The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals

  • Sebastian Kohl
  • Jan Schoenfelder
  • Andreas Fügener
  • Jens O. Brunner
Article
  • 313 Downloads

Abstract

The healthcare sector in general and hospitals in particular represent a main application area for Data Envelopment Analysis (DEA). This paper reviews 262 papers of DEA applications in healthcare with special focus on hospitals and therefore closes a gap of over ten years that were not covered by existing review articles. Apart from providing descriptive statistics of the papers, we are the first to examine the research purposes of the publications. These research goals can be grouped into four distinct clusters according to our proposed framework. The four clusters are (1) “Pure DEA efficiency analysis”, i.e. performing a DEA on hospital data, (2) “Developments or applications of new methodologies”, i.e. applying new DEAy approaches on hospital data, (3) “Specific management question”, i.e. analyzing the effects of managerial specification, such as ownership, on hospital efficiency, and (4) “Surveys on the effects of reforms”, i.e. researching the impact of policy making, such as reforms of health systems, on hospital efficiency. Furthermore, we analyze the methodological settings of the studies and describe the applied models. We analyze the chosen inputs and outputs as well as all relevant downstream techniques. A further contribution of this paper is its function as a roadmap to important methodological literature and publications, which provide crucial information on the setup of DEA studies. Thus, this paper should be of assistance to researchers planning to apply DEA in a hospital setting by providing information on a) what has been published between 2005 and 2016, b) possible pitfalls when setting up a DEA analysis, and c) possible ways to apply the DEA analysis in practice. Finally, we discuss what could be done to advance DEA from a scientific tool to an instrument that is actually utilized by managers and policymakers.

Keywords

Data Envelopment Analysis Efficiency Healthcare Hospital 

References

  1. 1.
    Afonso A, Aubyn MS (2011) Assessing health efficiency across countries with a two-step and bootstrap analysis. Appl Econ Lett 18(15):1427–1430CrossRefGoogle Scholar
  2. 2.
    Afzali HHA, Moss JR, Mahmood MA (2009) A conceptual framework for selecting the most appropriate variables for measuring hospital efficiency with a focus on Iranian public hospitals. Health Serv Manag Res. 22(2):81–91CrossRefGoogle Scholar
  3. 3.
    Agarwal S, Yadav SP, Singh SP (2011) A new slack DEA model to estimate the impact of slacks on the efficiencies. Int J Oper Res 12(3):241–256CrossRefGoogle Scholar
  4. 4.
    Ajlouni MM, Zyoud A, Jaber B, Shaheen H, Al-Natour M, Anshasi RJ (2013) The Relative Efficiency of Jordanian Public Hospitals Using Data Envelopment Analysis and Pabon Lasso Diagram. Glob J Bus Res 7(2):59–72Google Scholar
  5. 5.
    Akazili J, Adjuik M, Chatio S, Kanyomse E, Hodgson A, Aikins M, Gyapong J (2008a) What are the technical and allocative efficiencies of public health centres in Ghana? Ghana Med J 42(4):149–155Google Scholar
  6. 6.
    Akazili J, Adjuik M, Jehu-Appiah C, Asbu EZ (2008b) Using data envelopment analysis to measure the extent of technical efficiency of public health centres in Ghana. BMC Int Health Hum Rights 8(1):11–22CrossRefGoogle Scholar
  7. 7.
    Aksezer CS, Benneyan JC (2010) Assessing the efficiency of hospitals operating under a unique owner: a DEA application in the presence of missing data. Int J Serv OperManag 7(1):53–75Google Scholar
  8. 8.
    Aletras V, Kontodimopoulos N, Zagouldoudis A, Niakas D (2007) The short-term effect on technical and scale efficiency of establishing regional health systems and general management in Greek 5NHS6 hospitals. Health Policy 83(2-3):236–245CrossRefGoogle Scholar
  9. 9.
    Allen R, Athanassopoulos A, Dyson RG, Thanassoulis E (1997) Weights restrictions and value judgements in Data Envelopment Analysis: Evolution, development and future directions. AnnOper Res 73(0):13–34Google Scholar
  10. 10.
    Allin S, Grignon M, Wang L (2016) The determinants of efficiency in the Canadian health care system. Health Econ Policy Law 11(1):39–65CrossRefGoogle Scholar
  11. 11.
    Allin S, Veillard J, Wang L, Grignon M (2015) How can health system efficiency be improved in Canada? Healthcare Policy 11(1):33Google Scholar
  12. 12.
    Almeida Á, Frias R, Fique JP (2015) Evaluating Hospital efficiency adjusting for quality indicators: An application to Portuguese NHS Hospitals. Health Econ Outcome Res Open Access 103(1)Google Scholar
  13. 13.
    Alonso JM, Clifton J, Díaz-Fuentes D (2015) The impact of New Public Management on efficiency: An analysis of Madrid's hospitals. Health Policy 119(3):333–340CrossRefGoogle Scholar
  14. 14.
    Al-Refaie A, Fouad RH, Li M-H, Shurrab M (2014) Applying simulation and DEA to improve performance of emergency department in a Jordanian hospital. Simulation Model Pract Theory 41(0):59–72CrossRefGoogle Scholar
  15. 15.
    Al-Shayea AM (2011) Measuring hospital’s units efficiency: A data envelopment analysis approach. Int J Eng Technol 11(6):7–19Google Scholar
  16. 16.
    Amado CAF, Dyson RG (2008) On comparing the performance of primary care providers. Eur J Oper Res 185(3):915–932CrossRefGoogle Scholar
  17. 17.
    Ancarani A, Di Mauro C, Giammanco MD (2009) The impact of managerial and organizational aspects on hospital wards' efficiency: Evidence from a case study. Eur J Oper Res 194(1):280–293CrossRefGoogle Scholar
  18. 18.
    Andersen P, Petersen NC (1993) A Procedure for Ranking Efficient Units in Data Envelopment Analysis. Manag Sci 39(10):1261–1264CrossRefGoogle Scholar
  19. 19.
    Araújo C, Barros CP, Wanke P (2014) Efficiency determinants and capacity issues in Brazilian for-profit hospitals. Health Care Manag Sci 17(2):1–13CrossRefGoogle Scholar
  20. 20.
    Arfa C, Leleu H, Goaïed M, van Mosseveld C (2016) Measuring the capacity utilization of public district hospitals in tunisia: using dual data envelopment analysis approach. Int J Health Policy Manag 6(1):9–18CrossRefGoogle Scholar
  21. 21.
    Arocena P, Garcia-Prado A (2007) Accounting for quality in the measurement of hospital performance: evidence from Costa Rica // Accounting for quality in the measurement of hospital performance: evidence from Costa Rica. Health Econ 16(7):667–685CrossRefGoogle Scholar
  22. 22.
    Asbu EZ, Mbeeli T, Shangula K, Mandlhat C, Mutirua K, Tjivambi B, Kapenambili W (2006) Technical Efficiency of District Hospitals: Evidence from Namibia using Data Envelopment Analysis. Cost Eff Resour Alloc 4(5):5-14Google Scholar
  23. 23.
    Audibert M, Mathonnat J, Pelissier A, Huang XX, Ma A (2013) Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data. China Econ Rev 27(0):326–338CrossRefGoogle Scholar
  24. 24.
    Azadi M, Sean RF (2013) A combination of QFD and imprecise DEA with enhanced Russell graph measure: A case study in healthcare. Socio-Econ Plan Sci 47(4):281–291CrossRefGoogle Scholar
  25. 25.
    Bahari A, Emrouznejad A (2014) Influential DMUs and outlier detection in data envelopment analysis with an application to health care. Ann Oper Res 223(1):95–108CrossRefGoogle Scholar
  26. 26.
    Banker RD (1984) Estimating most productive scale size using data envelopment analysis. Eur J Oper Res 17(1):35–44CrossRefGoogle Scholar
  27. 27.
    Banker RD (1996) Hypothesis tests using data envelopment analysis. J Prod Anal 7(2-3):139–159CrossRefGoogle Scholar
  28. 28.
    Banker RD, Chang H (2006) The super-efficiency procedure for outlier identification, not for ranking efficient units. Eur J Oper Res 175(2):1311–1320CrossRefGoogle Scholar
  29. 29.
    Banker RD, Chang H, Cooper WW (1996) Simulation studies of efficiency, returns to scale and misspecification with nonlinear functions in DEA. AnnOper Res 66(4):231–253Google Scholar
  30. 30.
    Banker RD, Charnes A, Cooper WW (1984) Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis. Manag Sci 30(9):1078–1092CrossRefGoogle Scholar
  31. 31.
    Banker RD, Thrall RM (1992) Estimation of returns to scale using data envelopment analysis. Eur J Oper Res 62(1):74–84CrossRefGoogle Scholar
  32. 32.
    Barbetta GP, Turati G, Zago AM (2007) Behavioral differences between public and private not-for-profit hospitals in the Italian national health service. Health Econ 16(1):75–96CrossRefGoogle Scholar
  33. 33.
    Barnum D, Walton S, Shields K, Schumock G (2011) Measuring Hospital Efficiency with Data Envelopment Analysis: Nonsubstitutable vs. Substitutable Inputs and Outputs. J Med Syst 35(6):1393–1401CrossRefGoogle Scholar
  34. 34.
    Barros CP, de Menezes AG, Peypoch N, Solonandrasana B, Vieira JC (2008) An analysis of hospital efficiency and productivity growth using the Luenberger indicator. Health Care Manag Sci 11(4):373–381CrossRefGoogle Scholar
  35. 35.
    Bastian ND, Kang H, Swenson ER, Fulton LV, Griffin PM (2016) Evaluating the impact of hospital efficiency on wellness in the Military Health System. Mil Med 181(8):827–834CrossRefGoogle Scholar
  36. 36.
    Bates LJ, Mukherjee K, Santerre RE (2006) Market Structure and Technical Efficiency in the Hospital Services Industry: A DEA Approach. Med Care Re Rev 63(4):499–524CrossRefGoogle Scholar
  37. 37.
    Bernet PM, Moises J, Valdmanis VG (2011) Social Efficiency of Hospital Care Delivery: Frontier Analysis From the Consumer’s Perspective. Med Care Re Rev 68(1 suppl):36–54CrossRefGoogle Scholar
  38. 38.
    Bernet PM, Rosko MD, Valdmanis VG, Pilyavsky A, Aaronson WE (2008) Productivity efficiencies in Ukrainian polyclinics: lessons for health system transitions from differential responses to market changes. J Prod Anal 29(2):103–111CrossRefGoogle Scholar
  39. 39.
    Bhat V (2005) Institutional arrangements and efficiency of health care delivery systems. Eur J Health Econ 6(3):215–222CrossRefGoogle Scholar
  40. 40.
    Bilsel M, Davutyan N (2011) Hospital efficiency with risk adjusted mortality as undesirable output: the Turkish case. Ann Oper Res 221(1):73–88CrossRefGoogle Scholar
  41. 41.
    Bin S, Zhang L, Yang W, Zhang J, Luo D, Han C (2016) Data envelopment analysis on evaluating the efficiency of public hospitals in Tianjin, China. Transactions of Tianjin University 22 (2):182–188Google Scholar
  42. 42.
    Biørn E, Hagen TP, Iversen T, Magnussen J (2010) How different are hospitals’ responses to a financial reform? The impact on efficiency of activity-based financing. Health Care Manag Sci 13(1):1–16CrossRefGoogle Scholar
  43. 43.
    Blank JL, Valdmanis VG (2010) Environmental factors and productivity on Dutch hospitals: a semi-parametric approach. Health Care Manag Sci 13(1):27–34CrossRefGoogle Scholar
  44. 44.
    Blank JLT, van Hulst BL (2011) Governance and performance: the performance of Dutch hospitals explained by governance characteristics. J Med Syst 35(5):991–999CrossRefGoogle Scholar
  45. 45.
    Boussofiane A, Dyson RG, Thanassoulis E (1991) Applied data envelopment analysis. Eur J Oper Res 52(1):1–15CrossRefGoogle Scholar
  46. 46.
    Brockett PL, Cooper WW, Wang Y, Shin H-C (1998) Inefficiency and congestion in Chinese production before and after the 1978 economic reforms. Socio-Econ Plan Sci 32(1):1–20CrossRefGoogle Scholar
  47. 47.
    Büchner VA, Hinz V, Schreyögg J (2016) Health systems: changes in hospital efficiency and profitability. Health Care Manag Sci 19(2):130–143CrossRefGoogle Scholar
  48. 48.
    Butler TW, Li L (2005) The utility of returns to scale in DEA programming: An analysis of Michigan rural hospitals. Eur JOper Res 161(2):469–477Google Scholar
  49. 49.
    Bwana KM (2015) Measuring technical efficiency of faith based hospitals in Tanzania: An application of data envelopment analysis (DEA). Res Appl Econ 7(1):1–12CrossRefGoogle Scholar
  50. 50.
    Caballer-Tarazona M, Ismael M-C, Vivas-Consuelo D, Barrachina-Martínez I (2010) A model to measure the efficiency of hospital performance. Math Comput Model 52(7):1095–1102CrossRefGoogle Scholar
  51. 51.
    Caballer-Tarazona M, Vivas-Consuelo D (2016) A cost and performance comparison of Public Private Partnership and public hospitals in Spain. Heal Econ Rev 6(1):17CrossRefGoogle Scholar
  52. 52.
    Campos MS, Fernández-Montes A, Gavilan JM, 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 138:33–40CrossRefGoogle Scholar
  53. 53.
    Carrillo M, Jorge JM (2017) DEA-like efficiency ranking of regional health systems in Spain. Soc Indic Res 133(3):1133–1149Google Scholar
  54. 54.
    de Castro Lobo M, Ozcan Y, da Silva A, Lins M, Fiszman R (2010) Financing reform and productivity change in Brazilian teaching hospitals: Malmquist approach. CEJOR 18(2):141–152CrossRefGoogle Scholar
  55. 55.
    Cavalieri M, Guccio C, Lisi D, Pignataro G (2018) Does the Extent of per Case Payment System Affect Hospital Efficiency? Evid Italian NHS Public Finance Rev 46(1):117–149Google Scholar
  56. 56.
    Caves DW, Christensen LR, Diewert WE (1982) The Economic Theory of Index Numbers and the Measurement of Input, Output, and Productivity. Econometrica 50(6):1393–1414CrossRefGoogle Scholar
  57. 57.
    Chang S-J, Hsiao H-C, Huang L-H, Chang H (2011) Taiwan quality indicator project and hospital productivity growth. Omega 39(1):14–22CrossRefGoogle Scholar
  58. 58.
    Charnes A, Clark CT, Cooper WW, Golany B (1985a) A developmental study of data envelopment analysis in measuring the efficiency of maintenance units in the U.S. air forces. Ann Oper Res 2(1):95–112CrossRefGoogle Scholar
  59. 59.
    Charnes A, Cooper WW, Golany B, Seiford L, Stutz J (1985b) Foundations of data envelopment analysis for Pareto-Koopmans efficient empirical production functions. J Econ 30(1):91–107CrossRefGoogle Scholar
  60. 60.
    Charnes A, Cooper WW, Rhodes E (1978) Measuring the efficiency of decision making units. Eur J Oper Res 2(6):429–444CrossRefGoogle Scholar
  61. 61.
    Chen A, Hwang Y, Shao B (2005) Measurement and sources of overall and input inefficiencies: Evidences and implications in hospital services. Eur J Oper Res 161(2):447–468CrossRefGoogle Scholar
  62. 62.
    Chen S-N (2006) Productivity changes in Taiwanese hospitals and the national health insurance. Serv Ind J 26(4):459–477CrossRefGoogle Scholar
  63. 63.
    Cheng Z, Tao H, Cai M, Lin H, Lin X, Shu Q, Zhang R-n (2015) Technical efficiency and productivity of Chinese county hospitals: an exploratory study in Henan province, China. BMJ Open 5(9):e007267CrossRefGoogle Scholar
  64. 64.
    Cherchye L, Kuosmanen T, Post T (2001) Alternative treatments of congestion in DEA: a rejoinder to Cooper, Gu, and Li. Eur J Oper Res 132(1):75–80CrossRefGoogle Scholar
  65. 65.
    Chilingerian, J., H. Sherman. 2011. Health-Care Applications: From Hospitals to Physicians, from Productive Efficiency to Quality Frontiers. In W.W. Cooper, L.M. Seiford and J. Zhu (eds.) Handbook on Data Envelopment Analysis. Springer, New York.Google Scholar
  66. 66.
    Cho, N.-E., J. Chang, B. Atems. 2014. The effects of health information technology adoption and hospital-physician integration on hospital efficiency. The American journal of managed care 20(11 Spec No. 17) eSP9-eSP15.Google Scholar
  67. 67.
    Chowdhury H, Wodchis W, Laporte A (2011) Efficiency and technological change in health care services in Ontario: An application of Malmquist Productivity Index with bootstrapping. Int J Product Perform Manag 60(7):721–745CrossRefGoogle Scholar
  68. 68.
    Chowdhury H, Zelenyuk V (2016) Performance of hospital services in Ontario: DEA with truncated regression approach. Omega 63:111–122CrossRefGoogle Scholar
  69. 69.
    Chowdhury H, Zelenyuk V, Laporte A, Wodchis WP (2014) Analysis of productivity, efficiency and technological changes in hospital services in Ontario: How does case-mix matter? Int J Prod Econ 150(0):74–82CrossRefGoogle Scholar
  70. 70.
    Chu H-L, Chiang C-Y (2013) The effects of strategic hospital alliances on hospital efficiency. Serv Ind J 33(6):624–635CrossRefGoogle Scholar
  71. 71.
    Chua CL, Palangkaraya A, Yong J (2011) Hospital Competition, Technical Efficiency and Quality. Econ Rec 87(277):252–268CrossRefGoogle Scholar
  72. 72.
    Chuang C-L, Chang P-C, Lin R-H (2011) An Efficiency Data Envelopment Analysis Model Reinforced by Classification and Regression Tree for Hospital Performance Evaluation. J Med Syst 35(5):1075–1083CrossRefGoogle Scholar
  73. 73.
    Chung YH, Färe R, Grosskopf S (1997) Productivity and undesirable outputs: a directional distance function approach. J Environ Manag 51(3):229–240CrossRefGoogle Scholar
  74. 74.
    Clement JP, Valdmanis VG, Bazzoli GJ, Zhao M, Chukmaitov A (2008) Is more better? An analysis of hospital outcomes and efficiency with a DEA model of output congestion. Health Care Man Sci 11(1):67–77CrossRefGoogle Scholar
  75. 75.
    Coelli, T., D. S. Prasada Rao, G. E. Battese. 1998. An introduction to efficiency and productivity analysis. Kluwer Acad. Publ, Boston [u.a.].Google Scholar
  76. 76.
    Cook WD, Seiford LM, Zhu J (2013) Data envelopment analysis: The research frontier. Omega 41(1):1–2CrossRefGoogle Scholar
  77. 77.
    Cook WD, Zhu J (2007) Classifying inputs and outputs in data envelopment analysis. European Journal of Operational Research 180(2):692–699CrossRefGoogle Scholar
  78. 78.
    Cooper WW, Gu B, Li S (2001a) Comparisons and evaluations of alternative approaches to the treatment of congestion in DEA. Eur J Oper Res 132(1):62–74CrossRefGoogle Scholar
  79. 79.
    Cooper WW, Gu B, Li S (2001b) Note: alternative treatments of congestion in DEA-a response to the Cherchye, Kuosmanen and Post critique. Eur J Oper Res 132(1):81–87CrossRefGoogle Scholar
  80. 80.
    Cooper WW, Seiford LM, Tone K (2007b) Data envelopment analysis: a comprehensive text with models, applications, references and DEA-solver software. Springer Science & Business Media, New YorkGoogle Scholar
  81. 81.
    Cooper WW, Seiford LM, Zhu J (2000) A unified additive model approach for evaluating inefficiency and congestion with associated measures in DEA. Socio Econ Plan Sci 34(1):1–25CrossRefGoogle Scholar
  82. 82.
    Cooper WW, Seiford LM, Zhu J (2001c) Slacks and congestion: response to a comment by R. Färe and S. Grosskopf. Socio Econ Plan Sci 35(3):205–215CrossRefGoogle Scholar
  83. 83.
    Cooper WW, Seiford LM, Zhu J (2011) Handbook on data envelopment analysis. Springer, New YorkCrossRefGoogle Scholar
  84. 84.
    Cordero JM, Santín D, Sicilia G (2015) Testing the accuracy of DEA estimates under endogeneity through a Monte Carlo simulation. Eur J Oper Res 244(2):511–518CrossRefGoogle Scholar
  85. 85.
    Corredoira RA, Chilingerian JA, Kimberly JR (2011) Analyzing performance in addiction treatment: An application of data envelopment analysis to the state of Maryland system. J Subst Abus Treat 41(1):1–13CrossRefGoogle Scholar
  86. 86.
    Czypionka T, Kraus M, Mayer S, Röhrling G (2013) Efficiency, ownership, and financing of hospitals: The case of Austria. Health Care Manag Sci 17(4):331–347CrossRefGoogle Scholar
  87. 87.
    Czypionka T, Kraus M, Mayer S, Röhrling G, Schnabl A (2015) Hospital Ownership and Efficiency in Austria: Are Public Hospitals Better off?Google Scholar
  88. 88.
    Dash U, Vaishnavi SD, Muraleedharan VR (2010) Technical Efficiency and Scale Efficiency of District Hospitals: A Case Study. J Health Manag 12(3):231–248CrossRefGoogle Scholar
  89. 89.
    Dash U, Vaishnavi SD, Muraleedharan VR, Acharya D (2007) Benchmarking the Performance of Public Hospitals in Tamil Nadu: An Application of Data Envelopment Analysis. J Health Manag 9(1):59–74CrossRefGoogle Scholar
  90. 90.
    DeLellis NO, Ozcan YA (2013) Quality outcomes among efficient and inefficient nursing homes: A national study. Health Care Manag Rev 38(2):156–165CrossRefGoogle Scholar
  91. 91.
    Dexter F, O’Neill L, Xin L, Ledolter J (2008) Sensitivity of super-efficient data envelopment analysis results to individual decision-making units: an example of surgical workload by specialty. Health Care Manag Sci 11(4):307–318CrossRefGoogle Scholar
  92. 92.
    Dharmapala PS (2009) Adding value in healthcare service by improving operational efficiency using data envelopment analysis. Int J Oper Res 5(1):73–88CrossRefGoogle Scholar
  93. 93.
    Dimas G, Goula A, Soulis S (2012) Productive performance and its components in Greek public hospitals. Operational Research 12(1):15–27CrossRefGoogle Scholar
  94. 94.
    Donabedian A (1988) The quality of care: how can it be assessed? J Am Med Assoc 260(12):1743–1748CrossRefGoogle Scholar
  95. 95.
    Dotoli M, Epicoco N, Falagario M, Sciancalepore F (2015) A cross-efficiency fuzzy data envelopment analysis technique for performance evaluation of decision making units under uncertainty. Computers & Industrial Engineering 79:103–114CrossRefGoogle Scholar
  96. 96.
    Du J, Liang L, Zhu J (2010) A slacks-based measure of super-efficiency in data envelopment analysis: A comment. Eur J Oper Res 204(3):694–697CrossRefGoogle Scholar
  97. 97.
    Du J, Wang J, Chen Y, Chou S-Y, Zhu J (2014) Incorporating health outcomes in Pennsylvania hospital efficiency: an additive super-efficiency DEA approach. Ann Oper Res 221(1):161–172CrossRefGoogle Scholar
  98. 98.
    Dyson RG, Allen R, Camanho AS, Podinovski VV, Sarrico CS, Shale EA (2001) Pitfalls and protocols in DEA. Eur J Oper Res 132(2):245–259CrossRefGoogle Scholar
  99. 99.
    Ebrahimnejad A (2012) Cost efficiency measures with trapezoidal fuzzy numbers in data envelopment analysis based on ranking functions: application in insurance organization and hospital. Int J Fuzzy Syst Appl 2(3):51–68CrossRefGoogle Scholar
  100. 100.
    Emrouznejad A, Parker BR, Tavares G (2008) Evaluation of research in efficiency and productivity: A survey and analysis of the first 30 years of scholarly literature in DEA. Socio Econ Plan Sci 42(3):151–157CrossRefGoogle Scholar
  101. 101.
    Emrouznejad A, de Witte K (2010) COOPER-framework: A unified process for non-parametric projects. Eur J Oper Res 207(3):1573–1586CrossRefGoogle Scholar
  102. 102.
    Falavigna G, Ippoliti R, Manello A (2013) Hospital organization and performance: a directional distance function approach. Health Care Manag Sci 16(2):139–151CrossRefGoogle Scholar
  103. 103.
    Fang H-H, Lee H-S, Hwang S-N, Chung C-C (2013) A slacks-based measure of super-efficiency in data envelopment analysis: An alternative approach. Omega 41(4):731–734CrossRefGoogle Scholar
  104. 104.
    Farantos GI, Koutsoukis NS (2016) Efficiency Study of Greek Health Units of the Public Sector using Data Envelopment Analysis Method, before and during the start of the Economic Crisis. Int J Bus Econ Sci Appl Res 9(2):19–31Google Scholar
  105. 105.
    Färe R, Grosskopf S (2000a) Network DEA. Socio-Econ Plan Sci 34(1):35–49CrossRefGoogle Scholar
  106. 106.
    Färe R, Grosskopf S (2000b) Slacks and congestion: a comment. Socio Econ Plan Sci 34(1):27–33CrossRefGoogle Scholar
  107. 107.
    Färe R, Grosskopf S (2000c) Theory and Application of Directional Distance Functions. J Prod Anal 13(2):93–103CrossRefGoogle Scholar
  108. 108.
    Färe R, Grosskopf S (2001) When can slacks be used to identify congestion? An answer to WW Cooper, L. Seiford and J. Zhu. Socio Econ Plan Sci 35(3):217–221CrossRefGoogle Scholar
  109. 109.
    Färe R, Grosskopf S (2004) Modeling undesirable factors in efficiency evaluation: Comment. Eur J Oper Res 157(1):242–245CrossRefGoogle Scholar
  110. 110.
    Färe R, Grosskopf S, Lindgren B, Roos P (1992) Productivity changes in Swedish pharamacies 1980-1989: A non-parametric Malmquist approach. J Prod Anal 3(1-2):85–101CrossRefGoogle Scholar
  111. 111.
    Färe R, Grosskopf S, Lindgren B, Roos P (1994a) Productivity Developments in Swedish Hospitals: A Malmquist Output Index Approach. In: Data Envelopment Analysis: Theory, Methodology, and Applications (pp. 253-272). Springer, DordrechtGoogle Scholar
  112. 112.
    Färe R, Grosskopf S, Lovell C (1994b) Production Frontiers. Cambridge University Press, CambridgeGoogle Scholar
  113. 113.
    Färe R, Grosskopf S, Lovell CK (1985) The measurements of efficiency of production. Springer, New YorkCrossRefGoogle Scholar
  114. 114.
    Färe R, Grosskopf S, Norris M, Zhang Z (1994c) Productivity growth, technical progress, and efficiency change in industrialized countries. Am Econ Rev 84(1):66–83Google Scholar
  115. 115.
    Fareed N, Ozcan YA, DeShazo JP (2012) Hospital electronic medical record enterprise application strategies: Do they matter? Health Care Manag Rev 37(1):4–13CrossRefGoogle Scholar
  116. 116.
    Farrell MJ (1957) The Measurement of Productive Efficiency. Journal of the Royal Statistical Society. Series A (General) 120(3):253–290CrossRefGoogle Scholar
  117. 117.
    Feng Q, Antony J (2010) Integrating DEA into Six Sigma methodology for measuring health service efficiency. The Journal of the Operational Research Society 61(7):1112–1121CrossRefGoogle Scholar
  118. 118.
    Ferrari A (2006) Market oriented reforms of health services: A non-parametric analysis. Serv Ind J 26(1):1–13CrossRefGoogle Scholar
  119. 119.
    Ferrier G, Hirschberg J (1997) Bootstrapping Confidence Intervals for Linear Programming Efficiency Scores: With an Illustration Using Italian Banking Data. J Prod Anal 8(1):19–33CrossRefGoogle Scholar
  120. 120.
    Ferrier GD, Hirschberg JG (1999) Can we bootstrap DEA scores? J Prod Anal 11(1):81–92CrossRefGoogle Scholar
  121. 121.
    Ferrier GD, Leleu H, Valdmanis VG (2010) The impact of CON regulation on hospital efficiency. Health Care Manag Sci 13(1):84–100CrossRefGoogle Scholar
  122. 122.
    Ferrier GD, Rosko MD, Valdmanis VG (2006) Analysis of uncompensated hospital care using a DEA model of output congestion. Health Care Manag Sci 9(2):181–188CrossRefGoogle Scholar
  123. 123.
    Ferrier GD, Trivitt JS (2013) Incorporating quality into the measurement of hospital efficiency: a double DEA approach. J Prod Anal 40(3):337–355CrossRefGoogle Scholar
  124. 124.
    Fiallos J, Patrick J, Michalowski W, Farion K (2015) Using data envelopment analysis for assessing the performance of pediatric emergency department physicians. Health Care Managt Sci 20(1):129–140CrossRefGoogle Scholar
  125. 125.
    Flokou A, Aletras V, Niakas D (2017) Decomposition of potential efficiency gains from hospital mergers in Greece. Health Care Manag Sci 20(4):467-484Google Scholar
  126. 126.
    Flokou A, Kontodimopoulos N, Niakas D (2011) Employing post-DEA Cross-evaluation and Cluster Analysis in a Sample of Greek NHS Hospitals. J Med Syst 35(5):1001–1014CrossRefGoogle Scholar
  127. 127.
    Førsund FR, Sarafoglou N (2002) On the origins of data envelopment analysis. J Prod Anal 17(1):23–40CrossRefGoogle Scholar
  128. 128.
    Fragkiadakis G, Doumpos M, Zopounidis C, Germain C (2014) Operational and economic efficiency analysis of public hospitals in Greece. Ann Oper Res 247(2):787–806CrossRefGoogle Scholar
  129. 129.
    Friesner D, Rosenman R, McPherson MQ (2008) Are hospitals seasonally inefficient? Evidence from Washington State. Appl Econ 40(6):699–723CrossRefGoogle Scholar
  130. 130.
    Fulton L, Lasdon LS, McDaniel RR (2007) Cost drivers and resource allocation in military health care systems. Military medicine 172(3):244–249CrossRefGoogle Scholar
  131. 131.
    Gai R, Zhou C, Xu L, Zhu M, Wang X, Li S, Zheng W, Song P, Yang X, Fang L (2010) Health resource allocation and productive efficiency of Chinese county hospitals: Data from 1993 to 2005. Biosci Trends 4(5):218-224Google Scholar
  132. 132.
    Gannon B (2005) Testing for variation in technical efficiency of hospitals in Ireland. Economic and Social Review 36(3):273–294Google Scholar
  133. 133.
    Gannon B (2008) Total factor productivity growth of hospitals in Ireland: a nonparametric approach. Appl Econ Lett 15(2):131–135CrossRefGoogle Scholar
  134. 134.
    Garcia-Lacalle J, Martin E (2010) Rural vs urban hospital performance in a 'competitive' public health service. Soc Sci Med (1982) 71(6):1131–1140CrossRefGoogle Scholar
  135. 135.
    Gautam S, Hicks L, Johnson T, Mishra B (2013) Measuring the Performance of Critical Access Hospitals in Missouri Using Data Envelopment Analysis. J Rural Health 29(2):150–158CrossRefGoogle Scholar
  136. 136.
    Ghotbuee A, Hemati M, Fateminezhad R (2012) An empirical study based on BSC-DEA to measure the relative efficiencies of different health care centers in province of Semnan, Iran. Manag Sci Lett 2(7):2643–2650CrossRefGoogle Scholar
  137. 137.
    Girginer N, Köse T, Uçkun N (2015) Efficiency analysis of surgical services by combined use of data envelopment analysis and gray relational analysis. JMed Systs 39(5):56Google Scholar
  138. 138.
    Gok MS, Altındağ E (2015) Analysis of the cost and efficiency relationship: experience in the Turkish pay for performance system. Eur J Health Econ 16(5):459–469CrossRefGoogle Scholar
  139. 139.
    Gok MS, Sezen B (2013) Analyzing the ambiguous relationship between efficiency, quality and patient satisfaction in healthcare services: the case of public hospitals in Turkey. Health Policy 111(3):290–300CrossRefGoogle Scholar
  140. 140.
    Golany B, Roll Y (1989) An application procedure for DEA. Omega 17(3):237–250CrossRefGoogle Scholar
  141. 141.
    Gonçalves AC, Noronha CP, Lins MPE, Almeida RM (2007) Data envelopment analysis for evaluating public hospitals in Brazilian state capitals. Rev Saude Publica 41(3):427–435CrossRefGoogle Scholar
  142. 142.
    Gouveia MC, Dias LC, Antunes CH, Mota MA, Duarte EM, Tenreiro EM (2015) An application of value-based DEA to identify the best practices in primary health care. OR Spectr 38(3):743–767CrossRefGoogle Scholar
  143. 143.
    Goverdhan M, Nellutla R, Haragopal VV (2016) A critical Data Envelopment Analysis of hospital efficiency in India. Int J Sci Res 5(2):471–475Google Scholar
  144. 144.
    Grifell-Tatjé E, Lovell CK (1995) A note on the Malmquist productivity index. Econ Lett 47(2):169–175CrossRefGoogle Scholar
  145. 145.
    Groff J, Lien D, Su J (2007) Measuring efficiency gains from hospital mergers. Res Healthcare Financial Manag 11(1):77–90Google Scholar
  146. 146.
    Hajialiafzali H, Moss JR, Mahmood MA (2007) Efficiency Measurement for Hospitals Owned by the Iranian Social Security Organisation. J Med Syst 31(3):166–172CrossRefGoogle Scholar
  147. 147.
    Harrison JP, Coppola MN (2007) Is the quality of hospital care a function of leadership? Health Care Manag 26(3):263–272Google Scholar
  148. 148.
    Harrison JP, Meyer S (2014) Measuring efficiency among US federal hospitals. Health Care Manag 33(2):117–127Google Scholar
  149. 149.
    Harrison JP, Ogniewski R, Hoelscher S (2009) The improving efficiency of critical access hospitals. Health Care Manag 28(3):209–217Google Scholar
  150. 150.
    Harrison JP, Ogniewski RJ (2005) An efficiency analysis of Veterans Health Administration hospitals. Mil Med 170(7):607–611CrossRefGoogle Scholar
  151. 151.
    Harrison JP, Sexton C (2006) The Improving Efficiency Frontier of Religious Not-for-Profit Hospitals. Hosp Top 84(1):2–10CrossRefGoogle Scholar
  152. 152.
    Hatam N (2008) The role of Data Envelopment Analysis (DEA) pattern in the efficiency of social security hospitals in Iran. Iran Red Crescent Med J 10(3):211–217Google Scholar
  153. 153.
    Hatam N, Moslehi S, Askarian M, Shokrpour N, Keshtkaran A, Abbasi M (2010) The Efficiency of General Public Hospitals in Fars Prov-ince, Southern Iran. Iran Red Crescent Med J 12(2):138–144Google Scholar
  154. 154.
    Hatami-Marbini A, Tavana M, Emrouznejad A (2012) Productivity growth and efficiency measurements in fuzzy environments with an application to health care. Int J Fuzzy Syst Appl 2(2):1–35CrossRefGoogle Scholar
  155. 155.
    Helton JR, Langabeer JR (2012) Longitudinal Changes in the Operating Efficiency of Public Safety-Net Hospitals. J Healthc Manag 57(3):214–226CrossRefGoogle Scholar
  156. 156.
    Herwartz H, Strumann C (2012) On the effect of prospective payment on local hospital competition in Germany. Health Care Manag Sci 15(1):48–62CrossRefGoogle Scholar
  157. 157.
    Herwartz H, Strumann C (2014) Hospital efficiency under prospective reimbursement schemes: an empirical assessment for the case of Germany. Eur J Health Econ 15(2):175–186CrossRefGoogle Scholar
  158. 158.
    Highfill T, Ozcan Y (2016) Productivity and quality of hospitals that joined the Medicare Shared Savings Accountable Care Organization Program. Int JHealthcare Manag 9(3):210–217CrossRefGoogle Scholar
  159. 159.
    Hofmarcher MM, Lietz C, Schnabl A (2005) Inefficiency in Austrian Inpatient Care: Identifying Ailing Providers Based on DEA Results. Cent Eur JOper Res 13(4):341–363Google Scholar
  160. 160.
    Hollingsworth B (2003) Non-parametric and parametric applications measuring efficiency in health care. Health Care Manag Sci 6(4):203–218CrossRefGoogle Scholar
  161. 161.
    Hollingsworth B (2008) The measurement of efficiency and productivity of health care delivery. Health Econ 17(10):1107–1128CrossRefGoogle Scholar
  162. 162.
    Hollingsworth B, Dawson PJ, Maniadakis N (1999) Efficiency measurement of health care: a review of non-parametric methods and applications. Health Care Manag Sci 2(3):161–172CrossRefGoogle Scholar
  163. 163.
    Hollingsworth B, Peacock SJ (2008) Efficiency Measurement in Health and Healthcare. Routledge, LondonGoogle Scholar
  164. 164.
    Hollingsworth B, Street A (2006) The market for efficiency analysis of health care organisations. Health Econ 15(10):1055–1059CrossRefGoogle Scholar
  165. 165.
    Hsieh H-M, Clement DG, Bazzoli GJ (2010) Impacts of market and organizational characteristics on hospital efficiency and uncompensated care. Health Care Manag Rev 35(1):77–87CrossRefGoogle Scholar
  166. 166.
    Hsu P-F, Hu H-C (2007) "The development and application of a modified data envelopment analysis for assessing the efficiency of different kinds of hospitals." International Journal of Management 24(2):318.Google Scholar
  167. 167.
    Hu H-H, Qi Q, Yang C-H (2012a) Analysis of hospital technical efficiency in China: Effect of health insurance reform. China Economic Review 23(4):865–877CrossRefGoogle Scholar
  168. 168.
    Hu H-H, Qi Q, Yang C-H (2012b) Evaluation of China’s regional hospital efficiency: DEA approach with undesirable output. J Oper Res Soc 63(6):715–725CrossRefGoogle Scholar
  169. 169.
    Huerta TR, Ford EW, Peterson LT, Brigham KH (2008) Testing the hospital value proposition: An empirical analysis of efficiency and quality. Health Care Manag Rev 33(4):341–349CrossRefGoogle Scholar
  170. 170.
    Huerta TR, Thompson MA, Ford EW, Ford William F (2013) Implementing electronic lab order entry management in hospitals: Incremental strategies lead to better productivity outcomes. International Journal of Information Management 33(1):40–47CrossRefGoogle Scholar
  171. 171.
    Ichoku HE, Fonta WM, Onwujekwe OE, Kirigia JM (2011) Evaluating the Technical Efficiency of Hospitals in Southeastern Nigeria. Eur JBusManag 3(2):24–37Google Scholar
  172. 172.
    Ippoliti R, Falavigna G (2012) Efficiency of the medical care industry: Evidence from the Italian regional system. European Journal of Operational Research 217(3):643–652CrossRefGoogle Scholar
  173. 173.
    Ismail K, Thorwarth M, Arisha A (2014) Integrated decision support systems for improving emergency department performance in Irish hospitals. Int J Oper Res 19(1):40–59CrossRefGoogle Scholar
  174. 174.
    Iyengar RN, Ozcan YA (2009) Performance evaluation of ambulatory surgery centres: an efficiency approach. Health Serv Manag Res 22(4):184–190CrossRefGoogle Scholar
  175. 175.
    Jacobs R, Smith PC, Street A (2006) Measuring efficiency in health care: analytic techniques and health policy. Cambridge University Press, CambridgeCrossRefGoogle Scholar
  176. 176.
    Jandaghi G, Matin HZ, Doremami M, Aghaziyarati M (2010) Efficiency evaluation of Qom public and private hospitals using data envelopment analysis. Eur J Econ Finance Adm Sci 22(2):83–91Google Scholar
  177. 177.
    Jat TR, San Sebastian M (2013) Technical efficiency of public district hospitals in Madhya Pradesh, India: a data envelopment analysis. Glob Health Action 6(1):1–8Google Scholar
  178. 178.
    Jehu-Appiah C, Sekidde S, Adjuik M, Akazili J, Almeida S, Nyonator F, Baltussen R, Asbu E, Kirigia J (2014) Ownership and technical efficiency of hospitals: evidence from Ghana using data envelopment analysis. Cost Eff Res Allocation 12(1):9–22CrossRefGoogle Scholar
  179. 179.
    Kacak H, Ozcan YA, Kavuncubasi S (2014) A new examination of hospital performance after healthcare reform in Turkey. Sensitivity and quality comparisons. Int J Public Policy 10(4-5):178–194CrossRefGoogle Scholar
  180. 180.
    Kaitelidou D, Katharaki M, Kalogeropoulou M, Economou C, Siskou O, Souliotis K, Tsavalias K, Liaropoulos L (2016) The impact of economic crisis to hospital sector and the efficiency of Greek public hospitals. European Journal of Business and. Soc Sci 4(10):111–125Google Scholar
  181. 181.
    Kakeman E, Forushani AR, Dargahi H (2016) Technical Efficiency of Hospitals in Tehran, Iran. Iranian J Public Health 45(4):494Google Scholar
  182. 182.
    Kalhor R, Amini S, Sokhanvar M, Lotfi F, Sharifi M, Kakemam E (2016) Factors affecting the technical efficiency of general hospitals in Iran: data envelopment analysis. J Egyptian Public Health Assoc 91(1):20–25CrossRefGoogle Scholar
  183. 183.
    Karagiannis R, Velentzas K (2012) Productivity and quality changes in Greek public hospitals. Oper Res 12(1):69–81Google Scholar
  184. 184.
    Katharaki M (2008) Approaching the management of hospital units with an operation research technique: The case of 32 Greek obstetric and gynaecology public units. Health Policy 85(1):19–31CrossRefGoogle Scholar
  185. 185.
    Kawaguchi H, Tone K, Tsutsui M (2014) Estimation of the efficiency of Japanese hospitals using a dynamic and network data envelopment analysis model. Health Care Manag Sci 17(2):101–112CrossRefGoogle Scholar
  186. 186.
    Kazley AS, Ozcan YA (2009) Electronic medical record use and efficiency: A DEA and windows analysis of hospitals. Socio Econ Plan Sci 43(3):209–216CrossRefGoogle Scholar
  187. 187.
    Ketabi S (2011) Efficiency Measurement of Cardiac Care Units of Isfahan Hospitals in Iran. J Med Syst 35(2):143–150CrossRefGoogle Scholar
  188. 188.
    Khani F, Naderi H, Zangeneh M, Fazeli E (2012) Measuring the relative efficiency of Ilam hospitals using data envelopment analysis. Manag Sci Lett 2(4):1189–1194CrossRefGoogle Scholar
  189. 189.
    Kheirollahi H, Matin BK, Mahboubi M, Alavijeh MM (2015) Chance constrained input relaxation to congestion in stochastic DEA. An application to Iranian hospitals. Global J Health Sci 7(4):151CrossRefGoogle Scholar
  190. 190.
    Kiadaliri A, Jafari M, Gerdtham U-G (2013) Frontier-based techniques in measuring hospital efficiency in Iran: a systematic review and meta-regression analysis. BMC Health Serv Res 13(1):312–322CrossRefGoogle Scholar
  191. 191.
    Kirigia J, Asbu E (2013) Technical and scale efficiency of public community hospitals in Eritrea: an exploratory study. Heal Econ Rev 3(1):6–21CrossRefGoogle Scholar
  192. 192.
    Kirigia J, Emrouznejad A, Cassoma B, Asbu EZ, Barry S (2008) A Performance Assessment Method for Hospitals: The Case of Municipal Hospitals in Angola. J Med Syst 32(6):509–519CrossRefGoogle Scholar
  193. 193.
    Kirigia J, Sambo L, Renner A, Alemu W, Seasa S, Bah Y (2011) Technical efficiency of primary health units in Kailahun and Kenema districts of Sierra Leone. Int Arch Med 4(1):15–28CrossRefGoogle Scholar
  194. 194.
    Kirigia JM, Asbu EZ, Greene W, Emrouznejad A (2007a) Technical efficiency, efficiency change, technical progress and productivity growth in the national health systems of continental African countries. East Afr Soc Sci Res Rev 23(2):19–40CrossRefGoogle Scholar
  195. 195.
    Kirigia JM, Emrouznejad A, Gama Vaz R, Bastiene H, Padayachy J (2007b) A comparative assessment of performance and productivity of health centres in Seychelles. Int J Product Perform Manag 57(1):72–92CrossRefGoogle Scholar
  196. 196.
    Kjekshus L, Hagen T (2007) Do hospital mergers increase hospital efficiency? Evidence from a National Health Service country. J Health Serv Res Policy 12(4):230–235CrossRefGoogle Scholar
  197. 197.
    Kontodimopoulos N, Nanos P, Niakas D (2006) Balancing efficiency of health services and equity of access in remote areas in Greece. Health Policy 76(1):49–57CrossRefGoogle Scholar
  198. 198.
    Kontodimopoulos N, Niakas D (2005) Efficiency measurement of hemodialysis units in Greece with data envelopment analysis. Health Policy 71(2):195–204CrossRefGoogle Scholar
  199. 199.
    Kontodimopoulos N, Niakas D (2006) A 12-year Analysis of Malmquist Total Factor Productivity in Dialysis Facilities. J Med Syst 30(5):333–342CrossRefGoogle Scholar
  200. 200.
    Köse T, Uçkun N, Girginer N (2014) An efficiency analysis of the clinical departments of a public hospital in Eskisehir by using DEA. Global Journal on Advances Pure and. Applied Sciences 4:252–258Google Scholar
  201. 201.
    Kounetas K, Papathanassopoulos F (2013) How efficient are Greek hospitals? A case study using a double bootstrap DEA approach. Eur J Health Econ 14(6):979–994CrossRefGoogle Scholar
  202. 202.
    Kristensen T, Bogetoft P, Pedersen K (2010) Potential gains from hospital mergers in Denmark. Health Care Management Science 13(4):334–345CrossRefGoogle Scholar
  203. 203.
    Kuntz L, Scholtes S, Vera A (2007) Incorporating efficiency in hospital-capacity planning in Germany. Eur J Health Econ 8(3):213–223CrossRefGoogle Scholar
  204. 204.
    Laine J, Finne-Soveri UH, Björkgren M, Linna M, Noro A, Häkkinen U (2005) The association between quality of care and technical efficiency in long-term care. Int J Qual Health Care 17(3):259–267CrossRefGoogle Scholar
  205. 205.
    Langabeer JR, Ozcan YA (2009) The economics of cancer care: longitudinal changes in provider efficiency. Health Care Management Science 12(2):192–200CrossRefGoogle Scholar
  206. 206.
    Lee K-H, Park J, Lim S, Park S-C (2015) Has competition increased hospital technical efficiency? Health Care Manag 34(2):106–112Google Scholar
  207. 207.
    Lee K-H, Yang S-B, Choi M (2009) The Association between Hospital Ownership and Technical Efficiency in a Managed Care Environment. J Med Syst 33(4):307–315CrossRefGoogle Scholar
  208. 208.
    Lee K-s, Chun K-h, Lee J-s (2008) Reforming the hospital service structure to improve efficiency: Urban hospital specialization. Health Policy 87(1):41–49CrossRefGoogle Scholar
  209. 209.
    Li H, Dong S (2015) Measuring and Benchmarking Technical Efficiency of Public Hospitals in Tianjin, China: A Bootstrap–Data Envelopment Analysis Approach. INQUIRY: J Health Care Org, Provision Financing 52:1–5Google Scholar
  210. 210.
    Li H, Dong S, Liu T (2014) Relative efficiency and productivity: a preliminary exploration of public hospitals in Beijing, China. BMC Health Serv Res 14(1):158–168CrossRefGoogle Scholar
  211. 211.
    Lindlbauer I, Schreyögg J (2014) The relationship between hospital specialization and hospital efficiency: do different measures of specialization lead to different results? Health Care Manag Sci 17(4):365–378CrossRefGoogle Scholar
  212. 212.
    Lindlbauer I, Schreyögg J, Winter V (2016) Changes in technical efficiency after quality management certification: A DEA approach using difference-in-difference estimation with genetic matching in the hospital industry. Eur J Oper Res 250(3):1026–1036CrossRefGoogle Scholar
  213. 213.
    Linna M, Häkkinen U, Magnussen J (2006) Comparing hospital cost efficiency between Norway and Finland. Health Policy 77(3):268–278CrossRefGoogle Scholar
  214. 214.
    Linna M, Häkkinen U, Peltola M, Magnussen J, Anthun KS, Kittelsen S, Roed A, Olsen K, Medin E, Rehnberg C (2010) Measuring cost efficiency in the Nordic Hospitals—a cross-sectional comparison of public hospitals in 2002. Health Care Manag Sci 13(4):346–357CrossRefGoogle Scholar
  215. 215.
    Liu JS, Lu LYY, Lu W-M, Lin BJY (2013a) A survey of DEA applications. Omega 41(5):893–902CrossRefGoogle Scholar
  216. 216.
    Liu JS, Lu LYY, Lu W-M, Lin BJY (2013b) Data envelopment analysis 1978-2010: A citation-based literature survey. Omega 41(1):3–15CrossRefGoogle Scholar
  217. 217.
    Liu Q, Zhang X, Guo Y, Zhang Y, Wang Y, Li B, Wang Y (2016) The Correlation of Hospital Operational Efficiency and Average Length of Stay in China: A Study Based on Provincial Level Data. J Biosci Med 4(12):49–55Google Scholar
  218. 218.
    Liu X, Mills A (2005) The effect of performance-related pay of hospital doctors on hospital behaviour: a case study from Shandong, China. Hum Resour Health 3(11):1–12Google Scholar
  219. 219.
    Lobo MSC, Ozcan YA, Lins MPE, Silva ACM, Fiszman R (2014) Teaching hospitals in Brazil: Findings on determinants for efficiency. Int J Healthcare Manag 7(1):60–68CrossRefGoogle Scholar
  220. 220.
    Lotfi F, Kalhor R, Bastani P, Zadeh NS, Eslamian M, Dehghani MR, Kiaee MZ (2014) Various Indicators for the Assessment of Hospitals’ Performance Status: Differences and Similarities. Iranian Red Crescent Medical Journal 16(4):1–7CrossRefGoogle Scholar
  221. 221.
    Löthgren M (1998) How to bootstrap DEA estimators: a Monte Carlo comparison. Working paper series in Economics and Finance (223)Google Scholar
  222. 222.
    Luenberger DG (1992) New optimality principles for economic efficiency and equilibrium. J Optim Theory Appl 75(2):221–264CrossRefGoogle Scholar
  223. 223.
    Lyroudi K, Glaveli N, Koulakiotis A, Angelidis D (2006) The productive performance of public hospital clinics in Greece: a case study. Health Serv Manag Res 19(2):67–72CrossRefGoogle Scholar
  224. 224.
    Magnussen J, Nyland K (2008) Measuring efficiency in clinical departments. Health Policy 87(1):1–7CrossRefGoogle Scholar
  225. 225.
    Mahate A, Hamidi S (2015) Frontier efficiency of hospitals in United Arab Emirates: An application of data envelopment analysis. Journal of Hospital Administration 5(1):7CrossRefGoogle Scholar
  226. 226.
    Mahate A, Hamidi S, Akinci F (2016) Measuring the Effect of Size on Technical Efficiency of the United Arab Emirates Hospitals. Global J Health Sci 9(3):116CrossRefGoogle Scholar
  227. 227.
    Malmquist S (1953) Index numbers and indifference surfaces. Trabajos de Estadistica y de Investigacion Operativa 4(2):209–242CrossRefGoogle Scholar
  228. 228.
    Mancuso P, Valdmanis VG (2016) Care appropriateness and health productivity evolution: a non-parametric analysis of the italian regional health systems. Appl Health Econ Health Policy 14(5):595–607CrossRefGoogle Scholar
  229. 229.
    Maniadakis N, Hollingsworth B, Thanassoulis E (1999) The impact of the internal market on hospital efficiency, productivity and service quality. Health Care Manag Sci 2(2):75–85CrossRefGoogle Scholar
  230. 230.
    Mark B, Jones C, Lindley L, Ozcan YA (2009) An examination of technical efficiency, quality, and patient safety in acute care nursing units. Policy Polit Nurs Pract 10(3):180–186CrossRefGoogle Scholar
  231. 231.
    Marnani AB, Sadeghifar J, Pourmohammadi K, Mostafaie D, Abolhalaj M, Bastani P (2012) Performance assessment indicators: how DEA and Pabon Lasso describe Iranian hospitals’ performance. HealthMED 13(3):791–796Google Scholar
  232. 232.
    Marques RC, Carvalho P (2013) Estimating the efficiency of Portuguese hospitals using an appropriate production technology. Int Trans Oper Res 20(2):233–249CrossRefGoogle Scholar
  233. 233.
    Marschall P, Flessa S (2009) Assessing the efficiency of rural health centres in Burkina Faso: an application of Data Envelopment Analysis. Journal of Public Health 17(2):87–95CrossRefGoogle Scholar
  234. 234.
    Marschall P, Flessa S (2011) Efficiency of primary care in rural Burkina Faso. A two-stage DEA analysis. Heal Econ Rev 1(5):1–15Google Scholar
  235. 235.
    Masiye F (2007) Investigating health system performance: An application of data envelopment analysis to Zambian hospitals. BMC Health Serv Res 7(1):58–68CrossRefGoogle Scholar
  236. 236.
    Masiye F, Kirigia J, Emrouznejad A, Sambo L, Mounkaila A, Chimfwembe D, Okello D (2006) Efficient Management of Health Centres Human Resources in Zambia. J Med Syst 30(6):473–481CrossRefGoogle Scholar
  237. 237.
    Matranga D, Sapienza F (2015) Congestion analysis to evaluate the efficiency and appropriateness of hospitals in Sicily. Health Policy 119(3):324–332CrossRefGoogle Scholar
  238. 238.
    Mehrtak M, Jaafaripooyan E, Yusefzadeh H (2014) Pabon Lasso and Data Envelopment Analysis: A Complementary Approach to Hospital Performance Measurement. Global J Health Sci 6(4):107–116CrossRefGoogle Scholar
  239. 239.
    Mirmirani S, Li HC, Ilacqua JA (2008) Health care efficiency in transition economies: an application of data envelopment analysis. Int Bus Econ Res J 7(2):47–56Google Scholar
  240. 240.
    Misiunas N, Oztekin A, Chen Y, Chandra K (2016) DEANN: A healthcare analytic methodology of data envelopment analysis and artificial neural networks for the prediction of organ recipient functional status. Omega 58:46–54CrossRefGoogle Scholar
  241. 241.
    Mitropoulos P, Mastrogiannis N, Mitropoulos I (2014) Seeking interactions between patient satisfaction and efficiency in primary healthcare: cluster and DEA analysis. Int J Multicriteria Decis Mak 4(3):234–251CrossRefGoogle Scholar
  242. 242.
    Mitropoulos P, Mitropoulos I, Sissouras A (2013) Managing for efficiency in health care: the case of Greek public hospitals. Eur J Health Econ 14(6):929–938CrossRefGoogle Scholar
  243. 243.
    Mitropoulos P, Talias ΜA, Mitropoulos I (2015) Combining stochastic DEA with Bayesian analysis to obtain statistical properties of the efficiency scores: An application to Greek public hospitals. Eur J Oper Res 243(1):302–311CrossRefGoogle Scholar
  244. 244.
    Mogha S, Yadav S, Singh SP (2014) New slack model based efficiency assessment of public sector hospitals of Uttarakhand: state of India. Int J Syst Assur Eng Manag 5(1):32–42CrossRefGoogle Scholar
  245. 245.
    Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred Reporting Items for Systematic Reviews and Meta-Analyses: The PRISMA StatementThe PRISMA Statement. Ann Intern Med 151(4):264–269CrossRefGoogle Scholar
  246. 246.
    Mossialos E, Wenzl M, Osborn R, Anderson C (2016) 2015 International profiles of health care systems. Canadian Agency for Drugs and Technologies in HealthGoogle Scholar
  247. 247.
    Mujasi PN, Kirigia JM (2016) Productivity and Efficiency Changes in Referral Hospitals in Uganda: An Application of Malmquist Total Productivity Index. Health Syst Policy Res 3(1):1–12Google Scholar
  248. 248.
    Mujasi PN, Asbu EZ, Puig-Junoy J (2016) How efficient are referral hospitals in Uganda? A data envelopment analysis and tobit regression approach. BMC Health Services Research 16(1)Google Scholar
  249. 249.
    Murphy SM, Rosenman R, McPherson MQ, Friesner DL (2011) Measuring Shared Inefficiency Between Hospital Cost Centers. Med Care Res Rev 68(1 suppl):55–74CrossRefGoogle Scholar
  250. 250.
    Mutter R, Valdmanis V, Rosko M (2010) High versus lower quality hospitals: a comparison of environmental characteristics and technical efficiency. Health Serv Outcome Res Methodol 10(3-4):134–153CrossRefGoogle Scholar
  251. 251.
    Mutter RL, Rosko MD, Greene WH, Wilson PW (2011) Translating Frontiers Into Practice: Taking the Next Steps Toward Improving Hospital Efficiency. Med Care Res Rev 68(1 suppl):3–19CrossRefGoogle Scholar
  252. 252.
    Nabilou B, Yusefzadeh H, Rezapour A, Azar FEF, Safi PS, Asiabar AS, Ahmadzadeh N (2016) The productivity and its barriers in public hospitals: case study of ran. Med J Islamic Republic Iran 30:316Google Scholar
  253. 253.
    Nakata Y, Yoshimura T, Watanabe Y, Otake H, Oiso G, Sawa T (2015) Resource utilization in surgery after the revision of surgical fee schedule in Japan. Int J Health Care Qual Assur 28(6):635–643CrossRefGoogle Scholar
  254. 254.
    Narcı, H. Ö., Y. A. Ozcan, İ. Şahin, M. Tarcan, M. Narcı. 2014. An examination of competition and efficiency for hospital industry in Turkey. Health Care Manag Sci 18(4) 407–418.Google Scholar
  255. 255.
    Navarro-Espigares JL, Torres EH (2011) Efficiency and quality in health services: a crucial link. Serv Ind J 31(3):385–403CrossRefGoogle Scholar
  256. 256.
    Nayar P, Ozcan Y (2008) Data Envelopment Analysis Comparison of Hospital Efficiency and Quality. J Med Syst 32(3):193–199CrossRefGoogle Scholar
  257. 257.
    Nayar P, Ozcan YA, Yu F, Nguyen AT (2013) Benchmarking urban acute care hospitals: efficiency and quality perspectives. Health Care Manag Rev 38(2):137–145CrossRefGoogle Scholar
  258. 258.
    Nedelea IC, Fannin JM (2013) Technical efficiency of Critical Access Hospitals: an application of the two-stage approach with double bootstrap. Health Care Manag Sci 16(1):27–36CrossRefGoogle Scholar
  259. 259.
    Ng YC (2008) The Productive Efficiency of the Health Care Sector of China. Rev Reg Stud 38(3):381–393Google Scholar
  260. 260.
    Ng YC (2011) The productive efficiency of Chinese hospitals. China Econ Rev 22(3):428–439CrossRefGoogle Scholar
  261. 261.
    de Nicola A, Gitto S, Mancuso P (2012) Uncover the predictive structure of healthcare efficiency applying a bootstrapped data envelopment analysis. Expert Syst Appl 39(12):10495–10499CrossRefGoogle Scholar
  262. 262.
    Nunamaker TR (1983) Measuring routine nursing service efficiency: a comparison of cost per patient day and data envelopment analysis models. Health Serv Res 18(2 Pt 1):183Google Scholar
  263. 263.
    Nuti S, Daraio C, Speroni C, Vainieri M (2011) Relationships between technical efficiency and the quality and costs of health care in Italy. Int J Qual Health Care 23(3):324–330CrossRefGoogle Scholar
  264. 264.
    O’Neill L, Dexter F (2005) Methods for Understanding Super-Efficient Data Envelopment Analysis Results with an Application to Hospital Inpatient Surgery. Health Care Manag Sci 8(4):291–298CrossRefGoogle Scholar
  265. 265.
    O’Neill L, Rauner M, Heidenberger K, Kraus M (2008) A cross-national comparison and taxonomy of DEA-based hospital efficiency studies. Socio Econ Plan Sci 42(3):158–189CrossRefGoogle Scholar
  266. 266.
    Oikonomou N, Tountas Y, Mariolis A, Souliotis K, Athanasakis K, Kyriopoulos J (2015) Measuring the efficiency of the Greek rural primary health care using a restricted DEA model; the case of southern and western Greece. Health Care Manag Sci 19(4):313–325CrossRefGoogle Scholar
  267. 267.
    Osei D, d’Almeida S, George M, Kirigia J, Mensah A, Kainyu L (2005) Technical efficiency of public district hospitals and health centres in Ghana: a pilot study. Cost Eff Resour Allocation 3(1):1–13CrossRefGoogle Scholar
  268. 268.
    Ozcan YA (2014) Health care benchmarking and performance evaluation: an assessment using Data Envelopment Analysis (DEA). Springer, BerlinCrossRefGoogle Scholar
  269. 269.
    Ozcan YA, Khushalani J (2016) Assessing efficiency of public health and medical care provision in OECD countries after a decade of reform. CEJOR 25(2):325–343CrossRefGoogle Scholar
  270. 270.
    Ozcan YA, Legg JS (2014) Performance measurement for radiology providers: a national study. Int J Healthc Technol Manag 14(3):209–221CrossRefGoogle Scholar
  271. 271.
    Ozcan YA, Lins ME, Lobo MSC, da Silva ACM, Fiszman R, Pereira BB (2010) Evaluating the performance of Brazilian university hospitals. Ann Oper Res 178(1):247–261CrossRefGoogle Scholar
  272. 272.
    Ozcan YA, Luke RD (2011) Health care delivery restructuring and productivity change: Assessing the Veterans Integrated Service Networks (VISNs) Using the Malmquist Approach. Med Care Res Rev 68(1 suppl):20–35CrossRefGoogle Scholar
  273. 273.
    Özgen H, Şahin İ (2010) Measurement of efficiency of the dialysis sector in Turkey using data envelopment analysis. Health Policy 95(2-3):185–193CrossRefGoogle Scholar
  274. 274.
    Pakyz AL, Ozcan YA (2014) Use of data envelopment analysis to quantify opportunities for antibacterial targets for reduction of health care-associated clostridium difficile infection. Am J Med Qual 29(5):437–444CrossRefGoogle Scholar
  275. 275.
    Park JS, Fowler KL, Giebel SA (2011) Measuring Hospital Operating Efficiencies for Strategic Decisions. Int J Bus Soc Sci 2(13):56–60Google Scholar
  276. 276.
    Pedraja-Chaparro, F., J. Salinas-Jiménez, P. Smith, others. 1999. On the quality of the data envelopment analysis model. J Oper Res Soc 50(6) 636–644.Google Scholar
  277. 277.
    Pelone F, Kringos DS, Romaniello A, Archibugi M, Salsiri C, Ricciardi W (2015) Primary care efficiency measurement using data envelopment analysis: a systematic review. J Med Syst 39(1):1–14CrossRefGoogle Scholar
  278. 278.
    Pham TL (2011) Efficiency and productivity of hospitals in Vietnam. J Health Organ Manag 25(2):195–213CrossRefGoogle Scholar
  279. 279.
    Pilyavsky A, Staat M (2006) Health care in the CIS countries. Eur J Health Econ 7(3):185–191CrossRefGoogle Scholar
  280. 280.
    Pilyavsky AI, Aaronson WE, Bernet PM, Rosko MD, Valdmanis VG, Golubchikov MV (2006) East-west: does it make a difference to hospital efficiencies in Ukraine? Health Econ 15(11):1173–1186CrossRefGoogle Scholar
  281. 281.
    Polyzos N (2012) A three-year Performance Evaluation of the NHS Hospitals in Greece. Hippokratia 16(4):350Google Scholar
  282. 282.
    Prakash V, Annapoorni D (2015) Performance Evaluation of Public Hospitals in Tamil Nadu: DEA Approach. J Health Manag 17(4):417–424CrossRefGoogle Scholar
  283. 283.
    Prior D (2006) Efficiency and total quality management in health care organizations: A dynamic frontier approach. Ann Oper Res 145(1):281–299CrossRefGoogle Scholar
  284. 284.
    Puenpatom R, Rosenman R (2008) Efficiency of Thai provincial public hospitals during the introduction of universal health coverage using capitation. Health Care Manag Sci 11(4):319–338CrossRefGoogle Scholar
  285. 285.
    Ramanathan R (2005) Operations assessment of hospitals in the Sultanate of Oman. Int J Oper Prod Manag 25(1):39–54CrossRefGoogle Scholar
  286. 286.
    Ray SC, Desli E (1997) Productivity growth, technical progress, and efficiency change in industrialized countries: comment. Am Econ Rev 87(5):1033–1039Google Scholar
  287. 287.
    Rego G, Nunes R, Costa J (2010) The challenge of corporatisation: the experience of Portuguese public hospitals. Eur J Health Econ 11(4):367–381CrossRefGoogle Scholar
  288. 288.
    Renner A, Kirigia J, Asbu EZ, Barry S, Kirigia D, Kamara C, Muthuri L (2005) Technical efficiency of peripheral health units in Pujehun district of Sierra Leone: a DEA application. BMC Health Serv Res 5(1):77–87CrossRefGoogle Scholar
  289. 289.
    Rezaee MJ, Karimdadi A (2015) Do geographical locations affect in hospitals performance? A multi-group data envelopment analysis. J Med Syst 39(9):85–95CrossRefGoogle Scholar
  290. 290.
    Rezapour A, Azar FE, Zadeh NY, Roumiani Y, Faradonbeh SB (2015) Technical efficiency and resources allocation in university hospitals in Tehran, 2009-2012. Med J Islam Repub Iran 29:266Google Scholar
  291. 291.
    Rouse P, Swales R (2006) Pricing public health care services using DEA: Methodology versus politics. Ann Oper Res 145(1):265–280CrossRefGoogle Scholar
  292. 292.
    Rouyendegh BD, Oztekin A, Ekong J, Dag A (2016) Measuring the efficiency of hospitals: a fully-ranking DEA–FAHP approach. Ann Oper Res:1–18Google Scholar
  293. 293.
    Safdar KA, Emrouznejad A, Dey PK (2016) Assessing the Queuing Process Using Data Envelopment Analysis: an Application in Health Centres. J Med Syst 40(1):32–54CrossRefGoogle Scholar
  294. 294.
    Sahin I, Ozcan YA, Ozgen H (2011) Assessment of hospital efficiency under health transformation program in Turkey. CEJOR 19(1):19–37CrossRefGoogle Scholar
  295. 295.
    Sebastian M, Lemma H (2010) Efficiency of the health extension programme in Tigray, Ethiopia: a data envelopment analysis. BMC Int Health Human Rights 10(1):16–25CrossRefGoogle Scholar
  296. 296.
    Seiford LM (1996) Data envelopment analysis: the evolution of the state of the art (1978-1995). J Prod Anal 7(2-3):99–137CrossRefGoogle Scholar
  297. 297.
    Shahhoseini R, Tofighi S, Jaafaripooyan E, Safiaryan R (2011) Efficiency measurement in developing countries: application of data envelopment analysis for Iranian hospitals. Health Serv Manag Res 24(2):75–80CrossRefGoogle Scholar
  298. 298.
    Shay PD, Ozcan YA (2013) Freestanding Inpatient Rehabilitation Facility Performance Following the 60 Percent Rule. Med Care Res Rev 70(1):46–67CrossRefGoogle Scholar
  299. 299.
    Sheikhzadeh Y, Roudsari AV, Vahidi RG, Emrouznejad A, Dastgiri S (2012) Public and private hospital services reform using data envelopment analysis to measure technical, scale, allocative, and cost efficiencies. Health promotion perspectives 2(1):28Google Scholar
  300. 300.
    Shephard RW (1970) Theory of cost and production functions. Univ, Press, PrincetonGoogle Scholar
  301. 301.
    Sherman HD (1984) Hospital Efficiency Measurement and Evaluation: Empirical Test of a New Technique. Medical Care 22(10):922–938CrossRefGoogle Scholar
  302. 302.
    Shetty U, Pakkala T (2010) Technical Efficiencies of Healthcare System in Major States of India: An Application of NP-RDM of DEA Formulation. J Health Manag 12(4):501–518CrossRefGoogle Scholar
  303. 303.
    Siciliani L (2006) Estimating Technical Efficiency in the Hospital Sector with Panel Data. Appl Health Econ Health Policy 5(2):99–116CrossRefGoogle Scholar
  304. 304.
    Sikka V, Luke RD, Ozcan YA (2009) The efficiency of hospital-based clusters: Evaluating system performance using data envelopment analysis. Health Care Manag Rev 34(3):251–261CrossRefGoogle Scholar
  305. 305.
    Simar L, Wilson PW (1998) Sensitivity Analysis of Efficiency Scores: How to Bootstrap in Nonparametric Frontier Models. Manag Sci 44(1):49–61CrossRefGoogle Scholar
  306. 306.
    Simar L, Wilson PW (1999a) Estimating and bootstrapping Malmquist indices. Eur J Oper Res 115(3):459–471CrossRefGoogle Scholar
  307. 307.
    Simar L, Wilson PW (1999b) Of Course We Can Bootstrap DEA Scores! But Does It Mean Anything? Logic Trumps Wishful Thinking. J Prod Anal 11(1):93–97CrossRefGoogle Scholar
  308. 308.
    Simar L, Wilson PW (1999c) Some Problems with the Ferrier/Hirschberg Bootstrap Idea. J Prod Anal 11(1):67–80CrossRefGoogle Scholar
  309. 309.
    Simar L, Wilson PW (2000a) A general methodology for bootstrapping in non-parametric frontier models. J Appl Stat 27(6):779–802CrossRefGoogle Scholar
  310. 310.
    Simar L, Wilson PW (2000b) Statistical Inference in Nonparametric Frontier Models: The State of the Art. J Prod Anal 13(1):49–78CrossRefGoogle Scholar
  311. 311.
    Simar L, Wilson PW (2002) Non-parametric tests of returns to scale. Eur J Oper Res 139(1):115–132CrossRefGoogle Scholar
  312. 312.
    Simar L, Wilson PW (2007) Estimation and inference in two-stage, semi-parametric models of production processes. J Econ 136(1):31–64CrossRefGoogle Scholar
  313. 313.
    Simar L, Wilson PW (2011) Performance of the bootstrap for DEA estimators and iterating the principle. In: Handbook on data envelopment analysis (pp. 241-271). Springer, Boston, MAGoogle Scholar
  314. 314.
    Simões P, Marques RC (2011) Performance and congestion analysis of the portuguese hospital services. CEJOR 19(1):39–63CrossRefGoogle Scholar
  315. 315.
    Smith PC, Street A (2005) Measuring the efficiency of public services: the limits of analysis. J R Stat Soc: Series A (Statistics in Society) 168(2):401–417CrossRefGoogle Scholar
  316. 316.
    Sommersguter-Reichmann M, Rauner MS (2015) Benchmarking the rescue departments of the Austrian Red Cross using data envelopment analysis and fractional regression models. Int J Prod Res 53(24):7271–7285CrossRefGoogle Scholar
  317. 317.
    Sommersguter-Reichmann M, Stepan A (2015) The interplay between regulation and efficiency: Evidence from the Austrian hospital inpatient sector. Socio-Economic Planning Sciences 52:10–21CrossRefGoogle Scholar
  318. 318.
    Souza AAD, Moreira DR, Avelar EA, Marques AMDF, Lara AL (2014) Data envelopment analysis of efficiency in hospital organisations. Int J Bus Innov Res 8(3):316–332CrossRefGoogle Scholar
  319. 319.
    Spinks J, Hollingsworth B (2009) Cross-country comparisons of technical efficiency of health production: a demonstration of pitfalls. Appl Econ 41(4):417–427CrossRefGoogle Scholar
  320. 320.
    Staat M (2006) Efficiency of hospitals in Germany: a DEA-bootstrap approach. Appl Econ 38(19):2255–2263CrossRefGoogle Scholar
  321. 321.
    Sulku SN (2012) The health sector reforms and the efficiency of public hospitals in Turkey: provincial markets. The European Journal of Public Health 22(5):634–638CrossRefGoogle Scholar
  322. 322.
    Sultan WI, Crispim J (2016) Evaluating the Productive Efficiency of Jordanian Public Hospitals. Int J Bus Manag 12(1):68–83CrossRefGoogle Scholar
  323. 323.
    Testi A, Fareed N, Ozcan YA, Tanfani E (2013) Assessment of physician performance for diabetes: a bias-corrected data envelopment analysis model. Qual Prim Care 21(6):345–357Google Scholar
  324. 324.
    Thanassoulis E, Portela MS, Graveney M (2016) Identifying the scope for savings at inpatient episode level: An illustration applying DEA to chronic obstructive pulmonary disease. Eur J Oper Res 255(2):570–582CrossRefGoogle Scholar
  325. 325.
    Thompson, R. G., F. D. Singleton Jr, R. M. Thrall, B. A. Smith. 1986. Comparative site evaluations for locating a high-energy physics lab in Texas. Interfaces 16(6) 35–49.Google Scholar
  326. 326.
    Thrall RM (2000) Measures in DEA with an Application to the Malmquist Index. J Prod Anal 13(2):125–137CrossRefGoogle Scholar
  327. 327.
    Tiemann O, Schreyögg J (2009) Effects of ownership on hospital efficiency in Germany. BUR-Busi Res 2(2):115–145CrossRefGoogle Scholar
  328. 328.
    Tiemann O, Schreyögg J (2012) Changes in hospital efficiency after privatization. Health Care Manag Sci 15(4):310–326CrossRefGoogle Scholar
  329. 329.
    Tigga NS, Mishra US (2015) On Measuring Technical Efficiency of the Health System in India: An Application of Data Envelopment Analysis. J Health Manag 17(3):285–298CrossRefGoogle Scholar
  330. 330.
    Tlotlego N, Nonvignon J, Sambo L, Asbu E, Kirigia J (2010) Assessment of productivity of hospitals in Botswana: a DEA application. Int Arch Med 3(1):27–40CrossRefGoogle Scholar
  331. 331.
    Toloo M (2014) Notes on classifying inputs and outputs in data envelopment analysis: A comment. European Journal of Operational Research 235(3):810–812CrossRefGoogle Scholar
  332. 332.
    Toloo M, Jalili R (2015) LU Decomposition in DEA with an Application to Hospitals. Comput Econ 47(3):473–488CrossRefGoogle Scholar
  333. 333.
    Tone K (2001) A slacks-based measure of efficiency in data envelopment analysis. Eur J Oper Res 130(3):498–509CrossRefGoogle Scholar
  334. 334.
    Tone K (2002) A slacks-based measure of super-efficiency in data envelopment analysis. Eur J Oper Res 143(1):32–41CrossRefGoogle Scholar
  335. 335.
    Tone K (2010) Variations on the theme of slacks-based measure of efficiency in DEA. Eur J Oper Res 200(3):901–907CrossRefGoogle Scholar
  336. 336.
    Tone K, Sahoo BK (2004) Degree of scale economies and congestion: A unified DEA approach. Eur J Oper Res 158(3):755–772CrossRefGoogle Scholar
  337. 337.
    Torabipour A, Najarzadeh M, Mohammad A, Farzianpour F, Ghasemzadeh R (2014) Hospitals productivity measurement using data envelopment analysis technique. Iranian journal of public health 43(11):1576Google Scholar
  338. 338.
    Torres-Jiménez M, García-Alonso CR, Salvador-Carulla L, Fernández-Rodríguez V (2015) Evaluation of system efficiency using the Monte Carlo DEA: The case of small health areas. Eur J Oper Res 242(2):525–535CrossRefGoogle Scholar
  339. 339.
    Tosun O (2012) Using data envelopment analysis-neural network model to evaluate hospital efficiency. Int J Prod Qual Manag 9(2):245–257Google Scholar
  340. 340.
    Valdmanis V, DeNicola A, Bernet P (2014) Public health capacity in the provision of health care services. Health Care Manag Sci 18(4):475–482CrossRefGoogle Scholar
  341. 341.
    Valdmanis VG, Rosko MD, Mutter RL (2008) Hospital Quality, Efficiency, and Input Slack Differentials. Health Serv Res 43(5 Pt 2):1830–1848CrossRefGoogle Scholar
  342. 342.
    van Ineveld M, van Oostrum J, Vermeulen R, Steenhoek A, van de Klundert J (2016) Productivity and quality of Dutch hospitals during system reform. Health Care Manag Sci 19(3):279–290CrossRefGoogle Scholar
  343. 343.
    VanderWielen LM, Ozcan YA (2014) An Assessment of the Health Care Safety Net: Performance Evaluation of Free Clinics. Nonprofit Volunt Sect Q 44(3):474–486CrossRefGoogle Scholar
  344. 344.
    Varabyova Y, Blankart CR, Schreyögg J (2017a) Using nonparametric conditional approach to integrate quality into efficiency analysis: empirical evidence from cardiology departments. Health Care Manag Sci 20(4):565-576Google Scholar
  345. 345.
    Varabyova Y, Blankart CR, Torbica A, Schreyögg J (2017b) Comparing the Efficiency of Hospitals in Italy and Germany: Nonparametric Conditional Approach Based on Partial Frontier. Health Care Manag Sci 20(3):379-394Google Scholar
  346. 346.
    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):70–79CrossRefGoogle Scholar
  347. 347.
    Vera A, Kuntz L (2007) Process-based organization design and hospital efficiency. Health Care Manag Rev 32(1):55–65CrossRefGoogle Scholar
  348. 348.
    Villalobos-Cid M, Chacón M, Zitko P, Instroza-Ponta M (2016) A New Strategy to Evaluate Technical Efficiency in Hospitals Using Homogeneous Groups of Casemix. J Med Syst 40(4):1–12CrossRefGoogle Scholar
  349. 349.
    Vitikainen K, Street A, Linna M (2009) Estimation of hospital efficiency—Do different definitions and casemix measures for hospital output affect the results? Health Policy 89(2):149–159CrossRefGoogle Scholar
  350. 350.
    Wang X, Luo H, Qin X, Feng J, Gao H, Feng Q (2016) Evaluation of performance and impacts of maternal and child health hospital services using Data Envelopment Analysis in Guangxi Zhuang Autonomous Region, China: a comparison study among poverty and non-poverty county level hospitals. Int J Equity Health 15(1):131–136CrossRefGoogle Scholar
  351. 351.
    Wei C-K, Chen L-C, Li R-K, Tsai C-H (2011) Using the DEA-R model in the hospital industry to study the pseudo-inefficiency problem. Expert Syst Appl 38(3):2172–2176CrossRefGoogle Scholar
  352. 352.
    Williams C, Asi Y, Raffenaud A, Bagwell M, Zeini I (2016) The effect of information technology on hospital performance. Health Care Manag Sci 19(4):338–346CrossRefGoogle Scholar
  353. 353.
    Wilson AB, Kerr BJ, Bastian ND, Fulton LV (2012) Financial performance monitoring of the technical efficiency of critical access hospitals: a data envelopment analysis and logistic regression modeling approach. J Healthc Manag 57(3):200–213CrossRefGoogle Scholar
  354. 354.
  355. 355.
    Wu C-H, Chang C-C, Chen P-C, Kuo K-N (2013) Efficiency and productivity change in Taiwan’s hospitals: a non-radial quality-adjusted measurement. CEJOR 21(2):431–453CrossRefGoogle Scholar
  356. 356.
    Xu G-C, Zheng J, Zhou Z-J, Zhou C-K, Zhao Y (2015) Comparative study of three commonly used methods for hospital efficiency analysis in Beijing tertiary public hospitals, China. Chin Med J 128(23):3185CrossRefGoogle Scholar
  357. 357.
    Yusefzadeh H, Ghaderi H, Bagherzade R, Barouni M (2013) The Efficiency and Budgeting of Public Hospitals: Case Study of Iran. Iran Red Crescent Med J 15(5):393–399CrossRefGoogle Scholar
  358. 358.
    Zaim S, Bayyurt N, Turkyilmaz A, Solakoglu N, Zaim H (2008) Measuring and Evaluating Efficiency of Hospitals Through Total Quality Management. J Trans Manag 12(4):77–97Google Scholar

Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018
corrected publication March/2018

Authors and Affiliations

  1. 1.Chair of Health Care Operations/Health Information Management, Faculty of Business and EconomicsUniversity of AugsburgAugsburgGermany
  2. 2.University Center of Health Sciences at Klinikum Augsburg (UNIKA-T)AugsburgGermany
  3. 3.Department of Supply Chain Management and Management Science, Faculty of Management, Economics and Social SciencesUniversity of CologneKölnGermany

Personalised recommendations