Dynamic Network DEA Approach for Evaluating Hospital Performance in the Healthcare Sector

Öz

This study simultaneously evaluates the performance of Training and Research Hospitals in Turkey for 2018 and 2019 at both the overall and sub-unit levels. Traditional Data Envelopment Analysis (DEA) models treat decision-making units as a single process, often neglecting internal structures. To overcome this limitation, the study employs the Dynamic Network Data Envelopment Analysis (DN-DEA) approach, which incorporates two interrelated sub-units: administrative services and medical care services. This enables independent evaluation of sub-units, without disregarding their mutual connections. The results show that hospitals efficient in both sub-units are classified as fully efficient. However, some hospitals not on the overall efficiency frontier demonstrated full efficiency in specific sub-units. For instance, H12 and H33 were efficient in administrative services, while hospitals such as H14, H17, H21, and H23 attained efficiency only in medical services. In 2018, the budget account balance was identified as the most critical input requiring reduction (72.7%) for inefficient hospitals, followed by the number of resident physicians (50.7%). In 2019, the budget balance remained the top priority for reduction (62.1%), while the insufficient reduction in resident physicians caused the required adjustment to rise to 52.3%. In light of these findings, it is recommended that hospital performance management consider not only overall efficiency scores but also sub-unit-level analyses. Furthermore, the study emphasizes that improvements in budget management and human resource planning may play a critical role in enhancing hospital efficiency.

Anahtar Kelimeler

• Hospital efficiency
• Network DEA
• Dynamic and network DEA
• Slack-based measure

Dinamik Ağ VZA Yaklaşımıyla Sağlık Sektöründe Hastane Performans Değerlendirmesi

Öz

Karar birimlerini tüm girdileri toplayan ve bunları çıktılara dönüştüren tek bir süreçten oluşan bir yapı olarak gören geleneksel Veri Zarflama Analizi (VZA) modelleri organizasyonu bir kara kutu olarak görür ve iç yapısının ilişkilerini ihmal etmektedir. Ağ VZA modeli, hastanelerin toplam etkinliğini değerlendirmekle kalmaz aynı zamanda ara değişkenler ile birbirine bağlı iç organizasyonlar arası bağlantıları da analiz ederek her bir alt faaliyet biriminin etkinliklerini ölçme imkanı sunmaktadır. Hastaneler idari birimler ve tedavi bakım hizmetleri olmak üzere iki alt birimden oluşmaktadır. Birimlerden birinin çıktı öğesi, diğerinin girdisi olarak birbirleriyle bağlantılı olarak faaliyetlerini sürdürür. Bu çalışma, Dinamik Ağ Veri Zarflama Analizi (DN-VZA) modeli kullanılarak Türkiye Eğitim araştırma hastanelerinin performansını ölçmeyi amaçlamaktadır. Bir dönemden diğerine aktarılan unsurların analize dahil edilmesi ve zamana bağlı etkinlik değişiminin araştırılması için Dinamik VZA (DN DEA) yaklaşımı tercih edilmiştir. Sağlık sektörüne ilişkin çıktılara müdahale etmek daha zor ve uzun süreç gerektirdiğinden hastanelerin etkinlik ölçümünde girdi odaklı VZA kullanmak uygulanabilir sonuçlar vermektedir. Mevcut kaynaklarla girdilerin azaltılabilirliğini ölçmek, maksimum etkinliği sağlayacaktır. Büyük ve küçük ölçekli hastane işletmelerini değerlendirirken ölçeğe gore değişken getiri yaklaşımını kullanmak daha doğru değerlendirme olacağından VZA’nın VRS (değişken getiri) modeli kullanılmıştır. DN modelin çözümünde Gevşek tabanlı ölçüm yaklaşımı uygulanmıştır. DN DEA model analizi sonuçlarına göre, birbirine görece etkin olmayan hastaneler belirlenmiş ve verimliliği artırabilecek olası iyileştirmeler sunulmuştur.

Anahtar Kelimeler

• Gevşek tabanlı ölçüm
• Hastene etkinliği
• Ağ VZA
• Dinamik ve ağ VZA

Kaynakça

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