Efficiency assessment of primary care providers: A conditional nonparametric approach

•We estimate efficiency measures for a set of primary care units.•We consider both (continuous and discrete) exogenous variables.•We also deal with the presence of undesirable outputs in data.•The characteristics of the population have a significant effect on results. This paper uses a fully nonpara...

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Bibliographic Details
Published in:European journal of operational research 2015-01, Vol.240 (1), p.235-244
Main Authors: Cordero, José Manuel, Alonso-Morán, Edurne, Nuño-Solinis, Roberto, Orueta, Juan F., Arce, Regina Sauto
Format: Article
Language:English
Subjects:
Ambulatory care
Data envelopment analysis
Efficiency
Environmental factors
Estimating techniques
Health care industry
Nonparametric analysis
OR in health services
Primary care
Productivity measurement
Studies
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Summary:•We estimate efficiency measures for a set of primary care units.•We consider both (continuous and discrete) exogenous variables.•We also deal with the presence of undesirable outputs in data.•The characteristics of the population have a significant effect on results. This paper uses a fully nonparametric approach to estimate efficiency measures for primary care units incorporating the effect of (exogenous) environmental factors. This methodology allows us to account for different types of variables (continuous and discrete) describing the main characteristics of patients served by those providers. In addition, we use an extension of this nonparametric approach to deal with the presence of undesirable outputs in data, represented by the rates of hospitalization for ambulatory care sensitive condition (ACSC). The empirical results show that all the exogenous variables considered have a significant and negative effect on efficiency estimates.
ISSN:0377-2217
1872-6860
DOI:10.1016/j.ejor.2014.06.040