Journal of Productivity Analysis

, Volume 40, Issue 3, pp 337–355

Incorporating quality into the measurement of hospital efficiency: a double DEA approach


DOI: 10.1007/s11123-012-0305-z

Cite this article as:
Ferrier, G.D. & Trivitt, J.S. J Prod Anal (2013) 40: 337. doi:10.1007/s11123-012-0305-z


This paper uses “double DEA” to assess how accounting for quality influences DEA technical efficiency scores of a sample of 1,074 US hospitals. In the first use of DEA, quality indices are estimated using a variety of process and outcome measures of quality. In the second use of DEA, technical efficiency is assessed while controlling for quality. A variety of DEA quality indices and a DEA variety of efficiency models are compared to determine how the treatment of quality influences findings regarding technical efficiency. Controlling for efficiency does matter, with outcome measures having an apparently greater impact than process measures. Given the call for improved quality and better cost containment, controlling for quality is an important contribution to efficiency analysis.


Double DEA US hospitals Quality of care Technical efficiency 

JEL Classification

D24 I12 L25 

Copyright information

© Springer Science+Business Media, LLC 2012

Authors and Affiliations

  1. 1.Department of EconomicsUniversity of ArkansasFayettevilleUSA

Personalised recommendations