Skip to main content

Advertisement

Log in

Early Warning System for Financially Distressed Hospitals Via Data Mining Application

  • ORIGINAL PAPER
  • Published:
Journal of Medical Systems Aims and scope Submit manuscript

Abstract

The aim of this study is to develop a Financial Early Warning System (FEWS) for hospitals by using data mining. A data mining method, Chi-Square Automatic Interaction Detector (CHAID) decision tree algorithm, was used in the study for financial profiling and developing FEWS. The study was conducted in Turkish Ministry of Health’s public hospitals which were in financial distress and in need of urgent solutions for financial issues. 839 hospitals were covered and financial data of the year 2008 was obtained from Ministry of Health. As a result of the study, it was determined that 28 hospitals (3.34%) had good financial performance, and 811 hospitals (96.66%) had poor financial performance. According to FEWS, the covered hospitals were categorized into 11 different financial risk profiles, and it was found that 6 variables affected financial risk of hospitals. According to the profiles of hospitals in financial distress, one early warning signal was detected and financial road map was developed for risk mitigation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3
Fig. 4

Similar content being viewed by others

References

  1. Ozgulbas, N., and Koyuncugil, A. S., Financial early warning system for risk detection and prevention from financial crisis. In: Koyuncugil, A. S., and Ozgulbas, N. (Eds.), Surveillance technologies and early warning systems: Data mining applications for risk detection. Idea Group Inc, New York, pp. 76–108, 2010.

    Chapter  Google Scholar 

  2. Koyuncugil, A. S., and Ozgulbas, N., Social aid fraud detection system and poverty map model suggestion based on data mining for social risk mitigation. In: Koyuncugil, A. S., and Ozgulbas, N. (Eds.), Surveillance technologies and early warning systems: Data mining applications for risk detection. Idea Group Inc, New York, pp. 173–193, 2010.

    Chapter  Google Scholar 

  3. Ministry of Health (MoH), 2005 inpatient facilities statistical almanac of the ministry of health, Ankara, 2006

  4. Ministry of Health (MoH), 2006 inpatient facilities statistical almanac of the ministry of health, Ankara, 2007

  5. Ministry of Health (MoH), 2007 inpatient facilities statistical almanac of the ministry of health, Ankara, 2008

  6. Ministry of Health (MoH), 2008 inpatient facilities statistical almanac of the ministry of health, Ankara, 2009

  7. Kisa, A., The Turkish commercial health insurance industry. J. Med. Syst. 25:233–239, 2001.

    Article  Google Scholar 

  8. World Bank (WB), Turkey reforming the health sector for improved access and efficiency, document of the world bank, Report No. 24358-TU, March 2003

  9. Giray, U. A., Health system in Turkey, Republic of Turkey ministry of health department of European Union Coordination: Ankara, 2003

  10. OECD, OECD Health data 2010: Statistics and indicators, http://www.oecd.org/document/30/0,3746,en_2649_37407_12968734_1_1_1_37407,00.html, accessed December 2010

  11. World Health Organization (WHO), National health accounts, http://www.who.int/nha/country/tur.xls, accessed December, 2010

  12. Ministry of Health (MoH), http://www.saglik.gov.tr/TR/dosya/1-63660/h/2008.pdf, accessed December, 2010

  13. State Planning Organization (SPO), Final report of Turkish master health plan. SPO, Ankara, Turkey, 1990.

    Google Scholar 

  14. Ministry of Health (MoH), Reports of study groups. Ministry of Health, Ankara, Turkey, 1992.

    Google Scholar 

  15. European Parliament’s Committee, General Overview of the Public Health Sector in Turkey, European Parliament’s Documents, No: IP/A/ENVI/NT/2006-312006

  16. Vassilou, L., and Tokat, M., Issues and options in health financing in Turkey. Document of World Bank, Report No: 8042-TU, 1990

  17. Ozcan, Y., and Ersoy, K., Efficiency of health care in The Republic of Turkey. TIMS, Alaska, p. XXXII, 1994.

    Google Scholar 

  18. Kavuncubasi, S., and Ersoy, K., Measurement of technical efficiency in hospitals. Journal of Public Management, XXVII(3), 1995

  19. Ozgulbas, N., Measuring effectiveness of ministry of health hospitals’ by data envelopment analysis. J. Prod. 1:69–90, 2003.

    Google Scholar 

  20. Ozgulbas, N., and Okem, G., The relationship between technical and financial performance at the ministry of health’s in Turkey. Global engagement in creating financially viable healthcare systems, Proceedings of Second International Healthcare Conference: 303–308, 2002

  21. Ozgulbas, N., and Kisa, A., Wasteful use of financial resources in public hospitals in Turkey: A trend analysis. Health Care Manager 25:144–149, 2005.

    Google Scholar 

  22. Ozgulbas N., and Koyuncugil, A. S., Application of benchmarking as a strategy for increasing the financial performance, In Proceedings of 9th National Finance Symposium, Nevsehir, Turkey, Sep. 28–30, 2005

  23. Ozgulbas, N., and Koyuncugil, A. S., Financial profiling of public hospitals: An application by data mining. Int. J. Health Plann. Manage. 24(1):69–83, 2009.

    Article  Google Scholar 

  24. Ministry of Finance (MoF), Public financial management and control law no. 5018, Published by Republic of Turkey Ministry of Finance Strategy Development Unit: Ankara, 95, 2010

  25. Warner, J., Bankruptcy costs: Some evidence. J. Finance 32:337–347, 1977.

    Article  Google Scholar 

  26. Terdpaopong, K., Financially distressed, small and medium-sized enterprises’ characteristics and discriminant analysis model: Evidence from the Thai market, In Proceedings of Small Enterprise Association of Australia & New Zealand (SEAANZ) Conference 2008, Sydney, Australia, ISBN: 978-0-646-50668-5, p.125–165, hhtp://www.seaanz.org/documents/SEAANZ2008ConferenceProceeding_000.pdf, accessed June, 2010

  27. Beaver, W., Financial ratios as predictors of failure. J. Acc. Res. 4:71–111, 1966.

    Article  Google Scholar 

  28. Altman, E., Financial ratios, discriminant analysis and the prediction of corporate bankruptcy. Journal of Finance, September, pp. 589–609, 1968.

    Google Scholar 

  29. Deakin, E. B., A discriminat analysis of predictors of business failure. J. Acc. Res. 10(1):167–179, 1972.

    Article  Google Scholar 

  30. Altman, E. I., Haldeman, G., and Narayanan, P., Zeta analysis: A new model to identify bancrupcy risk of corporations. Journal of Banking and Finance, June, 29–54, 1977

  31. Taffler, R. J., and Tisshaw, H., Going, going, gone-four factors which factors which predict. Accountancy, March, pp. 50–54, 1977.

    Google Scholar 

  32. Zmijewski, M. E., Methodological issues related to the estimation of financial distress prediction models, Journal of Accounting Research, Supplement: 59–82, 1984

  33. Zavgren, C., Assessing the vulnerability to failure of American industrial firms: A logistics analysis. J. Acc. Res. 22:59–82, 1985.

    Google Scholar 

  34. Jones, F., Current techniques in bankruptcy prediction. J. Acc. Lit. 6:131–164, 1987.

    Google Scholar 

  35. Pantalone, C., and Platt, M., Predicting failures of savings and loan associations. AREUEA J. 15:46–64, 1987.

    Google Scholar 

  36. Meyer, P. A., and Pifer, H. W., Prediction of bank failures. J. Finance XXV(4):853–886, 1970.

    Google Scholar 

  37. Brockett, P. L., and Cooper, W. W., Report to the state auditor and the state board of insurance on early warning systems to monitor the performance of insurance companies in Texas, Office of the State Auditor, Austin, TX., 1990

  38. Coyne, J., and Meadows, D., California HMOs may provide national forecast. Healthc. Financ. Manage. 45(5):34–39, 1991.

    Google Scholar 

  39. Lee, S. H., and Urrutia, J. L., Analysis of insolvency prediction in the property-liability insurance industry: A comparison of logit and hazard models. J. Risk Insur. 63:121–130, 1996.

    Article  Google Scholar 

  40. Barniv, R., and Hathorn, J., The merger or insolvency alternative in the insurance industry. J. Risk Insur. 64(1):89–113, 1997.

    Article  Google Scholar 

  41. Trieschmann, J. S., and Pinches, G. E., A multivariate model for predicting financially distressed property-liability insurers. J. Risk Insur. 40:327–338, 1973.

    Article  Google Scholar 

  42. Ambrose, J. M., and Seward, J. A., Best’s ratings financial ratios and prior probabilities in insolvency prediction. J. Risk Insur. 55:229–244, 1998.

    Google Scholar 

  43. Barniv, R., and McDonald, J. B., Identifying financial distress in the insurance industry: A synthesis of methodological and empirical issues. J. Risk Insur. 59:543–573, 1992.

    Article  Google Scholar 

  44. Laitinen, K., and Chong, H. G., Early warning system for crisis in SMEs: Preliminary evidence from Finland to the UK. J. Small Bus. Enterprise Dev. 6(1):89–102, 1999.

    Article  Google Scholar 

  45. Yang, B., Ling, X. L., Hai, J., and Jing, X., An early warning system for loan risk assessment using artificial neural networks. Knowl.-Based Syst. 14(5–6):303–306, 2001.

    Article  Google Scholar 

  46. Salas, V., and Saurina, J., Credit risk in two institutional regimes: Spanish commercial and savings banks. J. Financ. Serv. Res. 22(3):203–224, 2002.

    Article  Google Scholar 

  47. Edison, H. J., Do indicators of financial crises work? An evaluation of an early warning system. Int. J. Financ. Econ. 8(1):11–53, 2003.

    Article  Google Scholar 

  48. El-Shazly, A., Early warning of currency crises: An econometric analysis for Egypt. Middle East Bus. Econ. Rev. 18(1):34–48, 2003.

    Google Scholar 

  49. Jacobs, L. J., and Kuper, G. H., Indicators of financial crises do work! An early-warning system for six Asian countries. CCSO Working Paper 13. Department of Economics, University of Groningen, the Netherlands, 2004

  50. Berg, A., Borensztein, E., and Pattillo, C., Assessing early warning systems: How have they worked in practice? IMF Working Paper, March 2004, http://www.ksri.org/bbs/files/research02/wp0452.pdf, accessed April, 2009

  51. Price, C., Cameron, A. E., and Price, D. L., Distress detectors measures for predicting financial trouble in hospitals. Healthc. Financ. Manage. 59(8):74–80, 2005.

    Google Scholar 

  52. Brockett, P. L., Golden, L. L., Jang, J., and Yang, C., A comparison of neural network, statistical methods and variable. J. Risk Insur. 73(3):397–419, 2006.

    Article  Google Scholar 

  53. Abumustafa, N. I., Development of an early warning model for currency crises in emerging economies: An empirical study among Middle Eastern countries. Int. J. Manage. 23(3):403, 2006.

    Google Scholar 

  54. Kyong, J. O, Tae, Y. K, Chiho, K., and Suk, J. L., Using neural networks to tune the fluctuation of daily financial condition indicator for financial crisis forecasting, Advances in Artificial Intelligence, doi:10.1007/11941439_65 Volume 4304/2006

  55. Katz, M., Multivariable analysis: A practical guide for clinicians, New York: Churchill-Livingstone: 200, 2006

  56. Koyuncugil, A. S., and Ozgulbas, N., Developing financial early warning system via data mining, In Proceedings Book of 4th Congress of SMEs and Productivity, Istanbul: 153–166, 2007

  57. Koyuncugil, A. S., and Ozgulbas, N., Detecting financial early warning signs in Istanbul stock exchange by data mining. Int. J. Bus. Res. VII(3):188–193, 2007.

    Google Scholar 

  58. Davis, E. P., and Karim, D., Comparing early warning systems for banking crises. J. Financ. Stability 4(2):89–120, 2008.

    Article  Google Scholar 

  59. Davis, E. P., and Karim, D., Could early warning systems have helped to predict the sub-prime crisis? Natl Inst. Econ. Rev. 206(1):35–47, 2008.

    Article  Google Scholar 

  60. Coyne, J. S., and Singh, S. G., The early indicators of financial failure: A study of bankrupt and solvent health systems. J. Healthc. Manage. 53(5):333–346, 2008.

    Google Scholar 

  61. Koyuncugil, A. S., and Ozgulbas, N., Strengths and weaknesses of SMEs listed in ISE: A CHAID decision tree application, Journal of Dokuz Eylul University, Faculty of Economics and Administrative Sciences, 23(1): 1–22, 2008

    Google Scholar 

  62. Koyuncugil, A. S., and Ozgulbas, N., Measuring and hedging operational risk by data mining. Proceedings Book of World Summit on Economic-Financial Crisis and International Business, Washington: 1–6, 2009

  63. Koyuncugil, A. S., and Ozgulbas, N., An intelligent financial early warning system model based on data mining for SMEs. In Proceedings of the International Conference on Future Computer and Communication, Kuala Lumpur, Malaysia. doi:10.1109/ICFCC.2009.118: 662–666, 2009

  64. Frawley, W., Piatetsky-Shapiro, G., and Matheus, C., Knowledge discovery in databases: An overview, AI Magazine: Fall: 213–28, 1992

  65. Hand, D., Mannila, H., and Smyth, P., Principles of data mining. MIT Press, Cambridge, p. 555, 2001.

    Google Scholar 

  66. Thearling, K., Data mining and analytic technologies. hhtp://www.thearling.com/, accessed October, 2009

  67. Monk, E., and Wagner, B., Concepts in enterprise resource planning, 2nd edition. Thomson Course Technology, Boston, 2006.

    Google Scholar 

  68. Tam, K. Y., and Kiang, M. Y., Managerial applications of neural networks: The case of bank failure predictions. Decis. Sci. 38:926–948, 1992.

    MATH  Google Scholar 

  69. Lee, K. C., Han, I., and Kwon, Y., Hybrid neural network models for bankruptcy predictions. Decis. Support Syst. 18:63–73, 1996.

    Article  Google Scholar 

  70. Kumar, N., Krovi, R., and Rajagopalan, B., Financial decision support with hybrid genetic and neural based modeling tools. Eur. J. Oper. Res. 103:339–349, 1997.

    Article  MATH  Google Scholar 

  71. Nazem, S., and Shin, B., Data mining: New arsenal for strategic decision making. J. Database Manage. 10:39–42, 1999.

    Google Scholar 

  72. Eklund, T., Back, B., Vanharanta, H., and Visa, A., Using the self- organizing map as a visualization tool in financial benchmarking. Inf. Vis. 2:171–181, 2003.

    Article  Google Scholar 

  73. Hoppszallern, S., Healthcare benchmarking. Hosp. Health Netw. 77:37–44, 2003.

    Google Scholar 

  74. Derby, B. L., Data mining for improper payments. J. Gov. Financ. Manage. 52:10–13, 2003.

    Google Scholar 

  75. Chang, S., Chang, H., Lin, C., and Kao, S., The effect of organizational attributes on the adoption of data mining techniques in the financial service industry: An empirical study in Taiwan. Int. J. Manage. 20:497–503, 2003.

    Google Scholar 

  76. Kloptchenko, A., Eklund, T., Karlsson, J., Back, B., Vanhatanta, H., and Visa, A., Combining data and text mining techniques for analyzing financial reports. Intell. Syst. Acc. Finance Manage. 12:29–41, 2004.

    Article  Google Scholar 

  77. Magnusson, C., Arppe, A., Eklund, T., and Back, B., The language of quarterly reports as an indicator of change in the company’s financial status. Inf. Manage. 42:561–570, 2005.

    Google Scholar 

  78. Koyuncugil, A. S., and Ozgulbas, N., Is there a specific measure for financial performance of SMEs. Bus. Rev. Camb. 5(2):314–319, 2006.

    Google Scholar 

  79. Koyuncugil, A. S., and Ozgulbas, N., Financial profiling of SMEs: An application by data mining, In Proceedings of the European Applied Business Research (EABR) Conference, 2006

  80. Koyuncugil, A. S., and Ozgulbas, N., Determination of factors affected financial distress of SMEs listed in ISE by data mining, Proceedings of 3rd Congress of SMEs and Productivity, KOSGEB and Istanbul Kultur University, Istanbul, 2006

  81. Koyuncugil, A. S., and Ozgulbas, N., Early warning system approach to SMEs based on data mining as a financial risk detector. Hakikur Rahman (Ed), Data mining applications for empowering knowledge societies, Idea Group Inc., USA, 2008

  82. Ozgulbas, N., and Koyuncugil, A. S., Profiling and determining the strengths and weaknesses of SMEs listed in ISE by the data mining decision trees algorithm CHAID, Proceedings of 10th National Finance Symposium, Izmir, 2006

  83. Fayyad, G., Piatetsky-Shapiro, P., and Symth, P., From data mining to knowledge discovery in databases. AI Mag. 17(3):37–54, 1996.

    Google Scholar 

  84. Koyuncugil, A. S., Fuzzy data mining and its application to capital markets. Unpublished Ph.D. Thesis, Ankara University, 2006

  85. Berson, A., Smith, S., and Thearling, K., Building data mining applications for CRM. McGraw-Hill, USA, p. 510, 2000.

    Google Scholar 

  86. Kovalerchuk, B., and Vityaev, E., Data mining in finance. Kluwer Academic Publishers, Hingham MA USA, 2000.

    MATH  Google Scholar 

  87. SPSS, Answer Tree 3.0 user’s guide. SPSS Inc.: USA, 2001

  88. Cleverley, W. O., Improving financial performance: A study of 50 hospitals. Hosp. Health Serv. Adm. 35(2):173–187, 1990.

    Google Scholar 

  89. Cleverley, W. O., Does hospital financial performance measure up? Healthc. Financ. Manage. 46(5):20–26, 1992.

    Google Scholar 

  90. Cleverly, W. O., Understanding your hospital’s true financial position and changing it. Health Care Manage. Rev. 20(2):62–73, 1995.

    Google Scholar 

  91. Cleverley, W. O., and Baserman, S. J., Pauerns of financing for the largest hospital systems in the United States. J. Healthc. Manage. 50(6):361–365, 2005.

    Google Scholar 

  92. Volvana, J., and Sloan, F., Hospital profitability and capital structure: A comparative anaysis. Health Serv. Reserch 23(3):343–357, 1988.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Ali Serhan Koyuncugil.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Koyuncugil, A.S., Ozgulbas, N. Early Warning System for Financially Distressed Hospitals Via Data Mining Application. J Med Syst 36, 2271–2287 (2012). https://doi.org/10.1007/s10916-011-9694-1

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10916-011-9694-1

Keywords

Navigation