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A mixed-integer slacks-based measure data envelopment analysis for efficiency measuring of German university hospitals

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  • Mansour Zarrin

    (University of Augsburg)

Abstract

Standard Data Envelopment Analysis (DEA) models consider continuous-valued and known input and output statuses for measures. This paper proposes an extended Slacks-Based Measure (SBM) DEA model to accommodate flexible (a measure that can play the role of input and output) and integer measures simultaneously. A flexible measure’s most appropriate role (designation) is determined by maximizing the technical efficiency of each unit. The main advantage of the proposed model is that all inputs, outputs, and flexible measures can be expressed in integer values without inflation of efficiency scores since they are directly calculated by modifying input and output inefficiencies. Furthermore, we illustrate and examine the application of the proposed models with 28 university hospitals in Germany. We investigate the differences and common properties of the proposed models with the literature to shed light on both teaching and general inefficiencies. Results of inefficiency decomposition indicate that “Third-party funding income” that university hospitals receive from the research-granting agencies dominates the other inefficiencies sources. The study of the efficiency scores is then followed up with a second-stage regression analysis based on efficiency scores and environmental factors. The result of the regression analysis confirms the conclusion derived from the inefficiency decomposition analysis.

Suggested Citation

  • Mansour Zarrin, 2023. "A mixed-integer slacks-based measure data envelopment analysis for efficiency measuring of German university hospitals," Health Care Management Science, Springer, vol. 26(1), pages 138-160, March.
  • Handle: RePEc:kap:hcarem:v:26:y:2023:i:1:d:10.1007_s10729-022-09620-5
    DOI: 10.1007/s10729-022-09620-5
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    1. Grosskopf, Shawna & Margaritis, Dimitri & Valdmanis, Vivian, 2004. "Competitive effects on teaching hospitals," European Journal of Operational Research, Elsevier, vol. 154(2), pages 515-525, April.
    2. Toloo, Mehdi, 2009. "On classifying inputs and outputs in DEA: A revised model," European Journal of Operational Research, Elsevier, vol. 198(1), pages 358-360, October.
    3. Per Andersen & Niels Christian Petersen, 1993. "A Procedure for Ranking Efficient Units in Data Envelopment Analysis," Management Science, INFORMS, vol. 39(10), pages 1261-1264, October.
    4. Kazemi Matin, Reza & Kuosmanen, Timo, 2009. "Theory of integer-valued data envelopment analysis under alternative returns to scale axioms," Omega, Elsevier, vol. 37(5), pages 988-995, October.
    5. Henry Tulkens, 2006. "On FDH Efficiency Analysis: Some Methodological Issues and Applications to Retail Banking, Courts and Urban Transit," Springer Books, in: Parkash Chander & Jacques Drèze & C. Knox Lovell & Jack Mintz (ed.), Public goods, environmental externalities and fiscal competition, chapter 0, pages 311-342, Springer.
    6. Sebastian Kohl & Jan Schoenfelder & Andreas Fügener & Jens O. Brunner, 2019. "The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals," Health Care Management Science, Springer, vol. 22(2), pages 245-286, June.
    7. Kuosmanen, Timo & Matin, Reza Kazemi, 2009. "Theory of integer-valued data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 192(2), pages 658-667, January.
    8. Timo Kuosmanen & Abolfazl Keshvari & Reza Kazemi Matin, 2015. "Discrete and Integer Valued Inputs and Outputs in Data Envelopment Analysis," International Series in Operations Research & Management Science, in: Joe Zhu (ed.), Data Envelopment Analysis, edition 127, chapter 4, pages 67-103, Springer.
    9. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
    10. Francisco Javier Santos Arteaga & Debora Di Caprio & David Cucchiari & Josep M Campistol & Federico Oppenheimer & Fritz Diekmann & Ignacio Revuelta, 2021. "Modeling patients as decision making units: evaluating the efficiency of kidney transplantation through data envelopment analysis," Health Care Management Science, Springer, vol. 24(1), pages 55-71, March.
    11. Yasar Ozcan & Marcos Lins & Maria Lobo & Angela da Silva & Roberto Fiszman & Basilio Pereira, 2010. "Evaluating the performance of Brazilian university hospitals," Annals of Operations Research, Springer, vol. 178(1), pages 247-261, July.
    12. 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.
    13. Beasley, J. E., 1990. "Comparing university departments," Omega, Elsevier, vol. 18(2), pages 171-183.
    14. Annika Maren Schneider & Eva-Maria Oppel & Jonas Schreyögg, 2020. "Investigating the link between medical urgency and hospital efficiency – Insights from the German hospital market," Health Care Management Science, Springer, vol. 23(4), pages 649-660, December.
    15. Toloo, Mehdi & Ebrahimi, Bohlool & Amin, Gholam R., 2021. "New data envelopment analysis models for classifying flexible measures: The role of non-Archimedean epsilon," European Journal of Operational Research, Elsevier, vol. 292(3), pages 1037-1050.
    16. Du, Juan & Chen, Chien-Ming & Chen, Yao & Cook, Wade D. & Zhu, Joe, 2012. "Additive super-efficiency in integer-valued data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 218(1), pages 186-192.
    17. R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, vol. 30(9), pages 1078-1092, September.
    18. G. Tohidi & F. Matroud, 2017. "A new non-oriented model for classifying flexible measures in DEA," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 68(9), pages 1019-1029, September.
    19. Mansour Zarrin & Jan Schoenfelder & Jens O. Brunner, 2022. "Homogeneity and Best Practice Analyses in Hospital Performance Management: An Analytical Framework," Health Care Management Science, Springer, vol. 25(3), pages 406-425, September.
    20. Tone, Kaoru, 2001. "A slacks-based measure of efficiency in data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 130(3), pages 498-509, May.
    21. Cook, Wade D. & Zhu, Joe, 2007. "Classifying inputs and outputs in data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 180(2), pages 692-699, July.
    22. Mojtaba Ghiyasi & Wade D. Cook, 2021. "Classifying dual role variables in DEA: The case of VRS," Journal of the Operational Research Society, Taylor & Francis Journals, vol. 72(5), pages 1183-1190, May.
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