Approaching the Management of Hospital Units With An Operation Research Technique: The Case of 32 Greek Obstetric and Gynaecology Public Units (original) (raw)
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In Juan Varela and Sergio Acuña (Eds) Handbook of Optimization Theory: Decision Analysis and Application, NY: Nova Science Publishers, Inc., ISBN: 978-1-60876-500-3, 2010
Hospital institution's managers are called upon to combine and utilize efficiently the finite financial resources toward the goal of maximizing the number and quality of health services offered. The research aim of this study is to primarily estimate the relative technical efficiency by using a sample from public hospital units that provide obstetrical and gynaecological services in Greece and secondly, to emphasize the policy implications for health sector policy-makers. In order to effectively address the above goals, a comparative analysis of 32 Greek Public Hospital Units was conducted. The research was based on data collected from official public sources. Quantitative analysis, specifically data envelopment analysis (DEA) is used to estimate efficiency of hospital units. Based on the results that emerge from the application of Data Envelopment Analysis, information is provided to their managers, which refer to: (i) the degree of utilization of their production factors, (ii) the particular weight of each production factor in the modulation of the relative technical efficiency score, (iii) the utilization level of each production factor, and (iv) those hospital units that utilize their resources in an optimal way and constitute models for the exercising of effective management. Particular emphasis is given to the economic efficiency of central region hospital units' relative to those of the outlying regions. The derived information assists in the modulation of an appropriate policy mix per hospital unit which should be applied by their management teams along with a set of administrative measures that need to be undertaken in order to promote efficiency.
Healthcare Management: Comparison of efficiency between hospitals
2019
This dissertation was written as part of the MSc in Strategic Product Design at the International Hellenic University. In the modern society of consolidation and rapid change in the healthcare system in Greece, it is paramount that the healthcare centers ensure that they offer effective, efficient and high-quality services. One of the most important components to healthcare managers is the capability to benchmark in all facets of hospital performance with rival hospital centers. Over the last few decades, there were various approaches which have been used to measure the quality of healthcare. This research paper will use data envelopment analysis (DEA) to compare the efficiency of healthcare services along a major urban and a major suburban/regional hospital. Although the method has been used in government units, and non-profit companies it has not been fully utilized in healthcare centers. Taking that into consideration, there is a need to carry out more research on the effectivene...
Trend Analysis of Hospitals Efficiency Using an Operational Research Technique Approach
This research focuses on trend analysis of the efficiency of hospitals in twenty regions of the Kingdom of Saudi Arabia. Facilities for health care considered a key component of successful and sustainable community work. Research work in this area is limited in the Saudi context. DEA-an Operational Research approach, well-established methods used to estimate the performance of hospitals. In this research, the researcher aims to demonstrate the use of "Data Envelopment Analysis" (DEA) to evaluate hospital performance through twenty regions of the Kingdom of Saudi Arabia. The "Basic Radial Models with Variable Returns to scale (VRS) input-oriented" are used to estimate the efficiency of Hospitals. The DEA method helps administrators recognize inefficient interventions and take the steps required to change them. The input variables used in this analysis include the number of doctors, number of nurses, number of pharmacists, number of medical assistants, number of beds, number of hospitals and number of health centers. The output variables used in this analysis include the number of radiation tests, number of laboratory tests, number of patients (emergency), number of visits (outpatient clinics) and number of patients (number of inpatients at MOH's hospitals). The data obtained from the Ministry of Health's Portal. The lack of productivity should be resolved by increasing budget allocation and only in certain situations by improving policies on resource management.
A model to measure the efficiency of hospital performance
Mathematical and Computer Modelling, 2010
The establishment of specific and thoroughly researched criteria to evaluate hospitals' activity is very important because there is a huge and increasing amount of public resources dedicated to healthcare. Therefore, it is necessary to design a system to evaluate healthcare performance in order to discover and improve potential inefficiencies. With this goal in mind, the purpose of this paper is to analyse efficiency in three healthcare service units in Valencian hospitals to establish appropriate guidelines for efficiency performance.
Evaluation of Hospital Performance with Data Envelopment Analysis
European Journal of Multidisciplinary Studies, 2018
Performance evaluation provides information for lacking organizations and demonstrates how to improve performance for hospitals. Formerly, hospitals had to afford to meet the increased demand of their patients by only decreasing their operational costs. In this parallel most of the hospital was first to cut costs or avoid cases that would likely lose money. However, later health care administrators realized that the appropriate solution to keep their hospitals financially viable was to improve their performance. Efficiency analysis based on optimization techniques and their normative structure creates the benchmark for the hospitals. This is one of the most essential requirements of health care industry today. Data Envelopment Analysis (DEA) is a non-parametric linear programming technique that assesses the efficiency frontier by optimizing the weighted outputs to inputs. DEA models can provide the new solutions to increase the efficiency. DEA identifies the optimal ways of efficiency for each of the hospital rather than the averages. Since this is an appropriate way to understand the individual hospital efficiency, DEA provide the significant findings for the improvement process of hospitals. Hospitals can not only find their efficiency level, but also discover the alternative solutions to eliminate the inefficiency causes. The results of this study have also provided meaningful insights into Turkish health care managers' views of the interaction between efficiency and health care expenditures. It is expected that the findings will provide guidance for health care providers. Results also might be beneficial for other researchers in this area.
Two-stage hospital efficiency analysis including qualitative evidence: A Greek case
Journal of Hospital Administration, 2016
Background: The European Union health policy agenda stresses the importance of environmental and qualitative factors in structural hospital reforms. In response to the economic crisis, both cost containment and performance improvements of the Greek hospital sector, have become a pertinent issue for overall reforms. Objective: The study examines the efficiency of 112 Greek public hospitals, by applying bootstrapping techniques and investigating the effect of contextual factors on hospital efficiency. Furthermore, the effect of qualitative evidence, on hospital efficiency is explored by focusing on a subset of 28 large hospitals. Methods: The quality aspects of the Greek hospitals are investigated by applying two models of Data Envelopment Analysis (DEA), augmented by bootstrapping techniques, in order to assess the importance of quality dimensions on the efficiency of hospital scores. In addition, two Tobit regression models are estimated assessing the contribution of contextual factors, in the efficiency and bias-corrected efficiency scores. Results: Efficiency analysis indicated that only 23.2% of the hospitals are fully efficient (0.96-1.00), 37.5% are efficient (0.71-0.95) while 39.3% are inefficient (0.30-0.70). The Kolmogorov-Smirnov test, between the original and the bootstrap-corrected efficiency, indicates that their distributions are significantly different (p-value < .001). The environmental factors, influencing efficiency, are Occupancy Rate and the ratio between Outpatient Visits and Inpatient Days. Results indicate that the inclusion of Risk-Adjustment Mortality Rate significantly influences (p-value < .05) the efficiency of the hospitals. Conclusions: In the era of economic crisis, the inclusion of quality variables and the use of bootstrapping techniques provide a vital framework in assessing the efficiency of the hospital sector.
Ege Akademik Bakış Dergisi, 2019
In the study, it was targeted to increase the efficiency of business by identifying the performance and efficiency levels of 1533 public hospitals in 81 provinces of Turkey by means of data envelopment analysis and, in addition to this, identifying the problems of units causing disruptions; it was aimed to sort out these problems by suggesting solutions. The data obtained from health businesses, in which application was performed, were checked; their efficiency degrees were assessed; and analysis results were obtained. These results obtained from the study were used in the improvement studies that are going to be carried out to increase the efficiency of or remove the deficiencies of hospitals, in which application is performed. According to the results obtained, the technical efficiencies of 1533 businesses being active in 81 provinces and presenting similar health services were measured by means of data envelopment analysis and it was identified that 775 of these hospitals that are present in 36 provinces worked efficiently, and that 758 of them that are present in 45 provinces did not work efficiently.
Operational and economic efficiency analysis of public hospitals in Greece
Annals of Operations Research, 2014
The continuous growth of hospital costs has driven governments in many countries to seek ways to improve their efficiency. In Greece, this has consistently been a major issue for almost two decades, as efficiency assessment and monitoring systems are lacking. In response to this need, the evaluation of the National Health System hospitals' efficiency level is a precondition for planning, implementing and monitoring any promising reform. In this paper, a non-parametric modeling approach is employed to assess and analyze the efficiency of 87 Greek public hospitals over the period 2005-2009, using data envelopment analysis. The operational and economic aspects of the hospitals' operation are considered on the basis of their service/case mix and cost structure. We also investigate the efficiency trends over time with the Malmquist index and a second stage regression analysis is performed to explain the operational and economic efficiency results in terms of the hospitals' operating characteristics and the environment in which they operate.
Unnes Journal of Public Health
The selection of input and output variables usually pose a problem when carrying out efficiency assessment in hospitals. Data Envelopment Analysis (DEA) is an instrument that is used to calculate the efficiency of a hospital using some inputs and outputs. Therefore, this study aims to identify the most frequently used hospital inputs and outputs from an existing paper,, in order to assist the hospital management staffs in choosing the relevant variables that can represent available inputs, are easily accessible, and need improvement. It was conducted using keywords such as “hospital efficiency” and “DEA for hospital” to search for peer-reviewed journals in the PubMed and Open Knowledge Maps from the year 2014-2020. From, the 586 articles, 54 samples were obtained from the about 5-3504 hospitals which were analyzed from 23 countries. The results showed that, the five most used inputs were the number of beds, medical personnel, non-medical staff, medical technician staff and operatio...
The purpose of the study is to investigate technical efficiency and productivity change of a sample of Greek Hospitals over the period 1998-2005. Efficiency and productivity measurement became a crucial issue in Greece after the launching of health reforms in 2001, with the legislative Act No. 2889, aiming at cost containment and improvements in hospital efficiency. Applying the linear programming method of Data Envelopment Analysis we investigate how efficiently the hospital resources are used to obtain the maximum possible outcome, before and after the reforms. Hospital output is modelled in terms of interventions, laboratory examinations, outpatient and inpatient cases. Inputs considered include beds, doctors, nurses and rest personnel and operational expenses. The analysis indicates that the reforms have generated efficiency gains when only input and output quantities are considered. During the period 1998-2002 an overall efficiency regress is observed followed by an upturn, after the launching of managerial reforms. However, when the running costs of the hospitals are considered, then the sample experiences significant regress, implying relatively higher production costs over time. We conclude that DEA is a useful technique to assess relative efficiency and optimum hospital performance across hospitals.