Titre : | Evaluating physician efficiency in hospitals : a multivariate analysis of best practices. (1995) |
Auteurs : | J.A. CHILINGERIAN ; Euro XI. Mathematical programming and statistical approaches to measurement of effectivness and productivity. (16-19/07/1991; Aachen (GER)) |
Type de document : | Article |
Dans : | EUROPEAN JOURNAL OF OPERATIONAL RESEARCH (vol. 80, n° 3, 1995/02) |
Pagination : | 548-574 |
Langues: | Anglais |
Mots-clés : | Médecine hospitalière ; Efficience ; Hôpital ; Analyse donnée ; Méthodologie ; Qualité soins |
Résumé : | This paper reports on a six month study of the clinical efficiency of 36 physicians in a single hospitals. Both technical end scale efficiency are analyzed using Data Environnment Analysis (DEA) and a multi factorTobit analysis is conducted to see which variables are associated with higher levels of physician performance. DEA identifies 24 inefficient physicians. The slack associated with these physicians supports the hypothesis that a substancial amount of money could be saved if every physician practiced medicine as brillantly as the most competent physicians. The Tobit analysis revealed two categories of technically efficient physicians : those who (1) belong to a health maintenance organization (HMO) or (2) specialize by diagnostic related groups (DRGs)/Estimates of most productive output scale suggest that locally decreasing returns to scale set in a higher output levels for physicians who treat higher proportions of high severity patients. The results illustrate how blending DEA with censored regression can sharpen an analysis of best practices. |