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Benchmarking healthcare systems of OECD countries: A DEA – based Malmquist Productivity Index Approach

Year 2022, Volume: 10 Issue: 1, 25 - 40, 30.06.2022
https://doi.org/10.17093/alphanumeric.1057559

Abstract

Along with technological innovations and developments experienced in the second half of the twentieth century, very important changes have occurred in healthcare. Many different, complex and economically expensive services are being tried to be carried out together. For this reason, it is finally crucial that the health services delivered by providers to scarce resources are delivered effectively and efficiently to people without sacrificing quality. Today, the most important problem of the production of healthcare services is the resource shortage as it is in other sectors. Efficiency, quality and competition are important criteria in the production and delivery of health services. Reducing costs in the production of health services is one of the main health policies for many world countries. These policies have made it necessary for international competitiveness, product and service sectors to continually improve their performance. In this study, the efficiency evaluation of the health care services of OECD were examined using Data Envelopment Analysis and Malmquist Total Factor Productivity. Considering the input values of the countries, the results of the input-oriented model and Malmquist productivity index were analyzed with the fixed return assumption according to the scale.

References

  • [1] Koopmans, T. C. (1951). Efficient allocation of resources. Econometrica: Journal of the Econometric Society, 455-465.
  • [2] Hollingsworth, B., and Parkin, D. (2001). The efficiency of the delivery of neonatal care in the UK. Journal of Public Health, 23(1), 47-50.
  • [3] Harrison, J. P., Coppola, M. N., and Wakefield, M. (2004). Efficiency of federal hospitals in the United States. Journal of Medical Systems, 28(5), 411-422.
  • [4] Ehreth, J. L. (1994). The development and evaluation of hospital performance measures for policy analysis. Medical care, 568-587.
  • [5] Worthington, A. C. (2004). Frontier efficiency measurement in health care: a review of empirical techniques and selected applications. Medical care research and review, 61(2), 135-170.
  • [6] Charnes, A., Cooper, W. W., and Rhodes, E. (1978). Measuring the efficiency of decision making units. European journal of operational research, 2(6), 429-444.
  • [7] Farrell, M. J. (1957). The measurement of productive efficiency. Journal of the Royal Statistical Society: Series A (General), 120(3), 253-281.
  • [8] Şenel, T., ve Gümüştekin, S. (2017). Samsun'daki Hastanelerin Etkinliklerinin Değerlendirilmesinde Veri Zarflama Analizi Kullanılması. International Anatolia Academic Online Journal Fen Bilimleri Dergisi, 3(2).
  • [9] Wilson, G. W., and Jadlow, J. M. (1982). Competition, profit incentives, and technical efficiency in the provision of nuclear medicine services. The Bell Journal of Economics, 472-482.
  • [10] Nunamaker, T. R. (1983). Measuring routine nursing service efficiency: a comparison of cost per patient day and data envelopment analysis models. Health Services Research, 18(2 Pt 1), 183.
  • [11] Sherman, H. D. (1984). Hospital efficiency measurement and evaluation: empirical test of a new technique. Medical care, 922-938.
  • [12] Register, C. A., and Bruning, E. R. (1987). Profit incentives and technical efficiency in the production of hospital care. Southern Economic Journal, 899-914.
  • [13] Grosskopf, S., and Valdmanis, V. (1987). Measuring hospital performance: A non-parametric approach. Journal of health Economics, 6(2), 89-107.
  • [14] Cullinane, K., Song, D. W., Ji, P., and Wang, T. F. (2004). An application of DEA windows analysis to container port production efficiency. Review of network Economics, 3(2).
  • [15] Zare Ahmadabadi, H., Masoudian, S., & Zare Banadkouki, M. R. (2019). Evaluating the technical efficiency of Yazd City health centers with a combined approach of DEA and GT. SSU_Journals, 26(8), 717-732.
  • [16] Li, Y., Lei, X., & Morton, A. (2019). Performance evaluation of nonhomogeneous hospitals: the case of Hong Kong hospitals. Health care management science, 22(2), 215-228.
  • [17] Palmer, S., and Torgerson, D. J. (1999). Economics notes: Definitions of efficiency. BMJ: British Medical Journal, 318(7191), 1136.
  • [18] Lameire, N., Joffe, P., and Wiedemann, M. (1999). Healthcare systems—an international review: an overview. Nephrology Dialysis Transplantation, 14, 3-9.,
  • [19] Chou, S. Y., Liu, J. T., & Hammitt, J. K. (2003). National health insurance and precautionary saving: evidence from Taiwan. Journal of Public Economics, 87(9-10), 1873-1894.
  • [20]Wendt, C., Frisina, L., and Rothgang, H. (2009). Healthcare system types: a conceptual framework for comparison. Social Policy & Administration, 43(1), 70-90.
  • [21] Anderson, L. M., Scrimshaw, S. C., Fullilove, M. T., Fielding, J. E., Normand, J., and Task Force on Community Preventive Services. (2003). Culturally competent healthcare systems: A systematic review. American journal of preventive medicine, 24(3), 68-79.
  • [22] Abolghasem, S., Toloo, M., & Amézquita, S. (2019). Cross-efficiency evaluation in the presence of flexible measures with an application to healthcare systems. Health care management science, 22(3), 512-533.
  • [23] Sherman, H. D. (1984). Hospital efficiency measurement and evaluation: empirical test of a new technique. Medical care, 922-938.
  • [24] Färe, R., Grosskopf, S., Lindgren, B., and Roos, P. (1992). Productivity changes in Swedish pharamacies 1980–1989: A non-parametric Malmquist approach. Journal of productivity Analysis, 3(1-2), 85-101.
  • [25] Falavigna, G., Ippoliti, R., & Manello, A. (2013). Hospital organization and performance: a directional distance function approach. Health care management science, 16(2), 139-151.
  • [26] Çağlar, A. (2003). Veri zarflama analizi ile belediyelerin etkinlik ölçümü. Hacettepe Üniversitesi Fen Bilimleri Enstitüsü, Yayımlanmamış Doktora Tezi, Ankara.
  • [27] Dang-Thanh, N., & Nguyen, L. T. P. (2012). Total factor productivity of Thai banks in 2007-2010: An application of DEA and Malmquist index. Journal of Applied Finance and Banking, 2(5), 27-42.
  • [28] de Araújo Junior, J. N., Justo, W. R., de Lima, J. R. F., FERREIRA, M. D. O., Araújo, J. L. P., & Pereira, A. F. C. (2019). Analysis on the Technical Efficiency of Northeast Municipal Expenditure with Basic Education: A DEA Approach and Malmquist's Index. Embrapa Semiárido-Artigo em periódico indexado (ALICE).
  • [29] Malmquist, S. (1953). Index numbers and indifference surfaces. Trabajos de estadística, 4(2), 209-242.
  • [30] Caves, D. W., Christensen, L. R., and Diewert, W. E. (1982). The economic theory of index numbers and the measurement of input, output, and productivity. Econometrica: Journal of the Econometric Society, 1393-1414.
  • [31] Färe, R., Grosskopf, S., Lindgren, B., and Roos, P. (1994). Productivity developments in Swedish hospitals: a Malmquist output index approach. In Data envelopment analysis: Theory, methodology, and applications (pp. 253-272). Springer, Dordrecht.
  • [32] Rezitis, A. N. (2006). Productivity growth in the Greek banking industry: a non-parametric approach. Journal of Applied economics, 9(1).
  • [33] Kök, R., ve Şimşek, N. (2006). Endüstri-içi dış ticaret, patentler ve uluslararası teknolojik yayılma. Türkiye Ekonomi Kurumu Uluslararası Ekonomi Konferansı, 11-13.
  • [34] Wu, W. Y., Tsai, H. J., Cheng, K. Y., & Lai, M. (2006). Assessment of intellectual capital management in Taiwanese IC design companies: using DEA and the Malmquist productivity index. R&D Management, 36(5), 531-545.
  • [35] Al-Shammari, M. (1999). A multi-criteria data envelopment analysis model for measuring the productive efficiency of hospitals. International Journal of Operations & Production Management, 19(9), 879-891.
  • [36] Zavras, A., Andreopoulos, N., Katsikeris, N., Zavras, D., Cartsos, V., & Vamvakidis, A. (2002). Oral cancer treatment costs in Greece and the effect of advanced disease. BMC Public Health, 2(1), 12.
  • [37] Li, H. C., and Ilacqua, J. A. (2008). Health care efficiency in transition economies: an application of data envelopment analysis. International Business & Economics Research Journal, 7(2).
  • [38] Caballer-Tarazona, M., Moya-Clemente, I., Vivas-Consuelo, D., and Barrachina-Martínez, I. (2010). A model to measure the efficiency of hospital performance. Mathematical and computer modelling, 52(7-8), 1095-1102.
  • [39] Varabyova, Y., & Schreyögg, J. (2013). International comparisons of the technical efficiency of the hospital sector: panel data analysis of OECD countries using parametric and non-parametric approaches. Health policy, 112(1-2), 70-79.
  • [40] Moran, V., and Jacobs, R. (2013). An international comparison of efficiency of inpatient mental health care systems. Health Policy, 112(1-2), 88-99.
  • [41] Popescu, C., Asandului, L., and Fatulescu, P. (2014). A Data Envelopment Analysis for Evaluating Romania’s Health System. Procedia-Social and Behavioral Sciences, 109, 1185-1189.
  • [42] Asandului, L., Roman, M., and Fatulescu, P. (2014). The efficiency of healthcare systems in Europe: A data envelopment analysis approach. Procedia Economics and Finance, 10, 261-268.
  • [43] Daştan, İ., ve Çetinkaya, V. (2015). OECD Ülkeleri ve Türkiye’nin Sağlık Sistemleri, Sağlık Harcamaları ve Sağlık Göstergeleri Karşılaştırması. Sosyal Güvenlik Dergisi, 5(1), 104-134.
  • [44] Bekaroglu, C. (2015). A Multi-Stage Efficiency Analysis of OECD Healthcare and the Impact of Technical Change.
  • [45] Berenguer, G., Iyer, A. V., and Yadav, P. (2016). Disentangling the efficiency drivers in country-level global health programs: An empirical study. Journal of Operations Management, 45, 30-43.
  • [46] Campos, M. S., Fernández-Montes, A., Gavilan, J. M., and Velasco, F. (2016). Public resource usage in health systems: a data envelopment analysis of the efficiency of health systems of autonomous communities in Spain. Public health, 138, 33-40.
  • [47] Öztürk, E. G. (2016). Health System Performance in OECD Countries: Data Envelopment Analysis (Master's thesis, Sosyal Bilimler Enstitüsü).
  • [48] Kara, N. O., Yeşilaydın, G., ve Hancıoğlu, Y. A Study On Graduate Thesıs About Competıtıon In Turkey. CIEP 2017 Proceedıngs Book, 185.
  • [49] Herwartz, H., and Schley, K. (2018). Improving health care service provision by adapting to regional diversity: An efficiency analysis for the case of Germany. Health Policy, 122(3), 293-300.
  • [50] Zhong, K., Chen, L., Cheng, S., Chen, H., & Long, F. (2020). The Efficiency of Primary Health Care Institutions in the Counties of Hunan Province, China: Data from 2009 to 2017. International Journal of Environmental Research and Public Health, 17(5), 1781.
Year 2022, Volume: 10 Issue: 1, 25 - 40, 30.06.2022
https://doi.org/10.17093/alphanumeric.1057559

Abstract

References

  • [1] Koopmans, T. C. (1951). Efficient allocation of resources. Econometrica: Journal of the Econometric Society, 455-465.
  • [2] Hollingsworth, B., and Parkin, D. (2001). The efficiency of the delivery of neonatal care in the UK. Journal of Public Health, 23(1), 47-50.
  • [3] Harrison, J. P., Coppola, M. N., and Wakefield, M. (2004). Efficiency of federal hospitals in the United States. Journal of Medical Systems, 28(5), 411-422.
  • [4] Ehreth, J. L. (1994). The development and evaluation of hospital performance measures for policy analysis. Medical care, 568-587.
  • [5] Worthington, A. C. (2004). Frontier efficiency measurement in health care: a review of empirical techniques and selected applications. Medical care research and review, 61(2), 135-170.
  • [6] Charnes, A., Cooper, W. W., and Rhodes, E. (1978). Measuring the efficiency of decision making units. European journal of operational research, 2(6), 429-444.
  • [7] Farrell, M. J. (1957). The measurement of productive efficiency. Journal of the Royal Statistical Society: Series A (General), 120(3), 253-281.
  • [8] Şenel, T., ve Gümüştekin, S. (2017). Samsun'daki Hastanelerin Etkinliklerinin Değerlendirilmesinde Veri Zarflama Analizi Kullanılması. International Anatolia Academic Online Journal Fen Bilimleri Dergisi, 3(2).
  • [9] Wilson, G. W., and Jadlow, J. M. (1982). Competition, profit incentives, and technical efficiency in the provision of nuclear medicine services. The Bell Journal of Economics, 472-482.
  • [10] Nunamaker, T. R. (1983). Measuring routine nursing service efficiency: a comparison of cost per patient day and data envelopment analysis models. Health Services Research, 18(2 Pt 1), 183.
  • [11] Sherman, H. D. (1984). Hospital efficiency measurement and evaluation: empirical test of a new technique. Medical care, 922-938.
  • [12] Register, C. A., and Bruning, E. R. (1987). Profit incentives and technical efficiency in the production of hospital care. Southern Economic Journal, 899-914.
  • [13] Grosskopf, S., and Valdmanis, V. (1987). Measuring hospital performance: A non-parametric approach. Journal of health Economics, 6(2), 89-107.
  • [14] Cullinane, K., Song, D. W., Ji, P., and Wang, T. F. (2004). An application of DEA windows analysis to container port production efficiency. Review of network Economics, 3(2).
  • [15] Zare Ahmadabadi, H., Masoudian, S., & Zare Banadkouki, M. R. (2019). Evaluating the technical efficiency of Yazd City health centers with a combined approach of DEA and GT. SSU_Journals, 26(8), 717-732.
  • [16] Li, Y., Lei, X., & Morton, A. (2019). Performance evaluation of nonhomogeneous hospitals: the case of Hong Kong hospitals. Health care management science, 22(2), 215-228.
  • [17] Palmer, S., and Torgerson, D. J. (1999). Economics notes: Definitions of efficiency. BMJ: British Medical Journal, 318(7191), 1136.
  • [18] Lameire, N., Joffe, P., and Wiedemann, M. (1999). Healthcare systems—an international review: an overview. Nephrology Dialysis Transplantation, 14, 3-9.,
  • [19] Chou, S. Y., Liu, J. T., & Hammitt, J. K. (2003). National health insurance and precautionary saving: evidence from Taiwan. Journal of Public Economics, 87(9-10), 1873-1894.
  • [20]Wendt, C., Frisina, L., and Rothgang, H. (2009). Healthcare system types: a conceptual framework for comparison. Social Policy & Administration, 43(1), 70-90.
  • [21] Anderson, L. M., Scrimshaw, S. C., Fullilove, M. T., Fielding, J. E., Normand, J., and Task Force on Community Preventive Services. (2003). Culturally competent healthcare systems: A systematic review. American journal of preventive medicine, 24(3), 68-79.
  • [22] Abolghasem, S., Toloo, M., & Amézquita, S. (2019). Cross-efficiency evaluation in the presence of flexible measures with an application to healthcare systems. Health care management science, 22(3), 512-533.
  • [23] Sherman, H. D. (1984). Hospital efficiency measurement and evaluation: empirical test of a new technique. Medical care, 922-938.
  • [24] Färe, R., Grosskopf, S., Lindgren, B., and Roos, P. (1992). Productivity changes in Swedish pharamacies 1980–1989: A non-parametric Malmquist approach. Journal of productivity Analysis, 3(1-2), 85-101.
  • [25] Falavigna, G., Ippoliti, R., & Manello, A. (2013). Hospital organization and performance: a directional distance function approach. Health care management science, 16(2), 139-151.
  • [26] Çağlar, A. (2003). Veri zarflama analizi ile belediyelerin etkinlik ölçümü. Hacettepe Üniversitesi Fen Bilimleri Enstitüsü, Yayımlanmamış Doktora Tezi, Ankara.
  • [27] Dang-Thanh, N., & Nguyen, L. T. P. (2012). Total factor productivity of Thai banks in 2007-2010: An application of DEA and Malmquist index. Journal of Applied Finance and Banking, 2(5), 27-42.
  • [28] de Araújo Junior, J. N., Justo, W. R., de Lima, J. R. F., FERREIRA, M. D. O., Araújo, J. L. P., & Pereira, A. F. C. (2019). Analysis on the Technical Efficiency of Northeast Municipal Expenditure with Basic Education: A DEA Approach and Malmquist's Index. Embrapa Semiárido-Artigo em periódico indexado (ALICE).
  • [29] Malmquist, S. (1953). Index numbers and indifference surfaces. Trabajos de estadística, 4(2), 209-242.
  • [30] Caves, D. W., Christensen, L. R., and Diewert, W. E. (1982). The economic theory of index numbers and the measurement of input, output, and productivity. Econometrica: Journal of the Econometric Society, 1393-1414.
  • [31] Färe, R., Grosskopf, S., Lindgren, B., and Roos, P. (1994). Productivity developments in Swedish hospitals: a Malmquist output index approach. In Data envelopment analysis: Theory, methodology, and applications (pp. 253-272). Springer, Dordrecht.
  • [32] Rezitis, A. N. (2006). Productivity growth in the Greek banking industry: a non-parametric approach. Journal of Applied economics, 9(1).
  • [33] Kök, R., ve Şimşek, N. (2006). Endüstri-içi dış ticaret, patentler ve uluslararası teknolojik yayılma. Türkiye Ekonomi Kurumu Uluslararası Ekonomi Konferansı, 11-13.
  • [34] Wu, W. Y., Tsai, H. J., Cheng, K. Y., & Lai, M. (2006). Assessment of intellectual capital management in Taiwanese IC design companies: using DEA and the Malmquist productivity index. R&D Management, 36(5), 531-545.
  • [35] Al-Shammari, M. (1999). A multi-criteria data envelopment analysis model for measuring the productive efficiency of hospitals. International Journal of Operations & Production Management, 19(9), 879-891.
  • [36] Zavras, A., Andreopoulos, N., Katsikeris, N., Zavras, D., Cartsos, V., & Vamvakidis, A. (2002). Oral cancer treatment costs in Greece and the effect of advanced disease. BMC Public Health, 2(1), 12.
  • [37] Li, H. C., and Ilacqua, J. A. (2008). Health care efficiency in transition economies: an application of data envelopment analysis. International Business & Economics Research Journal, 7(2).
  • [38] Caballer-Tarazona, M., Moya-Clemente, I., Vivas-Consuelo, D., and Barrachina-Martínez, I. (2010). A model to measure the efficiency of hospital performance. Mathematical and computer modelling, 52(7-8), 1095-1102.
  • [39] Varabyova, Y., & Schreyögg, J. (2013). International comparisons of the technical efficiency of the hospital sector: panel data analysis of OECD countries using parametric and non-parametric approaches. Health policy, 112(1-2), 70-79.
  • [40] Moran, V., and Jacobs, R. (2013). An international comparison of efficiency of inpatient mental health care systems. Health Policy, 112(1-2), 88-99.
  • [41] Popescu, C., Asandului, L., and Fatulescu, P. (2014). A Data Envelopment Analysis for Evaluating Romania’s Health System. Procedia-Social and Behavioral Sciences, 109, 1185-1189.
  • [42] Asandului, L., Roman, M., and Fatulescu, P. (2014). The efficiency of healthcare systems in Europe: A data envelopment analysis approach. Procedia Economics and Finance, 10, 261-268.
  • [43] Daştan, İ., ve Çetinkaya, V. (2015). OECD Ülkeleri ve Türkiye’nin Sağlık Sistemleri, Sağlık Harcamaları ve Sağlık Göstergeleri Karşılaştırması. Sosyal Güvenlik Dergisi, 5(1), 104-134.
  • [44] Bekaroglu, C. (2015). A Multi-Stage Efficiency Analysis of OECD Healthcare and the Impact of Technical Change.
  • [45] Berenguer, G., Iyer, A. V., and Yadav, P. (2016). Disentangling the efficiency drivers in country-level global health programs: An empirical study. Journal of Operations Management, 45, 30-43.
  • [46] Campos, M. S., Fernández-Montes, A., Gavilan, J. M., and Velasco, F. (2016). Public resource usage in health systems: a data envelopment analysis of the efficiency of health systems of autonomous communities in Spain. Public health, 138, 33-40.
  • [47] Öztürk, E. G. (2016). Health System Performance in OECD Countries: Data Envelopment Analysis (Master's thesis, Sosyal Bilimler Enstitüsü).
  • [48] Kara, N. O., Yeşilaydın, G., ve Hancıoğlu, Y. A Study On Graduate Thesıs About Competıtıon In Turkey. CIEP 2017 Proceedıngs Book, 185.
  • [49] Herwartz, H., and Schley, K. (2018). Improving health care service provision by adapting to regional diversity: An efficiency analysis for the case of Germany. Health Policy, 122(3), 293-300.
  • [50] Zhong, K., Chen, L., Cheng, S., Chen, H., & Long, F. (2020). The Efficiency of Primary Health Care Institutions in the Counties of Hunan Province, China: Data from 2009 to 2017. International Journal of Environmental Research and Public Health, 17(5), 1781.
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Details

Primary Language English
Subjects Operation
Journal Section Articles
Authors

Ayhan Aydın 0000-0001-9127-0951

Publication Date June 30, 2022
Submission Date January 13, 2022
Published in Issue Year 2022 Volume: 10 Issue: 1

Cite

APA Aydın, A. (2022). Benchmarking healthcare systems of OECD countries: A DEA – based Malmquist Productivity Index Approach. Alphanumeric Journal, 10(1), 25-40. https://doi.org/10.17093/alphanumeric.1057559

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