Abstract
This study uses Data Envelopment Analysis to examine public sector hospital efficiency in 80 provincial markets in Turkey. Outputs of the study includes mortality rate as quality measure as well as inpatient discharges and outpatient visits. Patient beds, four levels of health labor, and expenditures are used to capture capital, labor and material resources as inputs. Results show that 55% of the public hospitals in served markets are operated inefficiently. Analysis of inefficient provinces suggests that in those 44 inefficient provinces are collectively overbedded, employ excessive number of specialists and other health labor. They spent approximately $70,000,000 from their revolving funds in excess compared to efficient provinces.
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REFERENCES
WHO, European Health Care Reforms. Analyses of Current Strategies, WHO Regional Office for Europe, Copenhagen, 1997.
WHO, Evaluation of Recent Changes in the Financing of Health Services, Report of a WHO Study Group, Geneva, 1993.
Ruchlin, H.S., Problems technical efficiency in health care organizations. Topics in Health Care Financing/ Improving Productivity, Aspen Publishers, Maryland, 1989.
Feldstein, P.J., Health Care Economics, Third Edition, AWiley Medical Publication, John Wiley & Sons Inc., 1988.
SB, Yatakli Tedavi Kurumlari Istatistik Yilligi 1997, Saglik Bakanligi Tedavi Hizmetleri Genel Mudurlugu, Yayin No: 599, Bizim Buro Basimevi, Ankara, 1998.
Tokat, M., Turkiye Saglik Harcamalari ve Finansmani (1992-96), Saglik Bakanligi Saglik Projesi Koordinatorlugu, Ankara, 1997.
Sherman, H.D., Hospital efficiency measurement and evaluation: Empirical test of a new technique. Medical Care 22(10):922–938, 1984.
Nunamaker, T. Measuring routine nursing service efficiency: A comparison of cost per patient day and data envelopment analysis models. Health Services Res. 18(2, Part 1):183–205.
Huang, Y.L., and McLaughlin, C.P., Relative efficiency in rural primary health care: An application of data envelopment analysis. Health Services Res. 24(2):143–158, 1989.
Sexton, T.R., Leiken, A.M., Nolan, A.H., Liss, S., Hogan, A., and Silkman, R.H., Evaluating managerial efficiency of Veterans Administration Medical Centers using data envelopment analysis. Medical Care 27(12):1175–1188, 1989.
Chilingerian, J., and Sherman, D.H., Managing physician efficiency and effectiveness in providing hospital services. Health Services Management Res. 3(1):3–15, 1990.
Ozcan, Y.A. Physician benchmarking: Measuring variation in practice behavior in treatment of otitis media. Health Care Management Science 1(1):5–17, 1998.
Ozcan, Y.A., Jiang, J.H., and Pai, C., Physician efficiency in treatment of sinusitis: Do primary care physicians or specialists provide more efficient care? Health Care Management Research, 13:90–96, 2000.
Ozcan, Y.A., Wogen, S.E., and Mau, L.W., Efficiency evaluation of skilled nursing facilities. J. Med. Systems 22(4):211–224, 1998.
Ozcan, Y.A., and Cotter, J.J., An assessment of area agencies on aging in Virginia through data envelopment analysis. Gerontologist 34(3):363–370, 1994.
Ozcan, Y.A., Luke, R.D., and Haksever, C., Ownership and organizational performance:Acomparison of technical efficiency across hospital types. Medical Care 30(9):781–794, 1992.
Ozcan, Y.A., and Luke, R.D., A national study of the efficiency of hospitals in urban markets. Health Services Res. 28(6):719–739, 1993.
Seiford, L.M., Data envelopment analysis: The evolution of the state of the art (1978-1995). Journal of Productivity Analysis 7:99–138, 1996.
Cooper, W.W., Seiford, L.M., and Tone, K., Data envelopment analysis, Kluwer Acafemic Publishers, Norwell, Mass., 2000.
Ozcan, Y.A., and Ersoy, K., TIMS XXXII presentation in Anchorage, Alaska. June 12-15, 1994.
Ersoy, K., Kavuncubasi, S., Ozcan, Y.A., and Harris, J.M., Technical Efficiencies of Turkish Hospitals: DEA Approach, Journal of Medical Systems, 21(2):67–74, 1997.
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Sahin, I., Ozcan, Y.A. Public Sector Hospital Efficiency for Provincial Markets in Turkey. Journal of Medical Systems 24, 307–320 (2000). https://doi.org/10.1023/A:1005576009257
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DOI: https://doi.org/10.1023/A:1005576009257