Health Care Blog

The implementation of BCC model defined by the 7 selected variables to the 66 health centers in the sample enabled the identification of efficient and inefficient institutions.

Of all the health facilities surveyed, half of slack variables are zero and an efficiency index unit requirements for the EDA requires that a school is considered efficient. For its part, the index assigned to other schools is indicative of the degree of inefficiency because, according to the underlying problem, such centers could increase its production to the extent that this rate exceeds the unit without the need to alter the level of resources available. Accordingly, the centers are inefficient, ineffective half rate of 40%, although this rate varies between 94.69% of CSN10 heart of Navarre and Alava CSA10 of 4%. Read more…

The development and refinement of techniques for assessing the efficiency based on the determination of the non-parametric frontiers AED has favored the implementation of the efficiency studies to areas such as the Primary Health Care, had been, until Just over five years, banned this kind of analysis.

Since the first application of the AED 198,915 in primary care to the present work have been mixed, especially Spaniards, who have valued the efficiency of care primaria11-14 ,16-20. Their review highlights the difficulties and restrictions that the area under study includes the analysis and attempts to overcome some of them. In this sense, the concern of some authors to improve the measurement of producto14 and incorporate the assessment of the productive factors influence externos13 or service quality prestado11, 12.14. None of the studies published so far has made a study of interregional efficiency of primary care as the Spanish that is presented in this work. Read more…

The fact that the measure of efficiency proposed by the EDA is raised in relative terms requires that the entities under study are comparable. This is a mandatory requirement and seconded by Charnes et AL6 in 1978 when, in developing the issue formally bound data, pointed to the need for institutions to be considered homogeneous in resource use and production, as in the environment in which they operate. Read more…

The technique used to carry out the assessment of the productive efficiency of the health centers is shown data envelopment analysis (EDA). This method is included within the boundary models for evaluating the efficiency, models that determine the efficiency (relative) of each entity in relation to the production frontier (or production costs, as appropriate) to delineate the more efficient.

While the estimate of the border can be made from other approaches metodológicos3, the characteristics of the Primary Health Care as the multidimensional nature of its production, the absence of reliable prices, the hierarchical organization of health professionals in schools and the difficulty
to model the production process dictate the use of flexible techniques able to respect the particularities of each production. From this perspective, the EDA is presented as the method of measuring efficiency greater acceptance and implementation has been in the public sphere in general and in Primary Care in particular4.

It is a method, based on theoretical work of Farrell and 19,575 by solving a maximization problem, is able to transform a situation in which various productive resources generate multiple products in a single index of efficiency. This index is identified with the value that maximizes the ratio of the weighted sum of outputs and inputs of the weighted sum of the entity analizada6:

where: H0: efficiency index of the rated entity; yr0: quantity of output r produced by the rated entity; xi0: amount of input i consumed by the rated entity; ur: weight assigned to output r vi: weight assigned to input i, j: number of units to be analyzed; s: number of outputs that are produced, and m: number of inputs that are used.

In addition to determining the set of weights that maximizes the efficiency index of the entity at issue, the resolution for each of the units under study, a mathematical programming problem similar to the former can separate the centers of efficient or inefficient, quantify the inefficiency of the latter, identifying the causes of which are inefficient and how to correct the inefficiency.

However, for operational and interpretative virtues of AED before Apresentadas can be of practical use, it is necessary for its application to a productive reality meets a specific set of requirements that support the scope and validity of the results. These requirements affect both the selection of the sample and model specification

For most scholars of the phenomenon of decentralization, efficiency gains are one of the main theoretical benefits of the transfer of certain powers to government public regionales1. User feedback regarding the decentralization of the public sector also seems to go in this direction. So while 51% of Spaniards believed that public services are better managed and transferred work better, 25% believed the contrario2.

Given the advantages, in terms of efficiency, both users of public services as the analysts seem to discover the theoretical decentralized supply of some goods and, at a time like this, where the process of transferring skills health to the autonomous communities has been completed, one wonders if indeed the health decentralization has contributed to increasing the productive efficiency of the centers. Read more…

Abstract
Objective: The purpose of this paper is to verify whether the productive performance of health centers in autonomous communities with competence in health care is more efficient than that of the centers under the INSALUD.
Methods: We conducted a comparative analysis of the technical efficiency of 66 health centers in Álava, Navarra and Rioja establishments in autonomous communities, in the year under review (1997), had fully transferred the skills health and whose management centers in the same year, was in the hands of INSALUD. The method used to measure and quantify the efficiency of these centers was data envelopment analysis (EDA).
Results: The contrast of the non-parametric efficiency rates half of health centers in La Rioja, Navarre and Alava revealed no significant differences in the (in) efficiency of schools.
Conclusions: The results obtained from the model of efficiency measurement used did not indicate a greater efficiency in the productive performance of primary care centers.
Keywords: Decentralization. Efficiency. Primary Health Care. Data envelopment analysis.

Summary
Objective: The purpose of this study was to evaluate whether the productive behavior of health centers in autonomous communities with competence in health is more efficient than that among centers belonging to Spanish public health system (INSALUD).
Methods: The technical efficiency of 66 health centers in Alava, Navarre and Rioja was analyzed. Centers in autonomous communities that in 1997 had been granted complete authority from the central government to manage their healthcare services were compared with centers whose administration, in the same year, was still in the hands of INSALUD. The method used to measure and quantify the efficiency of these centers was Data Envelopment Analysis.
Results: Nonparametric contrast of the health centers’ mean efficiency rates revealed no significant differences in the (in) efficiency of centers from Rioja, Navarre and Alava
Conclusions: The results obtained from the model of efficiency measurement used did not indicate that decentralization improves the productive efficiency of primary care centers.
Key words: Decentralization. Efficiency. Primary care. Data Envelopment Analysis.

The quality of health care has improved an average of 2.3 year between 1994 and 2005, the index shows that although some important progress, said a general slowdown of the improvement in quality, according to annual reports reported today by the Agency for Healthcare Research and Quality Agency (Research and Quality Health Care AHRQ-as its initials in English).

The rate of improvement published in the National Report on Quality of Health Care and the National Report on Disparities in Health Care for 2007 is below the average annual rate of improvement of 3.1 percent published in the reports of 2006 . Those reports measured trends between 1994 and 2004 measures. The rates of quality improvement are less than fully documented cost increases in health care. Centers of Care and Health Care estimated that expenditures on health care rose an average 6.7 percent annually over the same period. “The quality of health care increases only weakly as much,” said AHRQ Director Dr. Carolyn Clancy. “Given that expenditures on health care are increasing at a rate much faster, these findings about quality underscore the urgent need to improve the value Americans are getting for their investment in the care health. Every year, the reports from AHRQ Quality and Disparities update national trends in the provision of health care. Read more…