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

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, techn...

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Bibliographic Details
Published in:Journal of productivity analysis 2013-12, Vol.40 (3), p.337-355
Main Authors: Ferrier, Gary D., Trivitt, Julie S.
Format: Article
Language:English
Subjects:
Accounting/Auditing
Cost efficiency
Econometrics
Economics
Economics and Finance
Efficiency
Efficiency metrics
Health care access
Health care expenditures
Health care policy
Health care quality
Health insurance
Health outcomes
Hospital costs
Hospitals
Insurance coverage
Medicaid
Medicare
Microeconomics
Mortality
Nonprofit hospitals
Operations Research/Decision Theory
Quality of care
Statistical analysis
Teaching hospitals
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Summary: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.
ISSN:0895-562X
1573-0441
DOI:10.1007/s11123-012-0305-z