In this book the authors explore the state of the art on efficiency measurement in health systems and international experts offer insights into the pitfalls and potential associated with various measurement techniques. The authors show that: - The core idea of efficiency is easy to understand in principle - maximizing valued outputs relative to inputs, but is often difficult to make operational in real-life situations - There have been numerous advances in data collection and availability, as well as innovative methodological approaches that give valuable insights into how efficiently health care is delivered - Our simple analytical framework can facilitate the development and interpretation of efficiency indicators.
This book provides a concise synthesis of leading edge research in the theory and practise of efficiency measurement in health and health care. Whilst much of the literature in this area is confusing and impregnable, Hollingsworth and Peacock show the logical links between the economic theory underlying efficiency, the methods used in analysis and
This book provides a concise synthesis of leading edge research in the theory and practise of efficiency measurement in health and health care. Whilst much of the literature in this area is confusing and impregnable, Hollingsworth and Peacock show the logical links between the economic theory underlying efficiency, the methods used in analysis and practical application of measurement techniques including Data Envelopment Analysis and Stochastic Frontiers Analysis. The book outlines which methods are most suitable in which setting, how to specify valid models, and how to undertake a study and effectively disseminate results. The current state of the art is assessed in terms of methods and published applications, and undertakes practical applications of advanced methods, including analysis of economies of scale and scope, variable weightings, specification testing, and estimation of the efficient production of health. Finally, the way forward in efficiency measurement in health is outlined, mapping out an agenda for future research and policy development.
"This book examines some of the most important techniques currently available to measure the efficiency of systems and organisations, including data envelopment analysis and stochastic frontier analysis, and also presents some promising new methodological approaches." [Title verso].
In a world where there is increasing demand for the performance of health providers to be measured, there is a need for a more strategic vision of the role that performance measurement can play in securing health system improvement. This volume meets this need by presenting the opportunities and challenges associated with performance measurement in a framework that is clear and easy to understand. It examines the various levels at which health system performance is undertaken, the technical instruments and tools available, and the implications using these may have for those charged with the governance of the health system. Technical material is presented in an accessible way and is illustrated with examples from all over the world. Performance Measurement for Health System Improvement is an authoritative and practical guide for policy makers, regulators, patient groups and researchers.
The National Roundtable on Health Care Quality was established in 1995 by the Institute of Medicine. The Roundtable consists of experts formally appointed through procedures of the National Research Council (NRC) who represent both public and private-sector perspectives and appropriate areas of substantive expertise (not organizations). From the public sector, heads of appropriate Federal agencies serve. It offers a unique, nonadversarial environment to explore ongoing rapid changes in the medical marketplace and the implications of these changes for the quality of health and health care in this nation. The Roundtable has a liaison panel focused on quality of care in managed care organizations. The Roundtable convenes nationally prominent representatives of the private and public sector (regional, state and federal), academia, patients, and the health media to analyze unfolding issues concerning quality, to hold workshops and commission papers on significant topics, and when appropriate, to produce periodic statements for the nation on quality of care matters. By providing a structured opportunity for regular communication and interaction, the Roundtable fosters candid discussion among individuals who represent various sides of a given issue.
This new edition continues to emphasize the use of data envelopment analysis (DEA) to create optimization-based benchmarks within hospitals, physician group practices, health maintenance organizations, nursing homes and other health care delivery organizations. Suitable for graduate students learning DEA applications in health care as well as for practicing administrators, it is divided into two sections covering methods and applications. Section I considers efficiency evaluations using DEA; returns to scale; weight restricted (multiplier) models; non-oriented or slack-based models, including in this edition two versions of non-controllable variable models and categorical variable models; longitudinal (panel) evaluations and the effectiveness dimension of performance evaluation. A new chapter then looks at new and advanced models of DEA, including super-efficiency, congestion DEA, network DEA, and dynamic network models. Mathematical formulations of various DEA models are placed in end-of-chapter appendices. Section II then looks at health care applications within particular settings, chapter-by-chapter, including hospitals, physician practices, nursing homes and health maintenance organizations (HMOs). Other chapters then explore home health care and home health agencies; dialysis centers, community mental health centers, community-based your services, organ procurement organizations, aging agencies and dental providers; DEA models to evaluate provider performance for specific treatments, including stroke, mechanical ventilation and perioperative services. A new chapter then examines international-country-based applications of DEA in health care in 16 different countries, along with OECD and multi-country studies. Most of the existing chapters in this section were expanded with recent applications. Included with the book is online access to a learning version of DEA Solver software, written by Professor Kaoru Tone, which can solve up to 50 DMUs for various DEA models listed in the User’s Guide at the end of the book.
Thousands of measures are in use today to assess health and health care in the United States. Although many of these measures provide useful information, their usefulness in either gauging or guiding performance improvement in health and health care is seriously limited by their sheer number, as well as their lack of consistency, compatibility, reliability, focus, and organization. To achieve better health at lower cost, all stakeholders - including health professionals, payers, policy makers, and members of the public - must be alert to what matters most. What are the core measures that will yield the clearest understanding and focus on better health and well-being for Americans? Vital Signs explores the most important issues - healthier people, better quality care, affordable care, and engaged individuals and communities - and specifies a streamlined set of 15 core measures. These measures, if standardized and applied at national, state, local, and institutional levels across the country, will transform the effectiveness, efficiency, and burden of health measurement and help accelerate focus and progress on our highest health priorities. Vital Signs also describes the leadership and activities necessary to refine, apply, maintain, and revise the measures over time, as well as how they can improve the focus and utility of measures outside the core set. If health care is to become more effective and more efficient, sharper attention is required on the elements most important to health and health care. Vital Signs lays the groundwork for the adoption of core measures that, if systematically applied, will yield better health at a lower cost for all Americans.
How do the benefits of higher education compare with its costs, and how does this comparison vary across individuals and institutions? These questions are fundamental to quantifying the productivity of the education sector. The studies in Productivity in Higher Education use rich and novel administrative data, modern econometric methods, and careful institutional analysis to explore productivity issues. The authors examine the returns to undergraduate education, differences in costs by major, the productivity of for-profit schools, the productivity of various types of faculty and of outcomes, the effects of online education on the higher education market, and the ways in which the productivity of different institutions responds to market forces. The analyses recognize five key challenges to assessing productivity in higher education: the potential for multiple student outcomes in terms of skills, earnings, invention, and employment; the fact that colleges and universities are “multiproduct” firms that conduct varied activities across many domains; the fact that students select which school to attend based in part on their aptitude; the difficulty of attributing outcomes to individual institutions when students attend more than one; and the possibility that some of the benefits of higher education may arise from the system as a whole rather than from a single institution. The findings and the approaches illustrated can facilitate decision-making processes in higher education.
This book explores trends in health care outcomes and spending; ways of assessing efficiency; new indicators of health care policies and institutions; and the characteristics and performance of health care systems.
