Efficiency analysis of emergency departments in metropolitan areas

Abstract

The demand in the healthcare industry is increasing exponentially due to aging population of the world and this is leading to a rapid increase in the cost of healthcare. The emergency departments of the hospitals are the frontline of health care systems and play an additional critical role in providing an efficient and high-quality response for patients. The overcrowding at the emergency departments due to growing demand results in a situation where the demand for ED services exceeds the ability to provide care in a reasonable amount of time. This has led countries to reconsider their health policies in a way to increase their efficiency in their healthcare systems in general and in emergency departments, in particular. As in many countries, there has been a steady and significant increase in the number of patients that seek health services at the emergency departments of state hospitals of Turkey, due to the significant structural reforms in health services since 2003. While meeting this increasing demand, it is ever more important to provide these critical health services efficiently. Therefore, the efficiency of the emergency departments of seven general hospitals run by Istanbul's Beyoglu State Hospitals Association have been analyzed using categorical Data Envelopment Analysis (DEA) models. The analysis of DEA results is supported by a set of statistical methods to make it easier for the hospital administrators to interpret the analysis and draw conclusions. The analysis shows that less-equipped EDs are supported by better equipped, larger EDs, resulting in a hub-and-spoke type of structure among the EDs where "satellite" EDs serve an important referral function and thus evaluating their efficiency without taking the interoperability among these units into account would not be an accurate assessment of their performance.

A Sample of The Relationship Between The Non-Integrated Healthcare System And National Epidemic of Emergency Department Overcrowding In Turkey

“…Various studies report rates ranging from 4.8-90.0%, as the de nition of non-urgent or inappropriate emergency room visits differs worldwide (1,13,14). In addition to those patients in critical condition, patients who should usually be treated in ambulatory tend to go to emergency services to accelerate their treatment process (15). Certain hospitallevel factors such as the availability of acute beds and emergency department admission procedures have been shown to drive geographical variation in potentially avoidable emergency department visits (16).…”

Economic Evaluation, Use of Renewable Energy, and Sustainable Urban Development Mamminasata Metropolitan, Indonesia

“…Thus, energy resources have the potential to become a source of investment, supply industrial raw materials, fulfill the transportation sector's fuel needs, and drive regional economic growth. One of the most effective ways to achieve sustainability targets, toward the use of renewable energy, is to reduce energy consumption [48,49]. The scarcity of non-renewable energy resources and the increasing demand require the use of renewable energy.…”

Türkiyedeki Hidroelektrik Santrallerin Etkinliklerinin Veri Zarflama Analizi (VZA) ile Değerlendirilmesi

“…Considering the current studies on DEA, it can be seen that it is applied to the following fields: measure to efficiency radiotherapy treatments (Ehrgott et al 2018), measure to efficiency of collective floodplain aquaculture (Bayazid et al 2019), analysis of efficiency and production volume in an armament manufacturer (de Souza et al 2018), identifying efficient construction sites in terms of safety (Nahangi et al 2019), hotels performance evaluation (Ang et al 2018), efficiency in the environmental management of plastic wastes (Gobbi et al 2019), identification of efficient dairy farms (Siafakas et al 2019), efficiency in the Brazilian banking system (Henriques et al 2018), evaluating the sustainability of national logistics performance (Rashidi and Cullinane 2019), regional tourism efficiency (Chaabouni 2019), assessment of the Global Food Security Index (Chen et al 2019), assessing China's agricultural water use efficiency (Geng et al 2019), eco-efficiency of centralized wastewater treatment plants in industrial parks (Hu et al 2019), inventory-related costs in green supplier selection (Dobos and Vörösmarty 2019), the university teaching performance evaluation (Zhang and Shi 2019), outsourcing performance quality assessment (Pournader et al 2019), performance measurement of Turkish electric distribution companies (Petridis et al 2019), efficiency analysis of emergency departments (Akkan et al 2019). Studies conducted on energy using DEA method are given in As can be seen in Table 1, there are so many studies conducted on the energy field using DEA method.…”