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Do Geographical Locations Affect in Hospitals Performance? A Multi-group Data Envelopment Analysis

  • Systems-Level Quality Improvement
  • Published:
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Abstract

Hospitals are the main and the last component of the health care systems. Therefore, evaluating the performance of hospitals is vital. Several studies are done in hospitals evaluation, but almost none of them consider the geographical features. This paper proposes a new approach for evaluating hospitals. In the proposed approach, hospitals are classified into various groups and each group is equivalent to a province. It causes hospitals in each category (province) must be evaluated in homogenous environment. For this purpose, the conventional data envelopment analysis (DEA) model has been developed to this structure. The main feature of the proposed model is that it takes into consideration the geographical location. In other words, we propose a multi-group DEA model. The data on 288 Iranian hospitals grouped under 31 provinces are used to demonstrate the model. The results show that the efficiency scores are greatly changed when hospitals are evaluated in own groups.

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References

  1. Charnes, A., Cooper, W. W., and Rhodes, E., Measuring the efficiency of decision making units. Eur. J. Oper. Res. 2:429–444, 1978.

    Article  Google Scholar 

  2. Banker, R. D., Charnes, A., and Cooper, W. W., Some models for estimating technical and scale inefficiencies in data envelopment analysis. Manag. Sci. 30:1078–1092, 1984.

    Article  Google Scholar 

  3. Chirikos, T. N., and Sear, A. M., Measuring hospital efficiency: A comparison of two approaches. Health Serv. Res. 34:1389, 2000.

    PubMed Central  CAS  PubMed  Google Scholar 

  4. Daidone, S., and D’Amico, F., Technical efficiency, specialization and ownership form: Evidences from a pooling of Italian hospitals. J. Prod. Anal. 32:203–216, 2009.

    Article  Google Scholar 

  5. Mutter, R. L., and Rosko, M. D., The impact of ownership on the cost-efficiency of US hospitals. Adv. Health Econ. Health Serv. Res. 18:113–138, 2007.

    Article  Google Scholar 

  6. Burgess, J. F., and Wilson, P. W., Hospital ownership and technical inefficiency. Manag. Sci. 42:110–123, 1996.

    Article  Google Scholar 

  7. Özcan, Y. A., Luke, R. D., and Haksever, C., Ownership and organizational performance: A comparison of technical efficiency across hospital types. Med. Care 30:781–794, 1992.

    Article  PubMed  Google Scholar 

  8. Lee, K.-H., Yang, S.-B., and Choi, M., The association between hospital ownership and technical efficiency in a managed care environment. J. Med. Syst. 33:307–315, 2009.

    Article  PubMed  Google Scholar 

  9. Tiemann, O., and Schreyögg, J., Effects of ownership on hospital efficiency in Germany. BUR-Bus. Res. 2(2):115–145, 2009.

  10. Lindlbauer, I., and Schreyögg, J., The relationship between hospital specialization and hospital efficiency: Do different measures of specialization lead to different results?. Health Care Manag. Sci. 1–14, 2014.

  11. Linna, M., and Häkkinen, U., Determinants of cost efficiency of Finnish hospitals. A comparison of DEA and SFA: Helsinki University of Technology. Syst. Anal. Lab., 1998.

  12. Lee, K.-s., Chun, K.-h., and Lee, J.-s., Reforming the hospital service structure to improve efficiency: Urban hospital specialization. Health Policy 87:41–49, 2008.

    Article  PubMed  Google Scholar 

  13. Herwartz, H., and Strumann, C., On the effect of prospective payment on local hospital competition in Germany. Health Care Manag. Sci. 15:48–62, 2012.

    Article  PubMed  Google Scholar 

  14. Flokou, A., Kontodimopoulos, N., and Niakas, D., Employing post-DEA cross-evaluation and cluster analysis in a sample of Greek NHS hospitals. J. Med. Syst. 35:1001–1014, 2011.

    Article  PubMed  Google Scholar 

  15. Dalmau-Atarrodona, E., and Puig-Junoy, J., Market structure and hospital efficiency: evaluating potential effects of deregulation in a National Health Service. Rev. Ind. Organ. 13:447–466, 1998.

    Article  Google Scholar 

  16. Sahin, I., and Özcan, Y. A., Public sector hospital efficiency for provincial markets in Turkey. J. Med. Syst. 24:307–320, 2000.

    Article  CAS  PubMed  Google Scholar 

  17. Ersoy, K., Kavuncubasi, S., Özcan, Y. A., and Harris, J. M., Technical efficiencies of Turkish hospitals: DEA approach. J. Med. Syst. 21:67–74, 1997.

    Article  CAS  PubMed  Google Scholar 

  18. Kontodimopoulos, N., Nanos, P., and Niakas, D., Balancing efficiency of health services and equity of access in remote areas in Greece. Health Policy 76:49–57, 2006.

    Article  PubMed  Google Scholar 

  19. Au, N., Hollingsworth, B., and Spinks, J., Measuring the efficiency of health services in lower‐income countries: The case of Papua New Guinea. Dev. Policy Rev. 32:259–272, 2014.

    Article  Google Scholar 

  20. Linna, M., Häkkinen, U., and Magnussen, J., Comparing hospital cost efficiency between Norway and Finland. Health Policy 77:268–278, 2006.

    Article  PubMed  Google Scholar 

  21. Özcan, Y. A., Efficiency of hospital service production in local markets: The balance sheet of US medical armament. Socio Econ. Plan. Sci. 29:139–150, 1995.

    Article  Google Scholar 

  22. Hajialiafzali, H., Moss, J. R., and Mahmood, M. A., Efficiency measurement for hospitals owned by the Iranian social security organisation. J. Med. Syst. 31:166–172, 2007.

    Article  PubMed  Google Scholar 

  23. Shahhoseini, R., Tofighi, S., Jaafaripooyan, E., and Safiaryan, R., Efficiency measurement in developing countries: application of data envelopment analysis for Iranian hospitals. Health Serv. Manag. Res. 24:75–80, 2011.

    Article  Google Scholar 

  24. Girginer, N., Köse, T., and Uçkun, N., Efficiency analysis of surgical services by combined use of data envelopment analysis and gray relational analysis. J. Med. Syst. 39:56, 2015.

  25. Deidda, M., Lupiáñez-Villanueva, F., Codagnone, C., and Maghiros, I., Using data envelopment analysis to analyse the efficiency of primary care units. J. Med. Syst. 38:122, 2014.

    Article  PubMed  Google Scholar 

  26. Jahangoshai, R. M., Moini, A., and Asgari, F. H. A., Unified performance evaluation of health centers with integrated model of data envelopment analysis and bargaining game. J. Med. Syst. 36(6):3805–3815, 2012.

    Article  Google Scholar 

  27. Mitropoulos, P., Mitropoulos, I., and Giannikos, I., Combining DEA with location analysis for the effective consolidation of services in the health sector. Comput. Oper. Res. 40(9):2241–2250, 2013.

    Article  Google Scholar 

  28. Torres-Jiménez, M., García-Alonso, C. R., Salvador-Carulla, L., and Fernández-Rodríguez, V., Evaluation of system efficiency using the Monte Carlo DEA: The case of small health areas. Eur. J. Oper. Res. 242(2):525–535, 2015.

    Article  Google Scholar 

  29. Cook, W. D., and Zhu, J., Within-group common weights in DEA: An analysis of power plant efficiency. Eur. J. Oper. Res. 178:207–216, 2007.

    Article  Google Scholar 

  30. Özcan, Y.A. Health care benchmarking and performance evaluation. Springer, 2008.

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Acknowledgments

We would like to thank Iranian Ministry of Health and Medical Education for their cooperation in providing the data needed for this academic research.

Conflict of interest

The authors have no conflict of interest about this research.

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Authors and Affiliations

  1. Urmia University of Technology, Urmia, West Azerbaijan, Islamic Republic of Iran

    Mustafa Jahangoshai Rezaee & Abuzar Karimdadi

Authors
  1. Mustafa Jahangoshai Rezaee
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  2. Abuzar Karimdadi
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Corresponding author

Correspondence to Mustafa Jahangoshai Rezaee.

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This article is part of the Topical Collection on Systems-Level Quality Improvement

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Rezaee, M.J., Karimdadi, A. Do Geographical Locations Affect in Hospitals Performance? A Multi-group Data Envelopment Analysis. J Med Syst 39, 85 (2015). https://doi.org/10.1007/s10916-015-0278-3

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  • DOI: https://doi.org/10.1007/s10916-015-0278-3

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