Technical efficiency in primary health care: does quality matter?
The accuracy required in the measurement of output is an issue that has as yet still not been satisfactorily addressed in empirical research on efficiency in primary health care. We exploit information retrieved from a newly constructed database (APEX06) for the Spanish region of Extremadura. The richness of our dataset allows us to consider original synthetic measures of output that take into account both the quantity and the quality of services provided by 85 primary care centres (PCCs) in 2006. We provide evidence that neglecting the issue of properly accounting for the quality of health services can lead to misleading results. Our main finding is that adjusting output for quality influences efficiency analysis in three senses. First, inefficiency now explains relatively more of the deviation from the potential output. Second, the average technical efficiency in the sector is lower, while its dispersion among PCCs is significantly higher. And third, the efficiency ranking of the PCCs is also affected.
|Date of creation:||Sep 2008|
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- Filipe Amado, Carla Alexandra & Dyson, Robert G., 2008. "On comparing the performance of primary care providers," European Journal of Operational Research, Elsevier, vol. 185(3), pages 915-932, March.
- Amado, Carla Alexandra da Encarnação Filipe & Santos, Sérgio Pereira dos, 2009. "Challenges for performance assessment and improvement in primary health care: The case of the Portuguese health centres," Health Policy, Elsevier, vol. 91(1), pages 43-56, June.
- Giuffrida, Antonio & Gravelle, Hugh & Sutton, Matthew, 2000.
"Efficiency and administrative costs in primary care,"
Journal of Health Economics,
Elsevier, vol. 19(6), pages 983-1006, November.
- Antonio Giuffrida & Hugh Gravelle & Matthew Sutton, "undated". "Efficiency and Administrative Costs in Primary Care," Discussion Papers 99/27, Department of Economics, University of York.
- Cervera, Juan Vega & Hernandez, Maria Isabel Sanchez & Mera, Antonio Chamorro & Miranda, Francisco Javier & Murillo, Luis Regino, 2010. "Adapting the Servqual Scale to Primary Health Care Services in Spain," Apas Papers 197, Academic Public Administration Studies Archive - APAS.
- Robert Rosenman & Daniel Friesner, 2004. "Scope and scale inefficiencies in physician practices," Health Economics, John Wiley & Sons, Ltd., vol. 13(11), pages 1091-1116.
- Jondrow, James & Knox Lovell, C. A. & Materov, Ivan S. & Schmidt, Peter, 1982. "On the estimation of technical inefficiency in the stochastic frontier production function model," Journal of Econometrics, Elsevier, vol. 19(2-3), pages 233-238, August.
- Jaume Puig-Junoy & Vicente Ortún, 2004. "Cost efficiency in primary care contracting: a stochastic frontier cost function approach," Health Economics, John Wiley & Sons, Ltd., vol. 13(12), pages 1149-1165.
- Jaume Puig & Vicente Ortún, 2003. "Cost efficiency in primary care contracting: A stochastic frontier cost function approach," Working Papers, Research Center on Health and Economics 719, Department of Economics and Business, Universitat Pompeu Fabra.
- Jaume Puig & Vicente Ortún, 2003. "Cost efficiency in primary care contracting: A stochastic frontier cost function approach," Economics Working Papers 719, Department of Economics and Business, Universitat Pompeu Fabra.
- Battese, George E. & Coelli, Tim J., 1988. "Prediction of firm-level technical efficiencies with a generalized frontier production function and panel data," Journal of Econometrics, Elsevier, vol. 38(3), pages 387-399, July.
- Antonio Giuffrida & Hugh Gravelle, 2001. "Measuring performance in primary care: econometric analysis and DEA," Applied Economics, Taylor & Francis Journals, vol. 33(2), pages 163-175.
- Antonio Giuffrida & Hugh Gravelle, "undated". "Measuring Performance in Primary Care: Econometric Analysis and DEA," Discussion Papers 99/36, Department of Economics, University of York.
- Goni, Salome, 1999. "An analysis of the effectiveness of Spanish primary health care teams," Health Policy, Elsevier, vol. 48(2), pages 107-117, August.
- Luis R. Murillo-Zamorano, 2004. "Economic Efficiency and Frontier Techniques," Journal of Economic Surveys, Wiley Blackwell, vol. 18(1), pages 33-77, 02.
- Battese, George E. & Corra, Greg S., 1977. "Estimation Of A Production Frontier Model: With Application To The Pastoral Zone Of Eastern Australia," Australian Journal of Agricultural Economics, Australian Agricultural and Resource Economics Society, vol. 21(03), December.
- Yasar Ozcan, 1998. "Physician benchmarking: measuring variation in practice behavior in treatment of otitis media," Health Care Management Science, Springer, vol. 1(1), pages 5-17, September.
- Battese, G E & Coelli, T J, 1995. "A Model for Technical Inefficiency Effects in a Stochastic Frontier Production Function for Panel Data," Empirical Economics, Springer, vol. 20(2), pages 325-332.
- Aigner, Dennis & Lovell, C. A. Knox & Schmidt, Peter, 1977. "Formulation and estimation of stochastic frontier production function models," Journal of Econometrics, Elsevier, vol. 6(1), pages 21-37, July.
- Jon Chilingerian & H. David Sherman, 1997. "DEA and primary care physician report cards: Deriving preferred practice cones from managed care service concepts and operating strategies," Annals of Operations Research, Springer, vol. 73(0), pages 35-66, October. Full references (including those not matched with items on IDEAS)
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