Assessing physician productivity following Norwegian hospital reform: A panel and data envelopment analysis

Johannessen, Karl-Arne; Kittelsen, Sverre A.C.; Hagen, Terje P.

doi:10.1016/j.socscimed.2017.01.008

Cited by 38 publications

(22 citation statements)

References 72 publications

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“…A recent study conducted by Johannessen et al (2017), investigated the impact of several political reforms of the Norwegian hospital sector occurred since 2002. All public hospitals were transferred from a system of county ownership to central government ownership.…”

Section: Discussionmentioning

confidence: 99%

“…In so doing, the government expected to increase hospital efficiency by providing greater autonomy with respect to planning, budgeting and workforce policies of the health units (Hagen and Kaarboe, 2006). Johannessen et al (2017) used a non-parametric DEA model and panel analyses to study the overall physician productivity. Their results showed that, in spite of comprehensive governmental efforts, there was a significant variation in productivity among the country's hospitals, along with a noticeable decline in physician productivity.…”

Section: Discussionmentioning

confidence: 99%

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A model for multidimensional efficiency analysis of public hospital management

2017

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Introduction: Multidimensional efficiency analysis can provide important insights into the performance of hospitals.In this paper, we propose a multidimensional model based on Data Envelopment Analysis (DEA) to investigate and compare the efficiency of public hospitals in Brazil. Methods: Data from 21 public hospitals were collected from public databases (OECD -Organization for Economic Co-operation and Development; SIH-SUS -SUS Hospital Information System, Datasus, Brazil). Four inputs (Number of medical and non-medical staff, Annual revenue, Number of beds, Average length of patient hospitalization), four Variables of Influence (Type of hospital, Accredited hospital, Number of medical specialties, Resources from government) and four Outputs (Number of outpatient care services, Number of hospitalizations, Number of surgeries, Number of exams) were used to feed the DEA model. Results: Seven hospital units reach 100% efficiency and, according to DEA, can be considered efficient units. Two units were considered "almost efficient" and the remaining twelve units perform poorly, considering the data supplied to the DEA model. As a whole, the average efficiency of the hospitals investigated was 79% (0.79). Conclusion: A very heterogeneous performance has been found among the Brazilian public hospitals investigated. Besides, the reasonably low average efficiency seems to indicate that the system has a large potential for improvement in almost all areas associated with the input and output variables investigated in this paper.Keywords Hospital efficiency, Data Envelopment Analyses, Public hospital.This is an Open Access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.How to cite this article: Soares AB, Pereira AA, Milagre ST. A model for multidimensional efficiency analysis of public hospital management.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

A model for multidimensional efficiency analysis of public hospital management

2017

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“…Rather than analysing changes at macro level, Johannessen et al, (13) analysed the effects of the reforms on the labour levels between 2001 and 2013. They found that that in general, the number of patients treated increased by 47% and DRG scores increased by 35%, indicating that more and sicker patients were being treated.…”

Section: Literature Reviewmentioning

confidence: 99%

Biased Technical Change in Hospital Care and the Demand for Physicians

Blank

Niaounakis

Valdmanis

2020

Preprint

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Background The development of labour productivity is relevant for accurately planning future staffing requirements, especially in sectors where technological developments may drive labour substitution. The present study investigates how labour productivity has developed across Dutch medical specialists (2007-2017) and discusses its implications for workforce planning, also in relation to the existing literature.Methods A regression model is developed in which the number of full-time equivalents is related to production (admissions), hospital characteristics and a trend parameter. The trend parameter captures the average annual change in the number of full-time equivalents per production output and is a measure for labour productivity. The model is applied to a micro-data set of Dutch hospitals in the period 2007-2017 across 24 different specialties using regression methods. Results The results indicate an increase in the number of full-time equivalents per admission has increased for most specialisms and that labour productivity has thus decreased. However, there is considerable heterogeneity and uncertainty across different specialisms.Conclusions The results amplify the issue of medical personnel shortages driven by the growing demand for health care. The research outcomes are linked to the existing literature regarding physicians’ productivity. Changes in accountability such as using relative value units, incentive payments, use of staff and mid-level providers, and technology have been discussed and some consensus has been reached.

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“…The DEA method was first proposed by Charnes et al [12] as a mathematical programming method to evaluate the relative efficiency of decision-making units (DMUs) with multiple inputs and outputs variables. Although some papers have used the DEA method to solve productivity-related issues, no research utilized this method to deal with the evaluation of dredging productivity [13][14][15][16][17]. This paper extends the DEA method to propose a novel dredging productivity evaluation method, solving the issues that are related to the evaluation of dredging productivity.…”

Section: Introductionmentioning

confidence: 99%

A Novel Method for Evaluating Dredging Productivity Using a Data Envelopment Analysis‐Based Technique

Lai

Chang

Lin³

2019

Mathematical Problems in Engineering

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The increase in the frequency of extreme weather has caused the impact of natural disasters to become more extensive. Natural disasters reduce the effective storage capacity of reservoirs and affect their normal function. Reservoir dredging is a key issue in the management of water resources and is a complicated multiple-attribute decision-making (MADM) problem. The traditional assessment of dredging productivity has been performed using a labor productivity method to evaluate the related issues of dredging performance. However, the traditional labor productivity method only deals with the single-input/single-output evaluation factor for various forms of productivity. The traditional labor productivity method cannot address complicated MADM problems in the assessment of dredging productivity. To resolve the limitations of the traditional labor productivity method, this paper extended data envelopment analysis (DEA) and proposed a novel method for evaluating dredging productivity. The proposed method can handle various combinations of evaluation factors (single-input, multi-input, single-output, and multioutput). Three real cases of reservoir dredging are applied to verify the effectiveness of the proposed method. The simulation results show that the proposed method can be applied generally and correctly assesses the related issues of dredging performance.

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Assessing physician productivity following Norwegian hospital reform: A panel and data envelopment analysis

Abstract: Our measures of physician productivity declined from 2001 to 2013. More support staff was a significant variable for predicting physician productivity. Personnel mix developments in the study period were unfavorable with respect to physician productivity.

Cited by 38 publications

References 72 publications

A model for multidimensional efficiency analysis of public hospital management

A model for multidimensional efficiency analysis of public hospital management

Biased Technical Change in Hospital Care and the Demand for Physicians

A Novel Method for Evaluating Dredging Productivity Using a Data Envelopment Analysis‐Based Technique

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