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Productivity growth in Norwegian psychiatric outpatient clinics A panel data analysis of the period 1996-2001

  • Hallsteinli, Vidar

    (SINTEF Unimed, Health Services Research)

  • Magnussen, Jon

    (SINTEF Unimed, Health Services Research)

  • Kittelsen, Sverre A.C.

    ()

    (The Ragnar Frisch Centre for Economic Research)

Norwegian government policy is to increase the supply of psychiatric services to children and young persons, both by increasing the number of personnel and by increasing productivity in the psychiatric outpatient clinics (BUP). Increased accessibility to services is observed for the last years, measured as the number of children receiving services every year. The question is to what extent this is related to increased productivity. The paper aims to estimate change in productivity among outpatient clinics. Questions whether change in productivity is related to the personnel mix of the clinics, growth in treatment capacity or change in financial incentives are analysed. We utilise a non-parametric method called Data Envelopment Analysis (DEA) to estimate a best-practise production frontier. The potential for efficiency improvement are estimated as the difference between actual and best-practice performance, while allowing for trade-offs between different staff groups and different mixes of service production. A Malmquist output-based productivity index is calculated, decomposed in technical efficiency change, scale efficiency change and frontier shifts. The paper analyses panel data on the psychiatric outpatient clinics of Norway for the period of 1996-2001. Output is measured as number of direct and indirect patientrelated interventions (visits and consultations) while input is measured by usage of different types of personnel. The results indicate increased overall productivity, with important contribution from increased technical efficiency. Personell growth has a negative influence on productivity growth, while a growth in the share of university educated personell improves productivity. The financial reform of 1997 that gave greater weight for interventions per patient lead to lower productivity growth in the subsequent period for those that had an inital budgetary gain from the reform.

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File URL: http://www.hero.uio.no/publicat/2003/HERO2003_9.pdf
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Paper provided by Oslo University, Health Economics Research Programme in its series HERO On line Working Paper Series with number 2003:9.

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Length: 21 pages
Date of creation: 21 Jun 2009
Date of revision:
Handle: RePEc:hhs:oslohe:2003_009
Contact details of provider: Postal: HERO / Institute of Health Management and Health Economics P.O. Box 1089 Blindern, N-0317 Oslo, Norway
Phone: 2307 5309
Fax: 2307 5310
Web page: http://www.hero.uio.no/eng.html
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  1. Biørn, Erik & Hagen, Terje P. & Iversen, Tor & Magnussen, Jon, 2009. "The effect of activity-based financing on hospital efficiency: A panel data analysis of DEA efficiency scores 1992-2000," HERO On line Working Paper Series 2002:8, Oslo University, Health Economics Research Programme.
  2. Chalkley, Martin & Malcomson, James M., 2000. "Government purchasing of health services," Handbook of Health Economics, in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 15, pages 847-890 Elsevier.
  3. 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.
  4. 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.
  5. 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.
  6. Berg, Sigbjorn Atle & Forsund, Finn R & Jansen, Eilev S, 1992. " Malmquist Indices of Productivity Growth during the Deregulation of Norwegian Banking, 1980-89," Scandinavian Journal of Economics, Wiley Blackwell, vol. 94(0), pages S211-28, Supplemen.
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