IDEAS home Printed from https://ideas.repec.org/a/spr/annopr/v145y2006i1p281-29910.1007-s10479-006-0035-6.html
   My bibliography  Save this article

Efficiency and total quality management in health care organizations: A dynamic frontier approach

Author

Listed:
  • Diego Prior

Abstract

This paper analyses hospital performance using Data Envelopment Analysis (DEA) and the Malmquist productivity index. We follow two approaches to quantify movements in productivity: (1) the traditional approach that only considers output and input variables; and (2) a more comprehensive approach that incorporates movements in quality and restricts some achievements, if quality is reduced. On the premise that the indicator for quality (nosocomial infections) is equivalent to a bad output, we explore the characteristics of, and compare the results of, the different technological ways to incorporate quality (good or bad attributes, strong or weak disposability technological assumptions). After discussing the virtues and limitations of the existing possibilities, the paper presents a better formulation that allows the preservation of TQM postulates. The decomposition in the Malmquist productivity index shows an improvement in productivity and a positive technical change, especially when quality is introduced. Copyright Springer Science+Business Media, LLC 2006

Suggested Citation

  • 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.
    • Handle: RePEc:spr:annopr:v:145:y:2006:i:1:p:281-299:10.1007/s10479-006-0035-6
    DOI: 10.1007/s10479-006-0035-6
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1007/s10479-006-0035-6
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1007/s10479-006-0035-6?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Forsund, Finn R & Hjalmarsson, Lennart, 1979. "Generalised Farrell Measures of Efficiency: An Application to Milk Processing in Swedish Dairy Plants," Economic Journal, Royal Economic Society, vol. 89(354), pages 294-315, June.
    2. Ray, Subhash C & Desli, Evangelia, 1997. "Productivity Growth, Technical Progress, and Efficiency Change in Industrialized Countries: Comment," American Economic Review, American Economic Association, vol. 87(5), pages 1033-1039, December.
    3. Sloan, Frank A. & Picone, Gabriel A. & TaylorJr., Donald H. & Chou, Shin-Yi, 2001. "Hospital ownership and cost and quality of care: is there a dime's worth of difference?," Journal of Health Economics, Elsevier, vol. 20(1), pages 1-21, January.
    4. Henry Tulkens & Philippe Eeckaut, 2006. "Nonparametric Efficiency, Progress and Regress Measures For Panel Data: Methodological Aspects," Springer Books, in: Parkash Chander & Jacques Drèze & C. Knox Lovell & Jack Mintz (ed.), Public goods, environmental externalities and fiscal competition, chapter 0, pages 395-429, Springer.
    5. 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.
    6. 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.
    7. Ozcan, Yasar A., 1995. "Efficiency of hospital service production in local markets: The balance sheet of U.S. medical armament," Socio-Economic Planning Sciences, Elsevier, vol. 29(2), pages 139-150, June.
    8. Gowrisankaran, Gautam & Town, Robert J., 1999. "Estimating the quality of care in hospitals using instrumental variables," Journal of Health Economics, Elsevier, vol. 18(6), pages 747-767, December.
    9. 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.
    10. Fare, Rolf, et al, 1989. "Multilateral Productivity Comparisons When Some Outputs Are Undesirable: A Nonparametric Approach," The Review of Economics and Statistics, MIT Press, vol. 71(1), pages 90-98, February.
    11. Richard Murray, 1992. "Measuring Public-Sector Output: The Swedish Report," NBER Chapters, in: Output Measurement in the Service Sectors, pages 517-542, National Bureau of Economic Research, Inc.
    12. 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.
    13. Seiford, Lawrence M. & Zhu, Joe, 2002. "Modeling undesirable factors in efficiency evaluation," European Journal of Operational Research, Elsevier, vol. 142(1), pages 16-20, October.
    14. Stijn Reinhard & C.A. Knox Lovell & Geert Thijssen, 1999. "Econometric Estimation of Technical and Environmental Efficiency: An Application to Dutch Dairy Farms," American Journal of Agricultural Economics, Agricultural and Applied Economics Association, vol. 81(1), pages 44-60.
    15. Daniel Tyteca, 1997. "Linear Programming Models for the Measurement of Environmental Performance of Firms—Concepts and Empirical Results," Journal of Productivity Analysis, Springer, vol. 8(2), pages 183-197, May.
    16. Rikard Althin, 2001. "Measurement of Productivity Changes: Two Malmquist Index Approaches," Journal of Productivity Analysis, Springer, vol. 16(2), pages 107-128, September.
    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. César Salazar & Roberto Cárdenas-Retamal & Marcela Jaime, 2023. "Environmental efficiency in the salmon industry—an exploratory analysis around the 2007 ISA virus outbreak and subsequent regulations in Chile," Environment, Development and Sustainability: A Multidisciplinary Approach to the Theory and Practice of Sustainable Development, Springer, vol. 25(8), pages 8107-8135, August.
    2. Aparicio, Juan & Santín, Daniel, 2024. "Global and local technical changes: A new decomposition of the Malmquist productivity index using virtual units," Economic Modelling, Elsevier, vol. 134(C).
    3. Managi, Shunsuke & Kaneko, Shinji, 2009. "Environmental performance and returns to pollution abatement in China," Ecological Economics, Elsevier, vol. 68(6), pages 1643-1651, April.
    4. Hoang, Viet-Ngu & Coelli, Tim, 2011. "Measurement of agricultural total factor productivity growth incorporating environmental factors: A nutrients balance approach," Journal of Environmental Economics and Management, Elsevier, vol. 62(3), pages 462-474.
    5. Mahlberg, Bernhard & Luptacik, Mikulas & Sahoo, Biresh K., 2011. "Examining the drivers of total factor productivity change with an illustrative example of 14 EU countries," Ecological Economics, Elsevier, vol. 72(C), pages 60-69.
    6. Adel Hatami-Marbini & Aliasghar Arabmaldar & John Otu Asu, 2022. "Robust productivity growth and efficiency measurement with undesirable outputs: evidence from the oil industry," OR Spectrum: Quantitative Approaches in Management, Springer;Gesellschaft für Operations Research e.V., vol. 44(4), pages 1213-1254, December.
    7. Rafael Benítez & Vicente Coll-Serrano & Vicente J. Bolós, 2021. "deaR-Shiny: An Interactive Web App for Data Envelopment Analysis," Sustainability, MDPI, vol. 13(12), pages 1-19, June.
    8. Gómez-Calvet, Roberto & Conesa, David & Gómez-Calvet, Ana Rosa & Tortosa-Ausina, Emili, 2014. "Energy efficiency in the European Union: What can be learned from the joint application of directional distance functions and slacks-based measures?," Applied Energy, Elsevier, vol. 132(C), pages 137-154.
    9. Dubrocard, Anne & Prombo, Michel, 2012. "International comparison of Environmental performance," MPRA Paper 48072, University Library of Munich, Germany, revised 05 Jul 2013.
    10. Taleb, Mushtaq & Khalid, Ruzelan & Ramli, Razamin & Ghasemi, Mohammad Reza & Ignatius, Joshua, 2022. "An integrated bi-objective data envelopment analysis model for measuring returns to scale," European Journal of Operational Research, Elsevier, vol. 296(3), pages 967-979.
    11. Juan Du & Yongrui Duan & Jinghua Xu, 2019. "The infeasible problem of Malmquist–Luenberger index and its application on China’s environmental total factor productivity," Annals of Operations Research, Springer, vol. 278(1), pages 235-253, July.
    12. Arocena, Pablo & Waddams Price, Catherine, 2002. "Generating efficiency: economic and environmental regulation of public and private electricity generators in Spain," International Journal of Industrial Organization, Elsevier, vol. 20(1), pages 41-69, January.
    13. Kim, Nam Hyok & He, Feng & Kwon, O Chol, 2023. "Combining common-weights DEA window with the Malmquist index: A case of China’s iron and steel industry," Socio-Economic Planning Sciences, Elsevier, vol. 87(PB).
    14. Puertas, Rosa & Guaita-Martinez, José M. & Carracedo, Patricia & Ribeiro-Soriano, Domingo, 2022. "Analysis of European environmental policies: Improving decision making through eco-efficiency," Technology in Society, Elsevier, vol. 70(C).
    15. 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.
    16. Aparicio, Juan & Ortiz, Lidia & Santín, Daniel, 2021. "Comparing group performance over time through the Luenberger productivity indicator: An application to school ownership in European countries," European Journal of Operational Research, Elsevier, vol. 294(2), pages 651-672.
    17. Triantis, Konstantinos & Otis, Paul, 2004. "Dominance-based measurement of productive and environmental performance for manufacturing," European Journal of Operational Research, Elsevier, vol. 154(2), pages 447-464, April.
    18. Zhou, Haibo & Yang, Yi & Chen, Yao & Zhu, Joe, 2018. "Data envelopment analysis application in sustainability: The origins, development and future directions," European Journal of Operational Research, Elsevier, vol. 264(1), pages 1-16.
    19. OA Carboni & P. Russu, 2014. "Measuring Environmental and Economic Efficiency in Italy: an Application of the Malmquist-DEA and Grey Forecasting Model," Working Paper CRENoS 201401, Centre for North South Economic Research, University of Cagliari and Sassari, Sardinia.
    20. Zhou, P. & Ang, B.W. & Poh, K.L., 2008. "A survey of data envelopment analysis in energy and environmental studies," European Journal of Operational Research, Elsevier, vol. 189(1), pages 1-18, August.

    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:spr:annopr:v:145:y:2006:i:1:p:281-299:10.1007/s10479-006-0035-6. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.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.