quality and access to hospital services impact on their technical efficiency?," Omega, Elsevier, vol. 86(C), pages 218-236.
    3. Varun Mahajan & D. K. Nauriyal & S. P. Singh, 2020. "Domestic market competitiveness of Indian drug and pharmaceutical industry," Review of Managerial Science, Springer, vol. 14(3), pages 519-559, June.
    4. Jongmin Shon, 2022. "Does Competition Tame the Leviathan? A Case of Earmarked Spending for Transportation," Hacienda Pública Española / Review of Public Economics, IEF, vol. 241(2), pages 59-78, June.
    5. Md. Abul Kalam Azad & Susila Munisamy & Abdul Kadar Muhammad Masum & Paolo Saona & Peter Wanke, 2017. "Bank efficiency in Malaysia: a use of malmquist meta-frontier analysis," Eurasian Business Review, Springer;Eurasia Business and Economics Society, vol. 7(2), pages 287-311, August.
    6. Kao, Chiang & Liu, Shiang-Tai, 2014. "Measuring performance improvement of Taiwanese commercial banks under uncertainty," European Journal of Operational Research, Elsevier, vol. 235(3), pages 755-764.
    7. 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.
    8. Bansal, Pooja & Kumar, Sunil & Mehra, Aparna & Gulati, Rachita, 2022. "Developing two dynamic Malmquist-Luenberger productivity indices: An illustrated application for assessing productivity performance of Indian banks," Omega, Elsevier, vol. 107(C).
    9. Victoria Kravtsova, 2008. "Foreign presence and efficiency in transition economies," Journal of Productivity Analysis, Springer, vol. 29(2), pages 91-102, April.
    10. Camilla Mastromarco & Léopold Simar, 2021. "Latent heterogeneity to evaluate the effect of human capital on world technology frontier," Journal of Productivity Analysis, Springer, vol. 55(2), pages 71-89, April.
    11. Jens J. Krüger, 2020. "Long‐run productivity trends: A global update with a global index," Review of Development Economics, Wiley Blackwell, vol. 24(4), pages 1393-1412, November.
    12. Pontus Mattsson & Jonas Månsson & Christian Andersson & Fredrik Bonander, 2018. "A bootstrapped Malmquist index applied to Swedish district courts," European Journal of Law and Economics, Springer, vol. 46(1), pages 109-139, August.
    13. 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.
    14. Managi, Shunsuke & Jena, Pradyot Ranjan, 2008. "Environmental productivity and Kuznets curve in India," Ecological Economics, Elsevier, vol. 65(2), pages 432-440, April.
    15. Barnabé Walheer, 2018. "Cost Malmquist productivity index: an output-specific approach for group comparison," Journal of Productivity Analysis, Springer, vol. 49(1), pages 79-94, February.
    16. Chen, Xiang & Grifell-Tatjé, Emili & Fu, Tsu-Tan, 2023. "A profit difference decomposition model for measuring group performance: an application to Chinese and Taiwanese commercial banks," Omega, Elsevier, vol. 120(C).
    17. Laure Latruffe & Yann Desjeux, 2016. "Common Agricultural Policy support, technical efficiencyand productivity change in French agriculture," Review of Agricultural, Food and Environmental Studies, INRA Department of Economics, vol. 97(1), pages 15-28.
    18. Muliaman Hadad & Maximilian Hall & Karligash Kenjegalieva & Wimboh Santoso & Richard Simper, 2011. "Banking efficiency and stock market performance: an analysis of listed Indonesian banks," Review of Quantitative Finance and Accounting, Springer, vol. 37(1), pages 1-20, July.
    19. Isabel-María García-Sánchez & Luis Rodríguez-Domínguez & Javier Parra-Domínguez, 2013. "Yearly evolution of police efficiency in Spain and explanatory factors," Central European Journal of Operations Research, Springer;Slovak Society for Operations Research;Hungarian Operational Research Society;Czech Society for Operations Research;Österr. Gesellschaft für Operations Research (ÖGOR);Slovenian Society Informatika - Section for Operational Research;Croatian Operational Research Society, vol. 21(1), pages 31-62, January.
    20. Chen, Kuan-Chen & Lin, Sun-Yuan & Yu, Ming-Miin, 2022. "Exploring the efficiency of hospital and pharmacy utilizations in Taiwan: An application of dynamic network data envelopment analysis," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).

    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:gam:jijerp:v:20:y:2023:i:4:p:3389-:d:1068970. 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: MDPI Indexing Manager (email available below). General contact details of provider: https://www.mdpi.com .

    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.