Abstract
In order to demonstrate how DEA modeling can be helpful to aid decision making relative to the Brazilian Teaching Hospital Policy by means of hospital performance assessment, we develop a case study with 30 general hospitals linked to Brazilian Federal Universities. We consider data on medical care (Medical Model—MM), teaching and research (Teaching-Research Model—TRM) and use the software IDEAL (Interactive Data Envelopment Analysis Laboratory) as a tool for the units’ efficiency evaluation. IDEAL, developed in Brazil, is unique in providing a 3-D frontiers visualization, assisting in exploratory analysis and allowing a better understanding of the DEA modeling (envelopment and multiplier). Both models are input-oriented and each hospital is categorized according to its relative efficiency in the MM and TRM. In this phase, it is very important to discuss with the decision-makers the results and patterns of the DEA models. Finally, the modelling indicates the necessary changes for the inefficient units and generates recommendations for teaching ratios and public financing.
Similar content being viewed by others
References
AAFP State Government Relations (2005). http://www.aafp.org/online/etc/medialib/aafp_org/documents/policy/state/medicaid-gme.Par.0001.File.dat/stateadvocacy_MedicaidGME.pdf.
Chen, A., Hwang, Y., & Shao, B. (2005). Measurement and sources of overall and input inefficiencies: evidences and implications in hospital services. European Journal of Operational Research, 161, 447–468.
Chilingerian, J. A., & Sherman, H. D. (2004). Health care applications: From hospitals to physicians. From productive efficiency to quality frontiers. In W. Cooper (Eds.), Handbook on data envelopment analysis (pp. 481–537). Norwell: Kluwer Academic. Chap. 17.
Cook, W. D., & Zhu, J. (2007). Classifying inputs and outputs in data envelopment analysis. European Journal of Operational Research, 180(2), 692–699.
Cooper, W. W., Seiford, L. M., & Tone, K. (2000). Data envelopment analysis: a comprehensive text with models, applications references and DEA-solver software. Norwell: Kluwer Academic.
Ersoy, K., Kavuncubasi, S., Ozcan, Y., & Harris, J. M. (1997). Technical efficiencies of Turkish hospitals: DEA approach. Journal of Medical Systems, 21(2), 67–74.
Färe, R., & Grosskopf, S. (2000). Network DEA. Socio-Economic Planning Sciences, 34, 35–49.
Grosskopf, S., Margaritis, D., & Valdmanis, V. (2001a). Comparing teaching and non-teaching hospitals: a frontier approach. Health Care Management Science, 4, 83–90.
Grosskopf, S., Margaritis, D., & Valdmanis, V. (2001b). The effects of teaching on hospital productivity. Socio-Economic Planning Sciences, 35, 189–204.
Grosskopf, S., Margaritis, D., & Valdmanis, V. (2004). Competitive effects on teaching hospitals. European Journal of Operational Research, 154, 515–525.
Hollingsworth, B. (2003). Non-parametric and parametric applications measuring efficiency in health care. Heath Care Management Science, 6, 203–218.
Lins, M. P. E., Sollero, M. K. V., Calôba, G. M., & Silva, A. C. M. (2006). Integrating the regulatory and utility firm perspectives when measuring the efficiency of electricity distribution. European Journal of Operational Research, doi:10.1016/j.ejor.2005.10.072.
Lins, M. P. E., Lobo, M. S. C., Fiszman, R., & Silva, A. M. (2007). O uso da análise envoltória de dados—DEA—para avaliação de hospitais universitários brasileiros. Revista Ciência e Saúde Coletiva, 12(4), 985–998.
Lobo, M. S. C., Bloch, K. V., Fiszman, R., Oliveira, M. R., & Ribeiro, V. J. P. (2006). Sistema de Informações dos Hospitais Universitários (SIHUF/MEC): Um banco de dados administrativo. Information System of Federal Teaching Hospitals (SIHUF/MEC): an administrative database. Cadernos Saúde Coletiva, Rio de Janeiro, 14(1), 149–162.
Marinho, A., & Façanha, L. O. (2000). Hospitais universitários: avaliação comparativa de eficiência técnica. Brazilian Journal of Applied Economics, 4(2), 315–349.
O’Neill, L., Rauner, M., Heidenberger, K., & Kraus, M. (2008). A cross-national comparison and taxonomy of DEA-based hospital efficiency studies. Socio-Economic Planning Sciences, 42(3), 158–189.
Ozcan, Y. A. (1993). Sensitivity analysis of hospital efficiency under alternative output/input and peer group: a review. Knowledge and policy. The International Journal of Knowledge Transfer and Utilization, 5(4), 1–29.
Ozcan, Y. A. (1995). Efficiency of hospital service production in local markets: the balance sheet of U.S. medical armament. Socio-Economic Planning Sciences, 29(2), 139–150.
Ozcan, Y. A. (2008). Health care benchmarking and performance evaluation: an assessment using data envelopment analysis. Norwell: Springer.
WHO/SDS/DHS/96.1 (1995). Institute for health policy studies—IEPS/World Health Organization. Seminar report: The proper function of teaching hospitals within health systems—September.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ozcan, Y.A., Lins, M.E., Lobo, M.S.C. et al. Evaluating the performance of Brazilian university hospitals. Ann Oper Res 178, 247–261 (2010). https://doi.org/10.1007/s10479-009-0528-1
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10479-009-0528-1