IDEAS home Printed from https://ideas.repec.org/a/spr/hecrev/v8y2018i1d10.1186_s13561-018-0191-9.html
   My bibliography  Save this article

Healthcare efficiency assessment using DEA analysis in the Slovak Republic

Author

Listed:
  • Robert Stefko

    (The University of Presov)

  • Beata Gavurova

    (Technical University of Kosice)

  • Kristina Kocisova

    (Technical University of Kosice)

Abstract

A regional disparity is becoming increasingly important growth constraint. Policy makers need quantitative knowledge to design effective and targeted policies. In this paper, the regional efficiency of healthcare facilities in Slovakia is measured (2008–2015) using data envelopment analysis (DEA). The DEA is the dominant approach to assessing the efficiency of the healthcare system but also other economic areas. In this study, the window approach is introduced as an extension to the basic DEA models to evaluate healthcare technical efficiency in individual regions and quantify the basic regional disparities and discrepancies. The window DEA method was chosen since it leads to increased discrimination on results especially when applied to small samples and it enables year-by-year comparisons of the results. Two stable inputs (number of beds, number of medical staff), three variable inputs (number of all medical equipment, number of magnetic resonance (MR) devices, number of computed tomography (CT) devices) and two stable outputs (use of beds, average nursing time) were chosen as production variable in an output-oriented 4-year window DEA model for the assessment of technical efficiency in 8 regions. The database was made available from the National Health Information Center and the Slovak Statistical Office, as well as from the online databases Slovstat and DataCube. The aim of the paper is to quantify the impact of the non-standard Data Envelopment Analysis (DEA) variables as the use of medical technologies (MR, CT) on the results of the assessment of the efficiency of the healthcare facilities and their adequacy in the evaluation of the monitored processes. The results of the analysis have shown that there is an indirect dependence between the values of the variables over time and the results of the estimated efficiency in all regions. The regions that had low values of the variables over time achieved a high degree of efficiency and vice versa. Interesting knowledge was that the gradual addition of variables number of MR, number of CT and number of medical devices together, to the input side did not have a significant impact on the overall estimated efficiency of healthcare facilities.

Suggested Citation

  • Robert Stefko & Beata Gavurova & Kristina Kocisova, 2018. "Healthcare efficiency assessment using DEA analysis in the Slovak Republic," Health Economics Review, Springer, vol. 8(1), pages 1-12, December.
    • Handle: RePEc:spr:hecrev:v:8:y:2018:i:1:d:10.1186_s13561-018-0191-9
    DOI: 10.1186/s13561-018-0191-9
    as

    Download full text from publisher

    File URL: http://link.springer.com/10.1186/s13561-018-0191-9
    File Function: Abstract
    Download Restriction: no
    File URL: https://libkey.io/10.1186/s13561-018-0191-9?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
    ---><---

    References listed on IDEAS

    as
    1. David Parkin & Bruce Hollingsworth, 1997. "Measuring production efficiency of acute hospitals in Scotland, 1991-94: validity issues in data envelopment analysis," Applied Economics, Taylor & Francis Journals, vol. 29(11), pages 1425-1433.
    2. Ancarani, Alessandro & Di Mauro, Carmela & Gitto, Simone & Mancuso, Paolo & Ayach, Ali, 2016. "Technology acquisition and efficiency in Dubai hospitals," Technological Forecasting and Social Change, Elsevier, vol. 113(PB), pages 475-485.
    3. Eduardo Ley, 1991. "Eficiencia productiva: un estudio aplicado al sector hospitalario," Investigaciones Economicas, Fundación SEPI, vol. 15(1), pages 71-88, January.
    4. Benoit Dervaux & Gary Ferrier & Herve Leleu & Vivian Valdmanis, 2004. "Comparing French and US hospital technologies: a directional input distance function approach," Applied Economics, Taylor & Francis Journals, vol. 36(10), pages 1065-1081.
    5. Thomas Czypionka & Markus Kraus & Susanne Mayer & Gerald Röhrling, 2014. "Efficiency, ownership, and financing of hospitals: The case of Austria," Health Care Management Science, Springer, vol. 17(4), pages 331-347, December.
    6. Nikolaos Oikonomou & Yannis Tountas & Argiris Mariolis & Kyriakos Souliotis & Kostas Athanasakis & John Kyriopoulos, 2016. "Measuring the efficiency of the Greek rural primary health care using a restricted DEA model; the case of southern and western Greece," Health Care Management Science, Springer, vol. 19(4), pages 313-325, December.
    7. Martini, Gianmaria & Berta, Paolo & Mullahy, John & Vittadini, Giorgio, 2014. "The effectiveness–efficiency trade-off in health care: The case of hospitals in Lombardy, Italy," Regional Science and Urban Economics, Elsevier, vol. 49(C), pages 217-231.
    8. Pınar Kaya Samut & Reyhan Cafrı, 2016. "Analysis of the Efficiency Determinants of Health Systems in OECD Countries by DEA and Panel Tobit," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 129(1), pages 113-132, October.
    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.
    10. Nikolaos Maniadakis & Emmanuel Thanassoulis, 2000. "Assessing productivity changes in UK hospitals reflecting technology and input prices," Applied Economics, Taylor & Francis Journals, vol. 32(12), pages 1575-1589.
    11. Jos Blank & Vivian Valdmanis, 2010. "Environmental factors and productivity on Dutch hospitals: a semi-parametric approach," Health Care Management Science, Springer, vol. 13(1), pages 27-34, March.
    12. Josef Jablonský, 2004. "Modely hodnocení efektivnosti produkčních jednotek [Models for efficiency evaluation of decision making units]," Politická ekonomie, Prague University of Economics and Business, vol. 2004(2).
    13. W. David Bradford & Andrew N. Kleit & Marie A. Krousel-Wood & Richard N. Re, 2001. "Stochastic Frontier Estimation Of Cost Models Within The Hospital," The Review of Economics and Statistics, MIT Press, vol. 83(2), pages 302-309, May.
    14. 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.
    15. Beatriz Gonzalez Lopez-Valcarcel & Patricia Barber Perez, 1996. "Changes in the efficiency of spanish public hospitals after the introduction of program-contracts," Investigaciones Economicas, Fundación SEPI, vol. 20(3), pages 377-402, September.
    16. Miika Linna & Unto Häkkinen & Eero Linnakko, 1998. "An econometric study of costs of teaching and research in Finnish hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 7(4), pages 291-305, June.
    17. Kostas Kounetas & Fotis Papathanassopoulos, 2013. "How efficient are Greek hospitals? A case study using a double bootstrap DEA approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(6), pages 979-994, December.
    18. U.‐G. Gerdtham & M. Löthgren & M. Tambour & C. Rehnberg, 1999. "Internal markets and health care efficiency: a multiple‐output stochastic frontier analysis," Health Economics, John Wiley & Sons, Ltd., vol. 8(2), pages 151-164, March.
    19. Eduardo Ley, 1991. "Eficiencia productiva: un estudio aplicado al sector hospitalario. Respuesta," Investigaciones Economicas, Fundación SEPI, vol. 15(3), pages 755-756, September.
    20. Kontodimopoulos, Nick & Nanos, Panagiotis & Niakas, Dimitris, 2006. "Balancing efficiency of health services and equity of access in remote areas in Greece," Health Policy, Elsevier, vol. 76(1), pages 49-57, March.
    21. Lee Rivers Mobley & Jon Magnussen, 1998. "An international comparison of hospital efficiency: does institutional environment matter?," Applied Economics, Taylor & Francis Journals, vol. 30(8), pages 1089-1100.
    22. 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.
    23. Roxani Karagiannis, 2015. "A system-of-equations two-stage DEA approach for explaining capacity utilization and technical efficiency," Annals of Operations Research, Springer, vol. 227(1), pages 25-43, April.
    24. Miika Linna, 1998. "Measuring hospital cost efficiency with panel data models," Health Economics, John Wiley & Sons, Ltd., vol. 7(5), pages 415-427, August.
    25. 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.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Silvia Jencova & Igor Petruska & Marta Lukacova, 2021. "Relationship Between ROA and Total Indebtedness by Threshold Regression Model," Montenegrin Journal of Economics, Economic Laboratory for Transition Research (ELIT), vol. 17(2), pages 37-46.
    2. Kwadwo Arhin & Eric Fosu Oteng-Abayie & Jacob Novignon, 2023. "Assessing the efficiency of health systems in achieving the universal health coverage goal: evidence from Sub-Saharan Africa," Health Economics Review, Springer, vol. 13(1), pages 1-16, December.
    3. Jin-Li Hu & Min-Yueh Chuang & Shang-Ho Yeh, 2023. "A Dynamic DEA Analysis of Health Output Efficiencies of Cities and Counties in Taiwan," IJERPH, MDPI, vol. 20(6), pages 1-12, March.
    4. Ghasemi, Abdolrasoul & Boroumand, Yasaman & Shirazi, Masoud, 2020. "How do governments perform in facing COVID-19?," MPRA Paper 99791, University Library of Munich, Germany, revised 20 Apr 2020.
    5. Mehdi Shamohammadi & Yonghwa Park & Jong Hae Choi & Oh Kyoung Kwon, 2022. "Exploring the Performance of International Airports in the Pre- and Post-COVID-19 Era: Evidence from Incheon International Airport," Sustainability, MDPI, vol. 14(7), pages 1-22, April.
    6. Qian Liu & Bo Li & Muhammad Mohiuddin, 2018. "Prediction and Decomposition of Efficiency Differences in Chinese Provincial Community Health Services," IJERPH, MDPI, vol. 15(10), pages 1-14, October.
    7. Michael Kourtis & Panayiotis Curtis & Michael Hanias & Eleftherios Kourtis, 2021. "A Strategic Financial Management Evaluation of Private Hospitals’ Effectiveness and Efficiency for Sustainable Financing: A Research Study," European Research Studies Journal, European Research Studies Journal, vol. 0(1), pages 1025-1054.
    8. Zhishuo Zhang & Yao Xiao & Huayong Niu, 2022. "DEA and Machine Learning for Performance Prediction," Mathematics, MDPI, vol. 10(10), pages 1-23, May.
    9. Onuferová Erika & Čabinová Veronika & Matijová Mária, 2020. "Categorization of the EU Member States in the Context of Selected Multicriteria International Indices Using Cluster Analysis," Review of Economic Perspectives, Sciendo, vol. 20(3), pages 379-401, September.
    10. Mélanie Lefèvre & Nicolas Bouckaert & Cécile Camberlin & Carine Van de Voorde, 2022. "Economies of scale and optimal size of maternity services in Belgium: A Data Envelopment Analysis," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(3), pages 1421-1438, May.
    11. Fenfen Li & Bo Dai & Qifan Wu, 2021. "Dynamic Green Growth Assessment of China’s Industrial System with an Improved SBM Model and Global Malmquist Index," Mathematics, MDPI, vol. 9(20), pages 1-26, October.
    12. Aneta Masternak‐Janus, 2022. "Measuring the efficiency of materials management based on data envelopment analysis approach: the case of Polish regions," Papers in Regional Science, Wiley Blackwell, vol. 101(3), pages 603-618, June.
    13. Aleksandar Medarević & Dejana Vuković, 2021. "Efficiency and Productivity of Public Hospitals in Serbia Using DEA-Malmquist Model and Tobit Regression Model, 2015–2019," IJERPH, MDPI, vol. 18(23), pages 1-22, November.
    14. Beata Gavurova & David Tucek & Viliam Kovac, 2019. "Investigation of Relationship Between Spatial Distribution of Medical Equipment and Preventable Mortality," IJERPH, MDPI, vol. 16(16), pages 1-33, August.
    15. Rahab Mbau & Anita Musiega & Lizah Nyawira & Benjamin Tsofa & Andrew Mulwa & Sassy Molyneux & Isabel Maina & Julie Jemutai & Charles Normand & Kara Hanson & Edwine Barasa, 2023. "Analysing the Efficiency of Health Systems: A Systematic Review of the Literature," Applied Health Economics and Health Policy, Springer, vol. 21(2), pages 205-224, March.
    16. Dana Jašková, 2021. "Efficiency of management processes in a private hospital," Entrepreneurship and Sustainability Issues, VsI Entrepreneurship and Sustainability Center, vol. 9(1), pages 436-446, September.
    17. Hassan Najadat & Ahmad Alaiad & Sanaa Abu Alasal & Ghadeer Anwar Mrayyan & Izzat Alsmadi, 2020. "Integration of Data Envelopment Analysis and Clustering Methods," Journal of Information & Knowledge Management (JIKM), World Scientific Publishing Co. Pte. Ltd., vol. 19(01), pages 1-19, March.

    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. Andrew Worthington, 1999. "An Empirical Survey Of Frontier Efficiency Measurement Techniques In Healthcare Services," School of Economics and Finance Discussion Papers and Working Papers Series 067, School of Economics and Finance, Queensland University of Technology.
    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. Lorena Androutsou & Michail Kokkinos & Dimitra Latsou & Mary Geitona, 2022. "Assessing the Efficiency and Productivity of the Hospital Clinics on the Island of Rhodes during the COVID-19 Pandemic," IJERPH, MDPI, vol. 19(23), pages 1-12, November.
    4. Varabyova, Yauheniya & Schreyögg, Jonas, 2013. "International comparisons of the technical efficiency of the hospital sector: Panel data analysis of OECD countries using parametric and non-parametric approaches," Health Policy, Elsevier, vol. 112(1), pages 70-79.
    5. Ján Dobrovič & Veronika Čabinová & Peter Gallo & Petra Partlová & Jan Váchal & Beáta Balogová & Jozef Orgonáš, 2021. "Application of the DEA Model in Tourism SMEs: An Empirical Study from Slovakia in the Context of Business Sustainability," Sustainability, MDPI, vol. 13(13), pages 1-19, July.
    6. Akkan, Can & Karadayi, Melis Almula & Ekinci, Yeliz & Ülengin, Füsun & Uray, Nimet & Karaosmanoğlu, Elif, 2020. "Efficiency analysis of emergency departments in metropolitan areas," Socio-Economic Planning Sciences, Elsevier, vol. 69(C).
    7. Camilla Mastromarco & Lenka Stastna & Jana Votapkova, 2019. "Efficiency of hospitals in the Czech Republic: Conditional efficiency approach," Journal of Productivity Analysis, Springer, vol. 51(1), pages 73-89, February.
    8. Medin, Emma & Häkkinen, Unto & Linna, Miika & Anthun, Kjartan S. & Kittelsen, Sverre A.C. & Rehnberg, Clas, 2013. "International hospital productivity comparison: Experiences from the Nordic countries," Health Policy, Elsevier, vol. 112(1), pages 80-87.
    9. Nistor Cristina Silvia & Ștefănescu Cristina Alexandrina & Crișan Andrei-Răzvan, 2017. "Performance Through Efficiency in the Public Healthcare System – A DEA Approach in an Emergent Country," Studia Universitatis Babeș-Bolyai Oeconomica, Sciendo, vol. 62(1), pages 31-49, April.
    10. Emma Medin & Kjartan Anthun & Unto Häkkinen & Sverre Kittelsen & Miika Linna & Jon Magnussen & Kim Olsen & Clas Rehnberg, 2011. "Cost efficiency of university hospitals in the Nordic countries: a cross-country analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(6), pages 509-519, December.
    11. 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.
    12. 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.
    13. George Fragkiadakis & Michael Doumpos & Constantin Zopounidis & Christophe Germain, 2016. "Operational and economic efficiency analysis of public hospitals in Greece," Post-Print hal-01414677, HAL.
    14. Angeliki Flokou & Vassilis Aletras & Dimitris Niakas, 2017. "Decomposition of potential efficiency gains from hospital mergers in Greece," Health Care Management Science, Springer, vol. 20(4), pages 467-484, December.
    15. Chowdhury, Hedayet & Zelenyuk, Valentin, 2016. "Performance of hospital services in Ontario: DEA with truncated regression approach," Omega, Elsevier, vol. 63(C), pages 111-122.
    16. Gian Paolo Barbetta & Gilberto Turati & Angelo M. Zago, 2007. "Behavioral differences between public and private not‐for‐profit hospitals in the Italian national health service," Health Economics, John Wiley & Sons, Ltd., vol. 16(1), pages 75-96, January.
    17. Pinar Guven Uslu & Thuy Pham Linh, 2008. "Effects of Changes in Public Policy on Efficiency and Productivity of General Hospitals in Vietnam," Working Paper series, University of East Anglia, Centre for Competition Policy (CCP) 2008-30, Centre for Competition Policy, University of East Anglia, Norwich, UK..
    18. Kostas Kounetas & Fotis Papathanassopoulos, 2013. "How efficient are Greek hospitals? A case study using a double bootstrap DEA approach," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(6), pages 979-994, December.
    19. Jacques Ngoie Kibambe & Steven F. Koch, 2005. "DEA Applied to a Gauteng Sample of South African Public Hospitals," Working Papers 200512, University of Pretoria, Department of Economics.
    20. Onder, O. & Cook, W. & Kristal, M., 2022. "Does quality help the financial viability of hospitals? A data envelopment analysis approach," Socio-Economic Planning Sciences, Elsevier, vol. 79(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:spr:hecrev:v:8:y:2018:i:1:d:10.1186_s13561-018-0191-9. 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/economics/journal/13561 .

    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.