Población y Salud en Mesoamérica ISSN electrónico: 1659-0201

OAI: https://revistas.ucr.ac.cr/index.php/psm/oai
Relative efficiency analysis of public hospitals in Costa Rica
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Eficiencia técnica global
análisis envolvente de datos
mortalidad hospitalaria
actividad hospitalaria
Costa Rica Global technical efficiency
data envelopment analysis
hospital mortality
hospital activity
Costa Rica

How to Cite

Morera-Salas, M. (2015). Relative efficiency analysis of public hospitals in Costa Rica. Población Y Salud En Mesoamérica, 12(2). https://doi.org/10.15517/psm.v12i2.17220


Data envelopment analysis helps determining which of hospitals have better relative performance and which could improve the use of resources. The objective is to analyze the hospitals technical efficiency in Costa Rica. Data for 2012-2013 of 23 general public hospitals come from CajaCostarricense de SeguroSocial.  We use data envelopment analysis to determine the efficiency of Costa Rican Public Hospitals. We use two inputs:spending hospitalization and hospital bed and three outputs:case mix adjusted hospital discharges, Functional Indexand adjusted in hospital mortality index.The efficiency level varies substantially among the 23 hospitals analyzed. In 2013, 30% of hospitals were technically efficient, this situation improved compared to 2012.This work is a first approach the analysis of efficiency of public hospitals in Costa Rica. An effort was made to standardize the data, adjusting the variables to consider the case mix and risk of cases in each hospital, so that results are comparable between centers of varying size and complexity. In conclusion, DEA results show that 70% of hospitals can improve the use of resources.

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Arah O.A., Westert G., Hurst J., Klazinga N.S. (2006). A conceptual framework for the OECD Health Care Quality Indicators project. International Journal for Quality in Health Care, 18(Suppl.1), 5–13. Recuperado de http://intqhc.oxfordjournals.org/content/intqhc/18/suppl_1/5.full.pdf

Canadian Institute for Health Information [CIHI]. (2014). Hospital Standardized Mortality Ratio. Technical notes 2014. Recuperado de http://www.cihi.ca/CIHI-ext-portal/pdf/internet/HSMR_TECH_NOTES_EN

Caves, D., Christensen, L. y Diewert, W. (1982). The Economic Theory of Index Numbers and the Measurement of Input, Output, and Productivity. Econometrica, 50(6), 1393-414. Recuperado de http://www.aae.wisc.edu/aae741/Ref/Caves%20Econometrica%201982.pdf

Conrad, D., Wickizer, T., Maynard, C., Klastorin, T., Lessler, D., Ross, A., … Travis, K. (1996). Managing Care, Incentives, and Information: An Exploratory Look Inside the ‘Black Box’ of Hospital Efficiency. Health Services Research, 31(3), 235–59. Recuperado de http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070118/pdf/hsresearch00041-0010.pdf

Copnell, B., Hagger, V., Wilson, S.G., Evans, S.M., Sprivulis, P.C. y Cameron, P.A. (2009). Measuring the quality of hospital care: an inventory of indicators. Intern Med J., 39(6), 352-60. Recuperado de http://www.ncbi.nlm.nih.gov/pubmed/19323697

Charnes, A., Cooper, W. y Rhodes, E. (1978). Measuring the efficiency of decision making units. European Journal of Operations Research, 2, 429-44. Recuperado de http://www.utdallas.edu/~ryoung/phdseminar/CCR1978.pdf

Farrell, M. (1957). The measurement of Productive Efficiency. Journal of the Royal Statistical Society, 120, 252-90. Recuperado de http://www.aae.wisc.edu/aae741/Ref/Farrell%201957.pdf

Ferro, G. y Romero, C. (2011). Comparación de Medidas de Cambio de Productividad. Las aproximaciones de Malmquist y Luenberger en una Aplicación al Mercado de Seguros. Buenos Aires, Argentina: UADE, Universidad Argentina de la Empresa, Instituto de Economía. Recuperado de https://hal.archives-ouvertes.fr/file/index/docid/597946/filename/Ferro_Romero_-_AAEP_180511_documento_de_trabajo.pdf

Groene, O., Skau, J.K. y Frølich, A. (2008). An international review of projects on hospital performance assessment. Int J Qual Health Care, 20(3), 162-71. Recuperado de http://intqhc.oxfordjournals.org/content/intqhc/20/3/162.full.pdf

Hollingsworth, B. (2003). Non-Parametric and Parametric Applications Measuring Efficiency in Health Care. Health Care Management Science, 6(4), 203–18. Recuperado de http://link.springer.com/article/10.1023/A:1026255523228#page-1

Hussey, P., de Vries, H., Romley, J., Wang, M. C., Chen, S. S., Shekelle, P.G. y McGlyn, E. A. (2009). Health Care Efficiency: A Systematic Review of Health Care Efficiency Measures. Health Services Research, 44(3), 784-805. Recuperado de http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2699907/pdf/hesr0044-0784.pdf

Kiadaliri, A., Jafari, M. y Gerdtham, U. (2013). Frontier-based techniques in measuring hospital efficiency in Iran: a systematic review and meta-regression analysis. BMC Health Services Research, 13, 312. Recuperado de http://www.biomedcentral.com/content/pdf/1472-6963-13-312.pdf

Lenard, M. L. y Shimshak, D. G. (2009). Benchmarking nursing home performance at the state level. Health Services Management Research, 22, 2, 51-61. Recuperado de http://www.unboundmedicine.com/medline/citation/19401498/Benchmarking_nursing_home_performance_at_the_state_level_

Martín, J. y López, M. P. (2007). La medida de la eficiencia en las organizaciones sanitarias. Presupuesto y Gasto Público, 49, 139-161. Recuperado de http://www.ief.es/documentos/recursos/publicaciones/revistas/presu_gasto_publico/49_medidaEficiencia.pdf

Masiye, F. (2007). Investigating health system performance: an application of data envelopment analysis to Zambian hospitals. BMC Health Services Research, 7, 58. Recuperado de http://www.biomedcentral.com/content/pdf/1472-6963-7-58.pdf

Miika, L. (1998). Measuring hospital cost efficiency with panel data models. Health Economics, 7, 415-427. Recuperado de http://www.capitaliran.com/Download.ashx?id=0W8k%2BMPTS5jTT%2BdnWaF%2Few%3D%3D

Moya, L. (1998). Aplicación de los grupos de diagnósticos relacionados a la gestión del sistema nacional de servicios de hospitalización de la CCSS. Rev. Cienc. Adm. Financ. Segur. Soc., 6(2), 13-33. Recuperado de http://www.scielo.sa.cr/scielo.php?script=sci_arttext&pid=S1409-12591998000200002

Nayar, P. y Ozcan, Y. (2008). Data envelopment analysis comparison of hospital efficiency and quality. Journal of Medical Systems, 32(3), 193-199. Recuperado de http://www.ncbi.nlm.nih.gov/pubmed/18444355

Nuti, S., Daraio, C., Speroni, C. y Vainieri, M. (2011). Relationships between technical efficiency and the quality and costs of health care in Italy. International Journal for Quality in Health Care, 23(3), 324–330. Recuperado de http://intqhc.oxfordjournals.org/content/early/2011/03/31/intqhc.mzr005.full-text.pdf

Quan, H., Li, B., Couris, Ch., Fushimi, K., Graham, P., Hider, P., Januel, J.M. y Sundararajan, V. (2011). Updating and Validating the Charlson Comorbidity Index and Score for Risk Adjustment in Hospital Discharge Abstracts Using Data From 6 Countries. American Journal of Epidemiology, 173(6), 676–682. Recuperado de http://aje.oxfordjournals.org/content/173/6/676.long

Veillard, J., Champagne, F., Klazinga, N., Kazandjian, V., Arah, O.A. y Guisset, A.L- (2005). A performance assessment framework for hospitals: the WHO regional office for Europe PATH project. Int J Qual Health Care, 17(6), 487-96. Recuperado de http://intqhc.oxfordjournals.org/content/17/6/487.full-text.pdf

Weingarten, S., Lloyd, L., Chiou, C. y Braunstein, G. (2002). Do Subspecialists Working Outside of Their Specialty Provide Less Efficient and Lower- Quality Care to Hospitalized Patients Than Do Primary Care Physicians? Archives of Internal Medicine, 162(5), 527–32. Recuperado de http://www.ncbi.nlm.nih.gov/pubmed/11871920

Whittington, J., Simmonds, T y Jacobsen, D. (2005). Reducing Hospital Mortality Rates. Cambridge, Massachussetts, EE.UU.: Institute for Healthcare Improvement.



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