Productivity and quality changes in Greek public hospitals

Karagiannis, Roxani; Velentzas, Kostas

doi:10.1007/s12351-010-0080-4

Cited by 16 publications

(9 citation statements)

References 18 publications

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“…MTFP change was the highest in 2008 (MTFP = 1.008) and the lowest in 2007 (MTFP = 0.963). The Botswana district hospitals average MTFP score of 0.985 was comparable to those obtained in Montreal Canada of 0.92 [17], China Inland of 0.9853 [21], Greece of 0.986-0.988 [23], Ireland County of 0.977 [19], South Africa of 0.879 [14] and Taiwan of 0.7877 [25]. Unlike Botswana, a number of countries hospitals had an average MTFP score greater than one signifying productivity growth: Angola municipal hospitals had 1.045 [8]; Brazilian Federal University hospitals had 1.209 [24]; China coastal hospitals had 1.1307 [21]; India district hospitals had 1.2358 [20]; Ireland regional hospitals had 1.028 [19]; and Portugal hospitals had 1.042 [18].…”

Section: Resultsmentioning

confidence: 60%

Assessment of productivity of hospitals in Botswana: a DEA application

Tlotlego¹,

Nonvignon²,

Sambo³

et al. 2010

Int Arch Med

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BackgroundBotswana national health policy states that the Ministry of Health shall from time to time review and revise its organization and management structures to respond to new developments and challenges in order to achieve and sustain a high level of efficiency in the provision of health care. Even though the government clearly views assuring efficiency in the health sector as one of its leadership and governance responsibilities, to date no study has been undertaken to measure the technical efficiency of hospitals which consume the majority of health sector resources. The specific objectives of this study were to quantify the technical and scale efficiency of hospitals in Botswana, and to evaluate changes in productivity over a three year period in order to analyze changes in efficiency and technology use.MethodsDEAP software was used to analyze technical efficiency along with the DEA-based Malmquist productivity index which was applied to a sample of 21 non-teaching hospitals in the Republic of Botswana over a period of three years (2006 to 2008).ResultsThe analysis revealed that 16 (76.2 percent), 16 (76.2 percent) and 13 (61.9 percent) of the 21 hospitals were run inefficiently in 2006, 2007 and 2008, with average variable returns to scale (VRS) technical efficiency scores of 70.4 percent, 74.2 percent and 76.3 percent respectively. On average, Malmquist Total Factor Productivity (MTFP) decreased by 1.5 percent. Whilst hospital efficiency increased by 3.1 percent, technical change (innovation) regressed by 4.5 percent. Efficiency change was thus attributed to an improvement in pure efficiency of 4.2 percent and a decline in scale efficiency of 1 percent. The MTFP change was the highest in 2008 (MTFP = 1.008) and the lowest in 2007 (MTFP = 0.963).ConclusionsThe results indicate significant inefficiencies within the sample for the years under study. In 2008, taken together, the inefficient hospitals would have needed to increase the number of outpatient visits by 117627 (18 percent) and inpatient days by 49415 (13 percent) in order to reach full efficiency. Alternatively, inefficiencies could have been reduced by transferring 264 clinical staff and 39 beds to health clinics, health posts and mobile posts. The transfer of excess clinical staff to those facilities which are closest to the communities may also contribute to accelerating progress towards the Millennium Development Goals related to child and maternal health.Nine (57.1 percent) of the 21 hospitals experienced MTFP deterioration during the three years. We found the sources of inefficiencies to be either adverse change in pure efficiency, scale efficiency and/or technical efficiency.In line with the report Health financing: A strategy for the African Region, which was adopted by the Fifty-sixth WHO Regional Committee for Africa, it might be helpful for Botswana to consider institutionalizing efficiency monitoring of health facilities within health management information systems.

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Section: Resultsmentioning

confidence: 60%

Assessment of productivity of hospitals in Botswana: a DEA application

Tlotlego¹,

Nonvignon²,

Sambo³

et al. 2010

Int Arch Med

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“…So considering limitation of resources and possibilities and ever-increasing level of products and services use 'maximum use of present possibilities is one of the most important possible solutions to decreasing the gap between demand and offer. In the present situation more profitability and efficient use of the present possibilities has practically exceeded a choice and has changed in a necessity (Karagiannis and Velentzas, 2010).…”

Section: Introductionmentioning

confidence: 99%

The Evaluation of Relative Efficiency of Teaching Hospitals

H.¹

2012

American Journal of Applied Sciences

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Problem statement: The main purpose of applying practical and scientific ways to evaluate the hospitals performance and activities the optimal use of physical facilities technology and the present human power. One the scientific way used for this purpose is using economic analysis and tools one of which is to determining hospitals technical efficiency the present study tries to determine the efficiency of the use of resources in teaching hospitals. Approach: The present study is a survey one. First considering the type of the research Decision Making Units (DMUs) of teaching hospitals of Tehran University of medical Sciences was chosen. Then considering previous similar studies and surveying the experts, input variables (1) the number of the physicians (2) the number of practicing nurse in health facilities (3) the number of active beds) and output variables (1) the number of the inpatients (2). The number of the outpatients and (3) the average length of stay) were determined and the data needed were gathered. The results of the research were examined using GAMS software and the data were analysed. Considering the society under the research the suitable model to evaluate efficiency is CCR model. The evaluation was conducted based on both in input CCR model and in output orientation approach. The results of the two methods were compared and analysed. Results: The results of the study show that the average technical efficiency of the teaching hospitals of Tehran University of medical sciences in 2010 considering variable efficiency was 0.958% and most of the teaching hospitals 56.29% were 100% efficient. Conclusion: Efficient managers of health and treatment centres using Data Envelopment Analysis (DEA) are able through controlling efficiency and production of the hospital to reduce the cost and devote more money to developing health-treatment cares.

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“…Their results suggest that productivity changes were dominated by the technology change while hospital's inefficiency was attributed to an excessive increase of their operational costs. In another study, Karagiannis and Velentzas examine the changes in hospital productivity and quality of eight rural hospitals for the period 2002 to 2007. Their empirical results indicate an average deterioration both in productivity and in quality.…”

Section: Measuring Hospital Productivitymentioning

confidence: 99%

The impact of economic crisis on the Greek hospitals' productivity

Mitropoulos

Karanikas

et al. 2017

Health Planning & Management

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During the recent economic crisis, Greece implemented a comprehensive reform in the health care system. The 2010 health reform occurred under the constraints imposed by the memorandum of understanding that the Greek Government signed with its EU/International Monetary Fund creditors to control its deficit. The objective of the study is to examine the impact of the reform on the efficiency and productivity of public hospitals in Greece. We use the Malmquist productivity index to comparatively examine the potential changes before and after the reform years. We compare productivity, efficiency, and technological changes using panel data of 111 public acute hospitals operating in Greece throughout the recession period of 2009 to 2012. Bootstrapping methods are applied to allow for uncertainty owing to sampling error and for statistical inference for the Malmquist productivity index and its decompositions. The analysis indicates that the productivity has been increased following the policy changes. It appears that the expected benefits from the reform in general have been achieved, at least in the short-term. This result is examined in the light of management and operations activities, which are related with the reform process. Therefore, at a second stage, the Malmquist index is regressed on variables that may potentially be statistically associated with productivity growth.

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Productivity and quality changes in Greek public hospitals

Cited by 16 publications

References 18 publications

Assessment of productivity of hospitals in Botswana: a DEA application

Assessment of productivity of hospitals in Botswana: a DEA application

The Evaluation of Relative Efficiency of Teaching Hospitals

The impact of economic crisis on the Greek hospitals' productivity

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