The Cost Efficiency of Turkish Hospitals: A Stochastic Frontier Analysis

Atilgan, Emre; Çalişkan, Zafer

doi:10.3848/iif.2015.355.4448

Cited by 7 publications

(9 citation statements)

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“…DEVINX found to be positive and significant in both models. This indicates that, similar to the findings of Atilgan & Çalişkan (2015), the hospitals which are located in more developed regions are more inefficient than the ones in the less developed regions. The coefficient of ROLE BERJ (7) 2 2016 is negative and significant in both models, implying that the rise in the hospitals' role group increases the efficiency scores.…”

Section: Estimation Resultssupporting

confidence: 78%

The Technical Efficiency of Hospital Inpatient Care Services: An Application for Turkish Public Hospitals

Atilgan¹

2016

berj

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In this study, the efficiency analysis of Turkish Ministry of Health (MoH) hospitals' inpatient care services is done by using the Stochastic Frontier Analysis (SFA) method. In the analysis, cross-sectional data on 459 acutecare hospitals in 2013 were used and the sample was consisted of only MoH general and teaching hospitals. A cross sectional version of SFA inefficiency efeects model speciiccation is used to estimate the inpatient care service production efficiency. The results of this paper suggest that, the technical inefficiency of inpatient care services of MoH hospitals is closely related with the hospital size. As the hospital capacity decreases or/and the role group of the hospital lowers down, the hospital efficiency scores reduces signiiccantly. The other important icnding of this paper is that the efficiency scores are inversely related with the socioeconomic development level of the region or province where the hospital is located. The mean efficiency scores decreases in the western part of the Turkey which has the regions that are socioeconomically more developed and more populated compared to the others.

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Section: Estimation Resultssupporting

confidence: 78%

The Technical Efficiency of Hospital Inpatient Care Services: An Application for Turkish Public Hospitals

Atilgan¹

2016

berj

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“…Outputs include health services provided (e.g., number of surgeries performed). [33] Guided by our literature review on e ciency analysis, [13,[34][35][36][37][38][39] we included as many input and output variables as possible. Speci cally, length of stay, inpatient admissions, outpatient visits, emergency visits, annual family visits, revenues, number of surgeries and number of discharges from hospital.…”

Section: Study Variablesmentioning

confidence: 99%

“…Moreover, facility type was also found to be an useful predictor of hospital e ciency whereby facilities operating at a large scale may realize greater technical e ciency due to increasing returns to scale. [30] Third, a higher mortality rate (low quality health services) was found to raise the costs of the hospitals [34] and thereby to erode hospital e ciency. Fourth, shorter average lengths of stay was expected to improve the use of medical beds and enhance e ciency.…”

Section: Study Variablesmentioning

confidence: 99%

Can Integrated Care Improve the Efficiency of Hospitals? - Research based on 200 Hospitals in China

Peng

Zhu

Wan

et al. 2020

Preprint

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Abstract Backgrounds: The shift towards integrated care (IC) represents a global trend towards more comprehensive and coordinated systems of care, particularly for vulnerable populations, such as the elderly. When health systems face fiscal constraints, integrated care has been advanced as a potential solution by simultaneously improving health service effectiveness and efficiency. This paper addresses the latter. There are three study objectives: first, to compare efficiency differences between IC and non-IC hospitals in China; second, to examine variations in efficiency among different types of IC hospitals; and finally, to explore whether the implementation of IC impacts hospital efficiency. Methods This study uses Data Envelopment Analysis (DEA) to calculate efficiency scores among a sample of 200 hospitals in H Province, China. Tobit regression analysis was performed to explore the influence of IC implementation on hospital efficiency scores after adjustment for potential confounding. Moreover, the association between various input and output variables and the implementation of IC was investigated using regression techniques. Results The study has four principal findings: first, IC hospitals, on average, are shown to be more efficient than non-IC hospitals after adjustment for covariates. Holding output constant, IC hospitals are shown to reduce their current input mix by 12% and 4% to achieve optimal efficiency under constant and variable returns-to-scale, respectively, while non-IC hospitals have to reduce their input mix by 26% and 20% to achieve the same level of efficiency; second, with respect to the efficiency of each type of IC, we show that higher efficiency scores are achieved by administrative and virtual IC models over a contractual IC model; third, we demonstrate that IC influences hospitals efficiency by impacting various input and output variables, such as length of stay, inpatient admissions, and staffing; fourth, while bed density per nurse was positively associated with hospital efficiency, the opposite was shown for bed density per physician. Conclusions Integrated Care has the potential to promote hospital efficiency by influencing an array of input and output variables. Policies designed to facilitate the implementation of IC in hospitals need to be cognizant of the complex way IC impacts hospital efficiency.

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“…Following Linna and Häkkinen (2006), Rosko and Mutter (2008) and Atilgan and Çalişkan (2015), the mortality rates are used as a proxy for quality of health care and this variable is named MORT. As there is a lack of data, risk adjusted mortality rates could not be used, which would be a much better proxy for quality measurement in the analysis.…”

Section: Control Variablesmentioning

confidence: 99%

“…Sahin and Ozcan (2000); Özgen, Sahin, and Gülcü (2008); Sahin (2009) ;Sahin, Ozcan, and Ozgen (2011)). Atilgan and Çalişkan (2015) and Atilgan (2015)are the pioneer studies that use the Stochastic Frontier Analysis for evaluation Turkish hospital efficiencies.…”

Section: Introductionmentioning

confidence: 99%

Technical Efficiency of Turkish Public Hospitals’ Intensive Care Units: Multiple Input – Output Technologies and Distance Functions

Atilgan

2016

Yönetim Ve Ekonomi Araştırmaları Dergisi

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The Cost Efficiency of Turkish Hospitals: A Stochastic Frontier Analysis

Cited by 7 publications

References 0 publications

The Technical Efficiency of Hospital Inpatient Care Services: An Application for Turkish Public Hospitals

The Technical Efficiency of Hospital Inpatient Care Services: An Application for Turkish Public Hospitals

Can Integrated Care Improve the Efficiency of Hospitals? - Research based on 200 Hospitals in China

Technical Efficiency of Turkish Public Hospitals’ Intensive Care Units: Multiple Input – Output Technologies and Distance Functions

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