Analyzing the ambiguous relationship between efficiency, quality and patient satisfaction in healthcare services: The case of public hospitals in Turkey

Gök, Mehmet Şahin; Sezen, Bülent

doi:10.1016/j.healthpol.2013.05.010

Cited by 110 publications

(81 citation statements)

References 19 publications

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“…This study found a significant correlation between the technical efficiency and "unwanted dimensions of Quality". Gok and Sezen [24] measured the efficiency of 348 public hospitals in Turkey utilizing DEA method and analyzed the trade-off between quality and efficiency of healthcare service by multiple regression analysis. In the process of analysis, they took the efficiency values as explained variables and regarded healthcare service quality as explanatory variables.…”

Section: Introductionmentioning

confidence: 99%

Performance Measurement of Healthcare Service and Association Discussion between Quality and Efficiency: Evidence from 31 Provinces of Mainland China

2017

Sustainability

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Performance of healthcare service includes quality and efficiency, so there is inevitably an association between them. In general, it is believed that there is a trade-off between quality and efficiency; however, we prove that it is not completely accurate. We take the quality as an additional output to measure the healthcare service efficiency creatively, and discuss the association between quality and efficiency based on the effect of quality on relative efficiency. Firstly, we use TOPSIS method to calculate relative quality index values of healthcare service of 31 provinces of mainland China. This practice ensures the consistent comparison of 31 provinces' qualities. Subsequently, we measure the 31 provinces' relative performances and efficiencies of healthcare service with consideration of quality or not, by constructing DEA models. Then, we analyze the association between quality and efficiency from each group of the national, east, central and west, and conclude that the association between them is different along with their advantage degrees of quality and efficiency. Finally, we use the Tobit regression method to test 12 environment variables' net impacts on efficiency values both with consideration of quality or not. The results indicate that the main drivers of healthcare service efficiency are different when we take quality as an additional output or not. This article contributes to the field of performance measurement of healthcare service, puts forward a new method to integrate quality and efficiency and provides management guidelines.

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Section: Introductionmentioning

confidence: 99%

Performance Measurement of Healthcare Service and Association Discussion between Quality and Efficiency: Evidence from 31 Provinces of Mainland China

2017

Sustainability

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“…The common element of the one-stage approach and the congestion analysis is that quality is used to augment the production set. In contrast to these two approaches, other studies advocated using quality as an external variable, which is not part of the production process, but is helpful in explaining the differences in efficiency across health care providers [19][20][21][22][23][24][25]. These studies applied the two-stage approach by estimating the values of provider efficiency in the first stage without considering quality and then regressing the obtained efficiency estimates on quality in the second stage of analysis.…”

Section: Introductionmentioning

confidence: 99%

Using nonparametric conditional approach to integrate quality into efficiency analysis: empirical evidence from cardiology departments

Varabyova

Blankart

Schreyögg

2016

Health Care Manag Sci

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Standard-Nutzungsbedingungen:Die Dokumente auf EconStor dürfen zu eigenen wissenschaftlichen Zwecken und zum Privatgebrauch gespeichert und kopiert werden.Sie dürfen die Dokumente nicht für öffentliche oder kommerzielle Zwecke vervielfältigen, öffentlich ausstellen, öffentlich zugänglich machen, vertreiben oder anderweitig nutzen.Sofern die Verfasser die Dokumente unter Open-Content-Lizenzen (insbesondere CC-Lizenzen) zur Verfügung gestellt haben sollten, gelten abweichend von diesen Nutzungsbedingungen die in der dort genannten Lizenz gewährten Nutzungsrechte. In the past decades, hospitals have been facing pressure to increase the efficiency of resource allocation. One way to achieve higher levels of technical efficiency is to treat more patients with the same amount of personnel, which could potentially lead to a trade-off between improving efficiency and maintaining good patient service. The aim of this study is to demonstrate how the nonparametric conditional approach can be used to integrate quality into the analysis of efficiency. The conditional approach allows investigating the mechanism through which quality enters the production process. Generally, an external variable may enter the production process by affecting either the attainable frontier or the distribution of inefficiencies inside the production set. To account for the heterogeneity of hospital services, we focus on a hospital department as the unit of analysis. We use data from 178 departments of interventional cardiology and consider three different measures of quality: patient satisfaction, risk-adjusted mortality, and patient radiation exposure. Our empirical assessment shows that the impact of quality on the production process differs according to the utilized quality measure. Patient satisfaction does not affect the attainable frontier but does have an inverted -shaped effect on the distribution of inefficiencies; risk-adjusted mortality negatively impacts the attainable frontier at high values of mortality but does not impact the distribution of inefficiencies; and patient radiation exposure is not associated with the production process. Our results refute the existence of a clear trade-off between efficiency and quality. The conditional approach can be applied to deal with the complexity of the underlying relationships between efficiency and quality. Terms of use: Documents in

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“…As iniciativas foram analisadas a partir do impacto que elas causam sobre os processos, a partir das ações necessárias para gerar resultados significativos. Tiveram como premissa: a) Aumento de produtividade(9-12); b) Aumento do nível de satisfação dos pacientes (11,(13)(14)(15)(16) …”

Section: Métodosunclassified

“…O Mundo da Saúde, São Paulo -2017;41(1): [11][12][13][14][15][16][17] As entrevistas buscaram associar as entradas com os resultados alcançados. O Quadro 2 apresenta os resultados do estudo, de acordo com as respostas apresentadas pelos hospitais.…”

Section: Acreditação Hospitalar E Seus Impactos Nas Boas Práticas Em unclassified

Acreditação hospitalar e seus impactos nas boas práticas em serviços da saúde

Terra

Berssaneti

2017

Mundo da Saúde

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ResumoO sistema de saúde brasileiro vem passando por profundas transformações. As instituições hospitalares têm adotado programas de gestão de qualidade com o objetivo de melhorar, continuamente, seus processos, produtos e serviços, utilizando a acreditação como metodologia de avaliação externa da qualidade em serviços de saúde. Este artigo analisa os impactos gerados pela acreditação na criação das boas práticas da qualidade em serviços da saúde. Utiliza a abordagem qualitativa, com estudos de múltiplos casos, realizados em cinco hospitais distintos, no período de novembro de 2015 a fevereiro de 2016, através de entrevistas e com o auxílio de questionário semiestruturado. Os resultados mostram que o apoio da alta direção é relevante para os processos de melhoria contínua e para o aumento da produtividade nos serviços e que os níveis de segurança dos pacientes estão relacionados com as melhorias na qualidade do atendimento. Conclui-se que as boas práticas da qualidade em serviços da saúde nos hospitais, quando associada à acreditação, proporciona aumento da produtividade, maior satisfação ao paciente e agrega valor à instituição.Palavras-chave: Acreditação hospitalar. Análise qualitativa. Gestão da qualidade. Produtividade. Serviços de saúde. AbstractThe Brazilian health system has undergone profound transformations. Hospital institutions have been adopting quality management programs with the objective of continuously improving their processes, products and services, using accreditation as methodology for the external evaluation of quality in health services. This article analyzes the impacts generated by this accreditation in the creation of good quality practices in health services. It uses a qualitative approach, with multiple case studies, conducted in five different hospitals, from November 2015 to February 2016, through interviews and with the aid of a semi-structured questionnaire. The results show that upper management support is relevant to the processes of continuous improvement, and to increase productivity in services. Also, patient safety levels are related to improvements in the quality of care. It is concluded that good quality practices in health services in hospitals, when associated with accreditation, increase productivity, increase patient satisfaction and add value to the institution.

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Analyzing the ambiguous relationship between efficiency, quality and patient satisfaction in healthcare services: The case of public hospitals in Turkey

Cited by 110 publications

References 19 publications

Performance Measurement of Healthcare Service and Association Discussion between Quality and Efficiency: Evidence from 31 Provinces of Mainland China

Performance Measurement of Healthcare Service and Association Discussion between Quality and Efficiency: Evidence from 31 Provinces of Mainland China

Using nonparametric conditional approach to integrate quality into efficiency analysis: empirical evidence from cardiology departments

Acreditação hospitalar e seus impactos nas boas práticas em serviços da saúde

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