Department of Applied Economic Analysis, University of Alicante, Ctra. San Vicente del Raspeig s/n, San Vicente del Raspeig, Alicante 03080, Spain.
Management & Planning of Health Services, Catholic University of Murcia, Campus de los Jerónimos, 135, Guadalupe, Murcia 30107, Spain.
J Comp Eff Res. 2019 Aug;8(11):929-946. doi: 10.2217/cer-2018-0150. Epub 2019 Aug 29.
To evaluate the level of efficiency of public acute hospitals situated in the region of Murcia (Spain). Data from nine acute general hospitals of Murcia's Health Service (SMS by its Spanish acronym) were analyzed over the 2012-2014 period. The data were extracted from the In-patient Health Establishment Statistics of the Ministry of Health, Social Services and Equality, from the National Health Service (SNS) portal and the SMS portal. To this end, the data envelopment analysis (DEA)-window method was used, since this extension of the basic DEA model allows to compare the efficiency of a small number of units over different years and analyze changes in efficiency over time. In addition, the model was complemented by smooth bootstrapping and a superefficiency analysis to improve the quality of the data interpretation. Four inputs were used (number of beds, number of operating rooms, personnel costs and operating costs), two undesirable outputs (average stay and rate of return) and three desirable outputs (weighted discharges, emergencies and surgical interventions). The average level of inefficiency was 1.58% over the study period, with a good evolution between 2012 (3.53%) and 2014 (0.20%). This improvement was also reflected in the number of efficient hospitals that rose from two in 2012 to eight in 2014. Moreover, the slack levels detected were small. The management of the public hospitals analyzed was favorable, both regarding average level of efficiency and the number of hospitals qualified as efficient. However, the analysis revealed several ways to increase efficiency by reducing specific inputs and nondesirable outputs (mainly operating and personnel costs as well as average length of stay) while increasing desirable outputs (mostly the number of surgical interventions). To finish, specific policy measures are suggested to improve the performance of these hospitals.
评估位于西班牙穆尔西亚地区的公立急性医院的效率水平。对穆尔西亚卫生局（SMS）的 9 家急性综合医院在 2012-2014 年期间的数据进行了分析。这些数据来自卫生部、社会服务和平等部的住院医疗机构统计数据、国家卫生服务（SNS）门户网站和 SMS 门户网站。为此，使用了数据包络分析（DEA）-窗口方法，因为该基本 DEA 模型的扩展允许比较不同年份的少量单位的效率，并分析效率随时间的变化。此外，该模型还通过平滑引导和超效率分析进行了补充，以提高数据解释的质量。使用了四个投入（病床数量、手术室数量、人员成本和运营成本）、两个不良产出（平均住院时间和回报率）和三个理想产出（加权出院人数、急诊和手术干预）。研究期间的平均无效水平为 1.58%，2012 年（3.53%）和 2014 年（0.20%）之间的变化较好。这一改进也反映在 2012 年的两家高效医院增加到 2014 年的 8 家。此外，检测到的松弛水平很小。所分析的公立医院管理是有利的，无论是在平均效率水平还是在被认定为有效的医院数量方面。然而，分析表明，通过减少特定投入和不良产出（主要是运营和人员成本以及平均住院时间），同时增加理想产出（主要是手术干预数量），可以提高效率。最后，建议采取具体的政策措施来提高这些医院的绩效。
