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The measurement of efficiency and productivity of health care delivery

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  • Bruce Hollingsworth

Abstract

The measurement of efficiency and productivity of health service delivery has become a small industry. This is a review of 317 published papers on frontier efficiency measurement. The techniques used are mainly based on non‐parametric data envelopment analysis, but there is increasing use of parametric techniques, such as stochastic frontier analysis. Applications to hospitals and other health care organizations and areas are reviewed and summarised, and some meta‐type analysis undertaken. Cautious conclusions are that public provision may be potentially more efficient than private, in certain settings. The paper also considers conceptualizations of efficiency, and points to dangers and opportunities in generating such information. Finally, some criteria for assessing the use and usefulness of efficiency studies are established, with a view to helping both researchers and those assessing whether or not to act upon published results. Copyright © 2008 John Wiley & Sons, Ltd.

Suggested Citation

  • 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.
  • Handle: RePEc:wly:hlthec:v:17:y:2008:i:10:p:1107-1128
    DOI: 10.1002/hec.1391
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    1. Wagner, Janet M. & Shimshak, Daniel G. & Novak, Michael A., 2003. "Advances in physician profiling: the use of DEA," Socio-Economic Planning Sciences, Elsevier, vol. 37(2), pages 141-163, June.
    2. Suthathip Yaisawarng & James F. Burgess, 2006. "Performance‐based budgeting in the public sector: an illustration from the VA health care system," Health Economics, John Wiley & Sons, Ltd., vol. 15(3), pages 295-310, March.
    3. 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.
    4. Anthony J. Culyer, 2006. "The bogus conflict between efficiency and vertical equity," Health Economics, John Wiley & Sons, Ltd., vol. 15(11), pages 1155-1158, November.
    5. P.C. Smith, 2002. "Measuring health system performance," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 3(3), pages 145-148, September.
    6. Carol Propper & Deborah Wilson, 2012. "The Use of Performance Measures in Health Care Systems," Chapters, in: Andrew M. Jones (ed.), The Elgar Companion to Health Economics, Second Edition, chapter 33, Edward Elgar Publishing.
    7. Afonso, Antonio & St. Aubyn, Miguel, 2005. "Non-Parametric Approaches to Education and Health Efficiency in OECD Countries," Journal of Applied Economics, Universidad del CEMA, vol. 8(2), pages 1-20, November.
    8. Maniadakis, Nikolaos & Thanassoulis, Emmanuel, 2004. "A cost Malmquist productivity index," European Journal of Operational Research, Elsevier, vol. 154(2), pages 396-409, April.
    9. Bruce Hollingsworth & P.J. Dawson & N. Maniadakis, 1999. "Efficiency measurement of health care: a review of non‐parametric methods and applications," Health Care Management Science, Springer, vol. 2(3), pages 161-172, July.
    10. Pestieau, P. & Tulkens, H., 1990. "Assessing the performance of the public sector activities: some recent evidence from the productive efficiency viewpoint," LIDAM Discussion Papers CORE 1990060, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    11. 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.
    12. Brenda Gannon, 2005. "Testing for Variation in Technical Efficiency of Hospitals in Ireland," The Economic and Social Review, Economic and Social Studies, vol. 36(3), pages 273-294.
    13. Butler, Timothy W. & Li, Ling, 2005. "The utility of returns to scale in DEA programming: An analysis of Michigan rural hospitals," European Journal of Operational Research, Elsevier, vol. 161(2), pages 469-477, March.
    14. Vinish Kathuria & Deepa Sankar, 2005. "Inter-State Disparities in Health Outcomes in Rural India: An Analysis Using a Stochastic Production Frontier Approach," Development Policy Review, Overseas Development Institute, vol. 23(2), pages 145-163, March.
    15. 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.
    16. 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.
    17. Mehdi Farsi & Massimo Filippini, 2004. "An Empirical Analysis of Cost Efficiency in Non‐profit and Public Nursing Homes," Annals of Public and Cooperative Economics, Wiley Blackwell, vol. 75(3), pages 339-365, September.
    18. Jos Blank & Vivian Valdmanis, 2005. "A modified three-stage data envelopment analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(1), pages 65-72, March.
    19. Chen, Andrew & Hwang, Yuhchang & Shao, Benjamin, 2005. "Measurement and sources of overall and input inefficiencies: Evidences and implications in hospital services," European Journal of Operational Research, Elsevier, vol. 161(2), pages 447-468, March.
    20. Bruce Hollingsworth & Andrew Street, 2006. "The market for efficiency analysis of health care organisations," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1055-1059, October.
    21. Matthias Staat, 2003. "The efficiency of treatment strategies of general practitioners," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 4(3), pages 232-238, September.
    22. Kontodimopoulos, Nick & Niakas, Dimitris, 2005. "Efficiency measurement of hemodialysis units in Greece with data envelopment analysis," Health Policy, Elsevier, vol. 71(2), pages 195-204, February.
    23. Juan Ventura & Eduardo GonzáLez & Ana Cárcaba, 2004. "Efficiency and Program‐Contract Bargaining in Spanish Public Hospitals," Annals of Public and Cooperative Economics, Wiley Blackwell, vol. 75(4), pages 549-573, December.
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