Performance evaluation of emergency department physicians using robust value‐based additive efficiency model

We propose a novel variant of the value‐based additive data envelopment analysis model. It conducts a comprehensive robustness analysis of efficiency outcomes for all feasible input and output weights using mathematical programming and the Monte Carlo simulation. We also introduce the original proce...

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Bibliographic Details
Published in:International transactions in operational research 2023-01, Vol.30 (1), p.503-544
Main Authors: Labijak‐Kowalska, Anna, Kadziński, Miłosz, Spychała, Inga, Dias, Luis C., Fiallos, Javier, Patrick, Jonathan, Michalowski, Wojtek, Farion, Ken
Format: Article
Language:English
Subjects:
common set of weights
Data envelopment analysis
efficiency analysis
emergency department
Emergency medical care
Emergency medical services
Head injuries
Mathematical analysis
Mathematical programming
Monte Carlo simulation
multiattribute value function
Operations research
Performance evaluation
physician's performance
Physicians
Robustness (mathematics)
robustness analysis
value‐based additive efficiency
Vectors (mathematics)
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Summary:We propose a novel variant of the value‐based additive data envelopment analysis model. It conducts a comprehensive robustness analysis of efficiency outcomes for all feasible input and output weights using mathematical programming and the Monte Carlo simulation. We also introduce the original procedures for selecting a common vector of weights and an approach for investigating the stability of results in a multiscenario setting. The presented framework is applied to evaluate the performance of emergency department physicians using data from the Children's Hospital of Eastern Ontario in Ottawa. Our focus is on the physicians' performance when dealing with groups of patients' complaints related to abdominal pain and constipation, fever, extremity injury, head injury, and laceration/puncture. The obtained results emphasize the strong dependence of the physicians' performances on the selected weight vectors. However, they prove helpful in pointing out overall good performers who can serve as universal benchmarks or niche performers being markedly better in providing care to a given complaint group. They also offer a basis for developing an improvement plan for the underperforming physicians, identifying the priorities for a practice‐oriented model, and recognizing the most challenging patients' complaints.
ISSN:0969-6016
1475-3995
DOI:10.1111/itor.13099