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Measuring the productive efficiency and clinical quality of institutional long‐term care for the elderly

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  • Juha Laine
  • Miika Linna
  • Unto Häkkinen
  • Anja Noro

Abstract

The authors consider the association between productive efficiency and clinical quality in institutional long‐term care for the elderly. Cross‐sectional data were collected from 122 wards in health‐centre hospitals and residential homes in Finland in 2001. Productive efficiency was measured in terms of technical efficiency, which was defined as the unit's distance from the (best practice) production frontier. The analysis employed stochastic production frontier estimation, where technical inefficiency in the production function was specified to be a function of ward characteristics and clinical quality of care. Several quality indicators based on the Resident Assessment Instrument, such as prevalence of pressure ulcers and depression with no treatment, were used in the analysis. The results did not reveal systematic association between technical efficiency and clinical quality of care. However, the prevalence of pressure ulcers, indicating poor quality of care was associated with technical efficiency, a fact which highlights the importance of including quality measures in the assessment of efficiency in long‐term care. Copyright © 2004 John Wiley & Sons, Ltd.

Suggested Citation

  • Juha Laine & Miika Linna & Unto Häkkinen & Anja Noro, 2005. "Measuring the productive efficiency and clinical quality of institutional long‐term care for the elderly," Health Economics, John Wiley & Sons, Ltd., vol. 14(3), pages 245-256, March.
    • Handle: RePEc:wly:hlthec:v:14:y:2005:i:3:p:245-256
    DOI: 10.1002/hec.926
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    References listed on IDEAS

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    1. Järviö, Maija-Liisa & Luoma, Kalevi & Räty, Tarmo & Aaltonen, Juho, 2005. "Productivity and its Drivers in Finnish Primary Care 1988-2003," Research Reports 118, VATT Institute for Economic Research.
    2. Giulia Garavaglia & Emanuele Lettieri & Tommaso Agasisti & Silvano Lopez, 2011. "Efficiency and quality of care in nursing homes: an Italian case study," Health Care Management Science, Springer, vol. 14(1), pages 22-35, March.
    3. Norton, E.C., 2016. "Health and Long-Term Care," Handbook of the Economics of Population Aging, in: Piggott, John & Woodland, Alan (ed.), Handbook of the Economics of Population Aging, edition 1, volume 1, chapter 0, pages 951-989, Elsevier.
    4. Ortega-Díaz, M. Isabel & Martín, Juan Carlos, 2022. "How to detect hospitals where quality would not be jeopardized by health cost savings? A methodological approach using DEA with SBM analysis," Health Policy, Elsevier, vol. 126(10), pages 1069-1074.
    5. 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.
    6. Alice Tran & Kim-Huong Nguyen & Len Gray & Tracy Comans, 2019. "A Systematic Literature Review of Efficiency Measurement in Nursing Homes," IJERPH, MDPI, vol. 16(12), pages 1-18, June.
    7. Tao Du, 2017. "Performance Measurement of Healthcare Service and Association Discussion between Quality and Efficiency: Evidence from 31 Provinces of Mainland China," Sustainability, MDPI, vol. 10(1), pages 1-19, December.
    8. Yang, Jinqiu & Zeng, Wu, 2014. "The trade-offs between efficiency and quality in the hospital production: Some evidence from Shenzhen, China," China Economic Review, Elsevier, vol. 31(C), pages 166-184.
    9. Iparraguirre, José Luis & Ma, Ruosi, 2015. "Efficiency in the provision of social care for older people. A three-stage Data Envelopment Analysis using self-reported quality of life," Socio-Economic Planning Sciences, Elsevier, vol. 49(C), pages 33-46.
    10. Mary E. Deily & Niccie L. McKay, 2006. "Cost inefficiency and mortality rates in Florida hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 419-431, April.
    11. David C. Grabowski & Edward C. Norton, 2012. "Nursing Home Quality of Care," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 29, Edward Elgar Publishing.
    12. Laura Di Giorgio & Massimo Filippini & Giuliano Masiero, 2014. "The relationship between costs and quality in nonprofit nursing homes," IdEP Economic Papers 1402, USI Università della Svizzera italiana.
    13. Lars-Erik Borge & Marianne Haraldsvik, 2009. "Efficiency potential and determinants of efficiency: an analysis of the care for the elderly sector in Norway," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 16(4), pages 468-486, August.
    14. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128, October.
    15. Topo, Päivi & Iltanen-Tähkävuori, Sonja, 2010. "Scripting patienthood with patient clothing," Social Science & Medicine, Elsevier, vol. 70(11), pages 1682-1689, June.
    16. Rajendra Dulal, 2017. "Cost efficiency of nursing homes: do five-star quality ratings matter?," Health Care Management Science, Springer, vol. 20(3), pages 316-325, September.

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