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The Determinants of the Technical Efficiency of Acute Inpatient Care in Canada
- Publication Year :
- 2018
- Publisher :
- John Wiley and Sons Inc., 2018.
-
Abstract
- Objective To evaluate the technical efficiency of acute inpatient care at the pan-Canadian level and to explore the factors associated with inefficiency-why hospitals are not on their production frontier. Data sources/study setting Canadian Management Information System (MIS) database (CMDB) and Discharge Abstract Database (DAD) for the fiscal year of 2012-2013. Study design We use a nonparametric approach (data envelopment analysis) applied to three peer groups (teaching, large, and medium hospitals, focusing on their acute inpatient care only). The double bootstrap procedure (Simar and Wilson 2007) is adopted in the regression. Data collection/extraction methods Information on inpatient episodes of care (number and quality of outcomes) was extracted from the DAD. The cost of the inpatient care was extracted from the CMDB. Principal findings On average, acute hospitals in Canada are operating at about 75 percent efficiency, and this could thus potentially increase their level of outcomes (quantity and quality) by addressing inefficiencies. In some cases, such as for teaching hospitals, the factors significantly correlated with efficiency scores were not related to management but to the social composition of the caseload. In contrast, for large and medium nonteaching hospitals, efficiency related more to the ability to discharge patients to postacute care facilities. The efficiency of medium hospitals is also positively related to treating more clinically noncomplex patients. Conclusions The main drivers of efficiency of acute inpatient care vary by hospital peer groups. Thus, the results provide different policy and managerial implications for teaching, large, and medium hospitals to achieve efficiency gains.
- Subjects :
- Systems Management and Health Policy
Canada
Databases, Factual
media_common.quotation_subject
Efficiency, Organizational
Fiscal year
03 medical and health sciences
0302 clinical medicine
Data envelopment analysis
Medicine
Humans
Quality (business)
030212 general & internal medicine
Hospital Costs
media_common
Inpatients
Data collection
Models, Statistical
Inpatient care
business.industry
030503 health policy & services
Health Policy
Peer group
Production–possibility frontier
medicine.disease
Hospitals
Management information systems
Acute Disease
Medical emergency
0305 other medical science
business
Subjects
Details
- Language :
- English
- Database :
- OpenAIRE
- Accession number :
- edsair.doi.dedup.....afb58bbf23d9afa6d2e1ccbac0c4f4e0