Efficiency assessment of primary care providers: A conditional nonparametric approach

Ferrera, José Manuel Cordero; Alonso-Morán, Edurne; Nuño-Solinís, Roberto; Orueta, Juan F.; Arce, Regina Sauto

doi:10.1016/j.ejor.2014.06.040

Cited by 53 publications

(34 citation statements)

References 105 publications

(85 reference statements)

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“…Since the seminal work by Charnes et al (1978), applications of efficiency models have emerged in various sectors, ranging from health care (e.g. Cordero et al 2015), water (Cherchye et al 2014), banking (Puri et al 2017), public sector (De Witte and Geys 2013), farming (Asmild et al 2016) or energy (e.g. Chen et al 2017;Hampf et al 2015).…”

Section: Introductionmentioning

confidence: 99%

Managerial efficiency and efficiency differentials in adult education: a conditional and bias-corrected efficiency analysis

2019

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In efficiency studies, inputs and outputs are often noisy measures, especially when education data is used. This article complements the conditional efficiency model by correcting for bias within conditional draws, using the m out of n bootstrap procedure. With a unique panel dataset, we estimate managerial efficiency, which accounts for nondiscretionary variables, and explain efficiency differentials of adult education programs in Flanders. Our results suggest that the characteristics of learners in a program matter for managerial efficiency, and that teacher characteristics are strongly correlated with efficiency differentials, as more homogeneity in the teacher workforce appears to result in higher program efficiency.

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Section: Introductionmentioning

confidence: 99%

Managerial efficiency and efficiency differentials in adult education: a conditional and bias-corrected efficiency analysis

2019

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“…Classical DEA models rely on the assumption that inputs have to be minimized while outputs have to be maximized [ 12 ]. However in health care, one or more outputs -called undesirable outputs- have to be minimized [ 13 ]. Even more, according to [ 14 ] considering such variables, in efficiency analysis, have paved the way for more thorough assessments.…”

Section: Methodsmentioning

confidence: 99%

Strategies for the quality assessment of the health care service providers in the treatment of Gastric Cancer in Colombia

Villamil

Barrera

Velasco

et al. 2017

BMC Health Serv Res

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BackgroundWhile, at its inception in 1993, the health care system in Colombia was publicized as a paradigm to be copied across the developing world, numerous problems in its implementation have led to, what is now, an inefficient and crisis-ridden health system. Furthermore, as a result of inappropriate tools to measure the quality of the health service providers, several corruption scandals have arisen in the country. This study attempts to tackle this situation by proposing a strategy for the quality assessment of the health service providers (Entidades Promotoras de Salud, EPS) in the Colombian health system. In particular, as a case study, the quality of the treatment of stomach cancer is analyzed.MethodsThe study uses two complementary techniques to address the problem. These techniques are applied based on data of the treatment of gastric cancer collected on a nation-wide scale by the Colombian Ministry of Health and Welfare. First, Data Envelopment Analysis (DEA) and the Malmquist Index (MI) are used to establish the most efficient EPS’s within the system, according to indicators such as opportunity indicators. Second, sequential clustering algorithm, related to process mining a field of data mining, is used to determine the medical history of all patients and to construct typical care pathways of the patients belonging to efficient and inefficient EPS’s. Lastly, efforts are made to identify traits and differences between efficient and inefficient EPS’s.ResultsEfficient and inefficient EPS were identified for the years 2010 and 2011. Additionally, a Malmquist Index was used to calculate the relative changes in the efficiency of the health providers. Using these efficiency rates, the typical treatment path of patients with gastric cancer was found for two EPSs: one efficient and another inefficient. Finally, the typical traits of the care pathways were established.ConclusionsCombining DEA and process mining proved to be a powerful approach understanding the problem and gaining valuable insight into the inner workings of the Colombian Health System, especially in terms of the treatment process performed by health care providers in critical illnesses such as cancer. However, no sufficiently compelling results were found to establish the contribution of such a combination to evaluate the quality in the delivery of health services.

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“…As a result, the conditional approach has become very popular in the recent literature on efficiency measurement. Hence, studies using this approach to measure efficiency are available in multiple frameworks (Bonaccorsi et al ., ; Cherchye et al ., ; De Witte and Geys, ; Halkos and Tzeremes, ; Haelermans and De Witte, ; Verschelde and Rogge, ; De Witte and Kortelainen, ; Cordero et al ., , ). However, we should note that there is not widely available software to conduct conditional DEA so far.…”

Section: Methodsmentioning

confidence: 99%

Monte‐Carlo Comparison of Conditional Nonparametric Methods and Traditional Approaches to Include Exogenous Variables

Ferrera

Polo

Santín

et al. 2016

Pacific Economic Review

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The aim of this paper is to compare the performance of the conditional nonparametric approach with several traditional nonparametric methods to incorporate the effect of exogenous or environmental variables into the estimation of efficiency measures. To do this, we conduct a Monte Carlo experiment using a translog production function with one output, two discretionary inputs and two exogenous variables to generate simulated data. According to the values of different accuracy measures calculated to evaluate the performance of each method, the conditional data envelopment analysis clearly outperforms all the traditional alternatives.1 There is also another body of literature dealing with those variables in stochastic frontier analysis such as the traditional model developed by Battese and Coelli (1995) or the recent semi-parametric approaches proposed by Kuosmanen (2011, 2012).

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Efficiency assessment of primary care providers: A conditional nonparametric approach

Cited by 53 publications

References 105 publications

Managerial efficiency and efficiency differentials in adult education: a conditional and bias-corrected efficiency analysis

Managerial efficiency and efficiency differentials in adult education: a conditional and bias-corrected efficiency analysis

Strategies for the quality assessment of the health care service providers in the treatment of Gastric Cancer in Colombia

Monte‐Carlo Comparison of Conditional Nonparametric Methods and Traditional Approaches to Include Exogenous Variables

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