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Measuring efficiency in health care: an application to out of hours primary care services in the island of Ireland

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  • Grace Lordan

Abstract

This paper is a cross border study that explores isolating the efficiency component and measuring its overall contribution to productivity in the case of out of hours (OOH) primary care services operating on the Island of Ireland. Out of hours GP care is supplied throughout the Island of Ireland by OOH co-operatives. Although Northern Ireland (NI) and the Republic of Ireland (ROI) have their own individual health systems the OOH organisations themselves are relatively homogenous in structure. The data for this study has been gathered and collated by the author and relates to six of twelve co-operatives operating in ROI and five of the seven co-operatives in NI. The primary aim of this paper is to estimate efficiency for these organisations using stochastic frontier analysis (SFA) SFA was chosen as the method for analysis as it allows distinction between ‘noise’ effects and efficiency effects. This paper outlines the means that SFA methodology can be used to derive sensible and robust efficiency estimates for OOH primary care organizations operating on the Island of Ireland. The paper also examines the sensitivity of these estimates to the choice of functional form for the health production function, the choice of error distribution for the efficiency terms and the means in which heterogeneity is incorporated into the analysis. Individual efficiency estimates, rankings, cross border rankings and comparisons are reported to allow recommendations to be made on how these organizations can improve their production process.

Suggested Citation

  • Grace Lordan, 2007. "Measuring efficiency in health care: an application to out of hours primary care services in the island of Ireland," Health, Econometrics and Data Group (HEDG) Working Papers 07/08, HEDG, c/o Department of Economics, University of York.
    • Handle: RePEc:yor:hectdg:07/08
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    References listed on IDEAS

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    1. Settlage, Daniel M. & Dixon, Bruce L. & Thomsen, Michael R., 2000. "A Comparison Of Various Frontier Estimation Methods Under Differing Data Generation Assumptions," Staff Papers 15773, University of Arkansas, Department of Agricultural Economics and Agribusiness.
    2. Vuong, Quang H, 1989. "Likelihood Ratio Tests for Model Selection and Non-nested Hypotheses," Econometrica, Econometric Society, vol. 57(2), pages 307-333, March.
    3. Robert Rosenman & Daniel Friesner, 2004. "Scope and scale inefficiencies in physician practices," Health Economics, John Wiley & Sons, Ltd., vol. 13(11), pages 1091-1116, November.
    4. 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.
    5. Grace Lordan, 2007. "What determines a patient’s treatment? Evidence from out of hours primary care co-op data in the Republic of Ireland," Health Care Management Science, Springer, vol. 10(3), pages 283-292, September.
    6. Greene, William H., 1980. "On the estimation of a flexible frontier production model," Journal of Econometrics, Elsevier, vol. 13(1), pages 101-115, May.
    7. Meeusen, Wim & van den Broeck, Julien, 1977. "Efficiency Estimation from Cobb-Douglas Production Functions with Composed Error," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 18(2), pages 435-444, June.
    8. Stevenson, Rodney E., 1980. "Likelihood functions for generalized stochastic frontier estimation," Journal of Econometrics, Elsevier, vol. 13(1), pages 57-66, May.
    9. Schmidt, Peter & Sickles, Robin C, 1984. "Production Frontiers and Panel Data," Journal of Business & Economic Statistics, American Statistical Association, vol. 2(4), pages 367-374, October.
    10. 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.
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    Keywords

    Primary Care; Out of Hours; Efficiency; Stochastic Production Frontiers.;
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