Effects of Ownership on Hospital Efficiency in Germany.

Tiemann, Oliver; Schreyögg, Jonas

doi:10.5465/ambpp.2009.44257961

Cited by 11 publications

(8 citation statements)

References 34 publications

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“…Obviously, the reported analysis results and differences regarding the distinction between general technological progress ("frontier shift") and its use on the one hand and the individual organizational reasons for efficiency changes ("catch-up") on the other hand for universities are interesting and should be studied further. In addition, in-depth analysis is required in terms of resource and organizational consequences of such efficiency development results for universities as done, e.g., in the health care or service sector [102,103]. For example, it can be questioned if an institution or a department should receive unequivocal research or teaching funding when long-term negative developments of efficiency are recognized.…”

Section: Discussionmentioning

confidence: 99%

The Index Number Problem with DEA: Insights from European University Efficiency Data

Klumpp

2018

Education Sciences

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An increasing effort has been put into dealing with the question of time-series analysis regarding institutional efficiency, including in the area of higher education. Universities are important institutions for economies and societies and are expected to provide excellence as well as efficiency in their processes and outputs. This is reflected in the context of an increased global competitive environment by more refined international university rankings. Combining the two areas, this paper points towards a methodological challenge in comparing different ranking datasets for their use in a data envelopment analysis (DEA) Malmquist index time-series efficiency analysis, namely, index-based data compared to additive data. The problem is discussed in a theoretical framework and complemented with an empirical application: calculations for 70 European universities with budget and staff input data and different ranking output data for the timeframe of 2011-2016 show that there is no evidence for a specific index data problem. Important implications regarding university management and higher education policies are outlined. Efficiency improvements among the analyzed universities are significant but also unevenly distributed and not easy to obtain for individual institutions.

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Section: Discussionmentioning

confidence: 99%

The Index Number Problem with DEA: Insights from European University Efficiency Data

Klumpp

2018

Education Sciences

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“…Thus, some studies treated quality as an additional freely (or strongly) disposable output of the efficiency model [3][4][5][6][7][8][9][10][11], applying the so-called one-stage approach [12]. These studies often performed some transformation to the quality measures in order to represent the idea that more is better for the production of outputs (e.g., mortality rate would be transformed to inverse mortality).…”

Section: Introductionmentioning

confidence: 99%

“…Thus, previous studies relied on the indicators of outcome quality (e.g., mortality rate [3,7,8,10,20], hospital-acquired infections [14,16], and readmissions [17]), process quality (e.g., acute myocardial infarction (AMI) patients who received aspirin within 24 hours of arrival [11]), structural quality (e.g., extra nursing hours [4]), and patient experience (e.g., patient satisfaction [5]) as well as various combinations of multiple quality measures. However, different measures of quality may have a different relationship to efficiency.…”

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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“…KH mit einer ungünstigen Kostenstruktur verzeich nen Verluste, während Einrichtungen mit einem unterdurchschnittlichen Ressourceneinsatz Ge winne erzielen können. Die Einführung des DRG Systems und die damit verbundene Rationalisie rung führten zu einer spürbaren Effizienzsteige rung [3]. [7,8].…”

Section: Introductionunclassified