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Measuring the efficiencies of visiting nurse service agencies using data envelopment analysis

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Abstract

This study develops a measure of the efficiency of visiting nurse (VN) agencies in Japan, examining the issues related to the measurement of efficiency, and identifying the characteristics that influence efficiency. We have employed a data envelopment analysis to measure the efficiency of 108 VN agencies, using the numbers of 5 types of staff as the input variables and the numbers of 3 types of visits as the output variables. The median efficiency scores of the VN agencies were found to be 0.80 and 1.00 according to the constant returns to scale (CRS) and variable returns to scale (VRS) models, respectively, and the median scale efficiency score was 0.95. This study supports using both the CRS and VRS models to measure the scale efficiency of VN service agencies. We also found that relatively efficient VN agencies filled at least 30 % of staff positions with experienced workers, and so concluded that this characteristic has a direct influence on the length of visits.

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References

  1. Mary BW (2007) Population aging. In: Robinson M, William N, Clarence P, Norris L (eds) A global overview: global health and global aging. Jossey-Bass, San Francisco, pp 15–30

    Google Scholar 

  2. Markle-Reid M, Browne G, Weir R, Gafni A, Roberts J, Henderson SR (2006) The effectiveness and efficiency of home-based nursing health promotion for older people: a review of the literature. Med Care Res Rev 63:531–569

    Article  Google Scholar 

  3. Murashima S, Nagata S, Magilvy JK, Fukui S, Kayama M (2002) Home care nursing in Japan: a challenge for providing good care at home. Public Health Nurs 19:94–103

    Article  Google Scholar 

  4. Ogata Y, Kobayashi Y, Fukuda T, Mori K, Hashimoto M, Otosaka K (2004) Measuring relative work values for home care nursing services in Japan. Nurs Res 53:145–153

    Article  Google Scholar 

  5. Japan Ministry of Health, Labor, and Welfare (2008) Kaigo sa-bisu shisetsu jigyousho chousa [Annual report of long-term care service]. Japan Ministry of Health, Labor and Welfare Statistics and Information Department, Tokyo, pp 466–467

    Google Scholar 

  6. Murashima S (2009) Homon kango jukyu keikakusakutei ni kansuru chosakenkyu gyomu [A large sample surveillance for estimation of service supply and demand in home visiting nursing] (Health labor sciences research report). Department of Community Health Nursing, University of Tokyo, Tokyo, pp 8–70

    Google Scholar 

  7. The national association for home-visit nursing care (2006) Aratana houmon kango station no jigyou tenkai no kentou [Discussion about new business deployment for VN service agencies]. The national association for home-visit nursing care, Tokyo, pp 1–19

    Google Scholar 

  8. Institute for Health Economics and Policy (2009) Homon kango no anteiteki teikyo taisei no arikata ni kansuru kenkyu [Research for stable supplying system of visiting nurse service]. Institute for Health Economics and Policy, Tokyo, pp 8–13

    Google Scholar 

  9. Cooper WW, Seiford LM, Thanassoulis E, Zanakis SH (2004) DEA and its use in different countries. Eur J Oper Res 154:337–344

    Article  Google Scholar 

  10. Hollingsworth B (2008) The measurement of efficiency and productivity of health care delivery. Heal Econ 17:1107–1128

    Article  Google Scholar 

  11. Ozcan YA (2008) Health care benchmarking and performance evaluation: an assessment using data envelopment analysis (DEA). Springer, New York, pp 159–167

    Google Scholar 

  12. Erlandsen E, Forsund FR (2002) Efficiency in the provision of municipal nursing- and home-care services: the Norwegian experience. In: Fox KJ (ed) Efficiency in the public sector. Kluwer Academic Publishers, London, pp 273–300

    Chapter  Google Scholar 

  13. Martinussen PE, Midttun L (2004) Day surgery and hospital efficiency: empirical analysis of Norwegian hospitals 1999–2001. Health Policy 68:183–196

    Article  Google Scholar 

  14. Linna M, Häkkinen U, Magnussen J (2006) Comparing hospital cost efficiency between Norway and Finland. Health Policy 77:268–278

    Article  Google Scholar 

  15. Laine J, Finne-Soveri UH, Björkgren M, Linna M, Noroand A, Häkkinen U (2005) The association between quality of care and technical efficiency in long-term care. Int J Qual Health Care 17:259–267

    Article  Google Scholar 

  16. Rosko MD, Chilingerian JA, Zinn JS, Aaronson WE (1995) The effects of ownership, operating environment, and strategic choices on nursing-home efficiency. Med Care 33:1001–1021

    Article  Google Scholar 

  17. Adams CE, Michel Y (2001) Correlation between home health resource utilization measures. Home Health Care Serv Q 20(3):45–56

    Article  Google Scholar 

  18. Charnes A, Cooper WW, Rhodes E (1978) Measuring the efficiency of decision making units. Eur J Oper Res 2:429–444

    Article  Google Scholar 

  19. Japan Ministry of Health, Labor, and Welfare (2010) houmon kango shien jigyou ni kakaru kentoukai [interim report for VN agencies support project].http://www.mhlw.go.jp/stf/shingi/2r9852000000mkae.html. Accessed 3 October 2012

  20. Banker RD, Charnes A, Cooper WW (1984) Some models for estimating technical and scale inefficiencies in data envelopment analysis. Manag Sci 30:1078–1092

    Article  Google Scholar 

  21. Cooper WW, Seiford LM, Tone K (2007) Data envelopment analysis: a comprehensive text with models, applications, reference and DEA-solver software, 2nd edn. Springer, New York

    Google Scholar 

  22. Coelli TJ (1996) A guide to DEAP, version 2.1: a data envelopment analysis (computer) program. CEPA working paper 96/8. Department of Econometrics, University of New England, Armidale

    Google Scholar 

  23. Giulia G, Emanuele L, Tommaso A, Silvano L (2011) Efficiency and quality of care in nursing homes: an Italian case study. Healthc Manag Sci 14:22–35

    Article  Google Scholar 

  24. Kontodimopoulos N, Bellali T, Labiris G, Niakas D (2006) Investigating sources of inefficiency in residential mental health facilities. J Med Syst 30:169–176

    Article  Google Scholar 

  25. Kooreman P (1994) Data envelopment analysis and parametric frontier estimation – complementary tools. J Heal Econ 13:301–316

    Article  Google Scholar 

  26. Naruse T, Taguchi A, Nagata S, Kuwahara Y, Murashima S (2012) Prevalence of home visiting nurse service clients who received insufficient number of nurse visits in the Japanese long-term care insurance. Jpn J Nurs Health Sci 10(1):2–8

    Google Scholar 

  27. Cathcart D, Jeska S, Karnas J (2004) Span of control matters. J Nurs Adm 34:395–399

    Article  Google Scholar 

  28. Koyama H (2004) Houmon kango station no management A to Z [How to manage visiting nurse offices]. Igakushoin, Tokyo

    Google Scholar 

  29. Rosenau PV, Linder SH (2001) The comparative performance of for-profit and nonprofit home health care services in the US. Home Health Care Serv Q 20(2):47–59

    Article  Google Scholar 

  30. The national association for home-visit nursing care (2011) 24 jikan houmon kango sa-bisu teikyou no arikata ni kansuru chousa kenkyu jigyo [Investigation report for around the clock visiting nurse services]. The national association for home-visit nursing care, Tokyo, pp 99–104

    Google Scholar 

  31. Simar L, Wilson PW (2011) Two-stage DEA: caveat emptor. J Product Anal 36:205–218

    Article  Google Scholar 

  32. Flynn L, Deatrick JA (2003) Home care nurses’ descriptions of important agency attributes. J Nurs Scholarsh 35:385–390

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Community Health Nursing, Graduate School of Medicine, The University of Tokyo, 7-3-1, Hongo, Bunkyo-ku, Tokyo, 113-0033, Japan

    Yuki Kuwahara, Satoko Nagata & Takashi Naruse

  2. Nursing Science of Community Health Care System, Health Development Nursing Science, Health Science, Tohoku University, 2-1, Seiryo-cho, Aoba-ku, Sendai-shi, Miyagi, 980-8575, Japan

    Atsuko Taguchi

  3. Graduate School of Economics, Seijo University, 6-1-20, Seijo, Setagaya-ku, Tokyo, 157-8511, Japan

    Hiroyuki Kawaguchi

  4. Oita University of Nursing and Health Science, 2944-9, Megusuno, Oita-shi, Oita, 870-1201, Japan

    Sachiyo Murashima

Authors
  1. Yuki Kuwahara
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  2. Satoko Nagata
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  3. Atsuko Taguchi
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  4. Takashi Naruse
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  5. Hiroyuki Kawaguchi
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  6. Sachiyo Murashima
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Correspondence to Yuki Kuwahara.

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Kuwahara, Y., Nagata, S., Taguchi, A. et al. Measuring the efficiencies of visiting nurse service agencies using data envelopment analysis. Health Care Manag Sci 16, 228–235 (2013). https://doi.org/10.1007/s10729-013-9228-0

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  • DOI: https://doi.org/10.1007/s10729-013-9228-0

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