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Hospital organization and performance: a directional distance function approach

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  • Greta Falavigna
  • Roberto Ippoliti
  • Alessandro Manello

Abstract

The present study considers the Italian healthcare system, investigating the aspects that might affect the efficiency of Italian hospitals. The authors analyze what influences a specific definition of efficiency, which is calculated maximizing healthcare production but minimizing potential financial losses. In other words, this work considers efficient each hospital which is able to maximize the production of medical treatments while complying, at the same time, with budget constraints. Hence, the results of this paper are twofold: from the organizational point of view, they underline the need for rebalancing the various administrative levels of hospitals; from the technical point of view, a more coherent model is proposed in order to account for all the aspects of the healthcare industry. Copyright Springer Science+Business Media New York 2013

Suggested Citation

  • Greta Falavigna & Roberto Ippoliti & Alessandro Manello, 2013. "Hospital organization and performance: a directional distance function approach," Health Care Management Science, Springer, vol. 16(2), pages 139-151, June.
  • Handle: RePEc:kap:hcarem:v:16:y:2013:i:2:p:139-151
    DOI: 10.1007/s10729-012-9217-8
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    1. Kris Siddharthan & Melissa Ahern & Robert Rosenman, 2000. "Data Envelopment Analysis to determine efficiencies of health maintenance organizations," Health Care Management Science, Springer, vol. 3(1), pages 23-29, January.
    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. Carlos Barros & António Gomes de Menezes & Nicolas Peypoch & Bernardin Solonandrasana & José Vieira, 2008. "An analysis of hospital efficiency and productivity growth using the Luenberger indicator," Health Care Management Science, Springer, vol. 11(4), pages 373-381, December.
    4. Ippoliti, Roberto & Falavigna, Greta, 2012. "Efficiency of the medical care industry: Evidence from the Italian regional system," European Journal of Operational Research, Elsevier, vol. 217(3), pages 643-652.
    5. Maindiratta, Ajay, 1990. "Largest size-efficient scale and size efficiencies of decision-making units in data envelopment analysis," Journal of Econometrics, Elsevier, vol. 46(1-2), pages 57-72.
    6. Margit Sommersguter-Reichmann, 2000. "The impact of the Austrian hospital financing reform on hospital productivity: empirical evidence on efficiency and technology changes using a non-parametric input-based Malmquist approach," Health Care Management Science, Springer, vol. 3(4), pages 309-321, September.
    7. Ouellette, Pierre & Vierstraete, Valerie, 2004. "Technological change and efficiency in the presence of quasi-fixed inputs: A DEA application to the hospital sector," European Journal of Operational Research, Elsevier, vol. 154(3), pages 755-763, May.
    8. 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.
    9. B. Dervaux & H. Leleu & E. Minvielle & V. Valdmanis & P. Aegerter & B. Guidet, 2009. "Assessing Performance of French Intensive Care Units: A Directional Distance Function Approach at the Patient Level," Post-Print halshs-00476492, HAL.
    10. Gary Ferrier & Michael Rosko & Vivian Valdmanis, 2006. "Analysis of uncompensated hospital care using a DEA model of output congestion," Health Care Management Science, Springer, vol. 9(2), pages 181-188, May.
    11. Retzlaff-Roberts, Donna L. & Morey, Richard C., 1993. "A goal-programming method of stochastic allocative data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 71(3), pages 379-397, December.
    12. Giokas, Dimitris I., 2001. "Greek hospitals: how well their resources are used," Omega, Elsevier, vol. 29(1), pages 73-83, February.
    13. 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.
    14. Gattoufi, Said & Oral, Muhittin & Kumar, Ashok & Reisman, Arnold, 2004. "Epistemology of data envelopment analysis and comparison with other fields of OR/MS for relevance to applications," Socio-Economic Planning Sciences, Elsevier, vol. 38(2-3), pages 123-140.
    15. Grosskopf, Shawna & Margaritis, Dimitri & Valdmanis, Vivian, 2001. "The effects of teaching on hospital productivity," Socio-Economic Planning Sciences, Elsevier, vol. 35(3), pages 189-204, September.
    16. 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.
    17. Murat Bilsel & Nurhan Davutyan, 2014. "Hospital efficiency with risk adjusted mortality as undesirable output: the Turkish case," Annals of Operations Research, Springer, vol. 221(1), pages 73-88, October.
    18. Diego Prior, 2006. "Efficiency and total quality management in health care organizations: A dynamic frontier approach," Annals of Operations Research, Springer, vol. 145(1), pages 281-299, July.
    19. Gillian McCallion & J. Colin Glass & Robert Jackson & Christine Kerr & Donal McKillop, 2000. "Investigating productivity change and hospital size: a nonparametric frontier approach," Applied Economics, Taylor & Francis Journals, vol. 32(2), pages 161-174.
    20. Rajiv D. Banker, 1993. "Maximum Likelihood, Consistency and Data Envelopment Analysis: A Statistical Foundation," Management Science, INFORMS, vol. 39(10), pages 1265-1273, October.
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    3. Thomas K. Dasaklis & Costas P. Pappis, 2018. "Critical success factors for implementing cholera vaccination campaigns in humanitarian emergencies: a DEMATEL-based approach," EURO Journal on Decision Processes, Springer;EURO - The Association of European Operational Research Societies, vol. 6(1), pages 1-20, June.
    4. Ayhan Aydın, 2022. "Benchmarking healthcare systems of OECD countries: A DEA - based Malmquist Productivity Index Approach," Alphanumeric Journal, Bahadir Fatih Yildirim, vol. 10(1), pages 25-40, June.
    5. Iablonskii, K. & Fedotov, Y., 2015. "Organizational performance measurement of healthcare organizations," Working Papers 6422, Graduate School of Management, St. Petersburg State University.
    6. Monica Giancotti & Annamaria Guglielmo & Marianna Mauro, 2017. "Efficiency and optimal size of hospitals: Results of a systematic search," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-40, March.
    7. Bruno, Clementina & Manello, Alessandro, 2015. "Benchmarking and effects of reforms in the fixed telecommunications industry: A DDF approach," Telecommunications Policy, Elsevier, vol. 39(2), pages 127-139.
    8. Sommersguter-Reichmann, Margit & Stepan, Adolf, 2015. "The interplay between regulation and efficiency: Evidence from the Austrian hospital inpatient sector," Socio-Economic Planning Sciences, Elsevier, vol. 52(C), pages 10-21.
    9. Jake Wagner & Joseph Cook & Peter Kimuyu, 2019. "Household Demand for Water in Rural Kenya," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 74(4), pages 1563-1584, December.
    10. Falavigna, G. & Ippoliti, R., 2020. "The socio-economic planning of a community nurses programme in mountain areas: A Directional Distance Function approach," Socio-Economic Planning Sciences, Elsevier, vol. 71(C).
    11. Vardanyan, Michael & Valdmanis, Vivian G. & Leleu, Hervé & Ferrier, Gary D., 2022. "Estimating technology characteristics of the U.S. hospital industry using directional distance functions with optimal directions," Omega, Elsevier, vol. 113(C).
    12. Cláudia Araújo & Carlos Barros & Peter Wanke, 2014. "Efficiency determinants and capacity issues in Brazilian for-profit hospitals," Health Care Management Science, Springer, vol. 17(2), pages 126-138, June.
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