Evaluating the quality and effectiveness of regional healthcare systems: A non-parametric analysis of ISTAT health for all data

Filippo Elba, Cristiano Ciappei, Riccardo Rialti, Lamberto Zollo

Abstract


Purpose. The aim of this paper is to evaluate the effectiveness and efficiency of the Health Services (RHSs) in Italy. Based on the Istat’s Health for All (IHFA) data, this study assesses Italian Hospital Services (HSs) and Health Assistance Services (HASs) between 2010 and 2013, considering both quantitative and qualitative aspects.

Methodology. The Multiplicative Non-Parametric Corporate Performance (MNCP) model by Emrouznejad and Cabanda (2010), namely the Data Envelopment Analysis (DEA). The assessment of effectiveness and efficiency of RHSs goes through three different steps. At first, we evaluate efficacy of regional HSs, integrating quantitative and qualitative analysis. Next, quality and efficacy of HASs have been evaluated. Finally, starting from the results obtained in the first two steps, the efficiency of RHSs in producing their quali-quantitative level of services has been assessed.

Practical implications. This research provides evidences of the potential of DEA to evaluate the quality and effectiveness of healthcare service.

Originality/value. In most of the existing literature, the evaluation of RHSs focuses on efficiency of health services supply, assessed by quantitative variables. This means not only that qualitative aspects are ignored, but also that efficacy is overlooked. The main aim of this kind of studies is to minimize RHSs cost, even if this choice implies low level of services provided, in terms of number and quality of benefits. This paper aims to fill in this gap, the aforementioned methodology.


Keywords


Healthcare management; service quality; public management; non-parametric analysis; data envelopment analysis

Full Text:

PDF

References


Aidemark, L.G. (2001). The meaning of balanced scorecards in the health care organization. Financial Accountability & Management, 17(1), 23-40.

Arah, O.A., Klazinga, N.S., Delnoij, D.M.J., Ten Asbroek, A.H.A., & Custers, T. (2003). Conceptual frameworks for health systems performance: a quest for effectiveness, quality, and improvement. International Journal for Quality in Health Care, 15(5), 377-398.

Arah, O.A., Westert, G.P., 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(1), 5-13.

Banker, R.D., Charnes, A., & Cooper, W.W. (1984). Some models for estimating technical and scale inefficiencies in data envelopment analysis. Management Science, 30(9), 1078-1092.

Cellini, R., Pignataro, G., & Rizzo, I. (2000). Competition and efficiency in health care: an analysis of the Italian case. International Tax and Public Finance, 7(4-5), 503-519.

Ciappei, C., Laudano, M. C., Zollo, L., & Rialti, R. (2016, December). Evaluating the quality of entrepreneurial education analysing its ability to increase entrepreneurial attitude and intent of students. In Toulon-Verona Conference" Excellence in Services".

Charnes, A., Cooper, W.W., & Rhodes, E. (1978). Measuring the efficiency of decision making units. European Journal of Operational Research, 2(6), 429-444.

Charnes, A., Cooper, W.W., & Rhodes, E. (1979). Measuring the efficiency of decision-making units. European Journal of Operational Research, 3(4), 339.

Emrouznejad, A., & Cabanda, E. (2010). An aggregate measure of financial ratios using a multiplicative DEA model. International Journal of Financial Services Management, 4(2), 114-126.

Emrouznejad, A., & Cabanda, E., & Gholami, R. (2010). An alternative measure of the ICT-opportunity index. Information Management, 47 (4) 246–254.

Emrouznejad, A., & Amin, G.R. (2009). DEA models for ratio data: Convexity consideration. Applied Mathematical Modelling, 33(1), 486-498.

Guerrini, A., Romano, G., Campedelli, B., Moggi, S., & Leardini, C. (2016). Public vs. Private in Hospital Efficiency: Exploring Determinants in a Competitive Environment. International Journal of Public Administration, 1-9. Available Online: http://dx.doi.org/10.1080/01900692.2016.1256892

Fernandez-Castro, A., & Smith, P. (1994). Towards a general non-parametric model of corporate performance. Omega, 22(3), 237-249.

Fottler, M.D., Erickson, E., & Rivers, P.A. (2006). Bringing human resources to the table: Utilization of an HR balanced scorecard at Mayo Clinic. Health Care Management Review, 31(1), 64-72.

Hilarion, P., Suñol, R., Groene, O., Vallejo, P., Herrera, E., & Saura, R.M. (2009). Making performance indicators work: the experience of using consensus indicators for external assessment of health and social services at regional level in Spain. Health policy, 90(1), 94-103.

Kloot, L., & Martin, J. (2000). Strategic performance management: A balanced approach to performance management issues in local government. Management Accounting Research, 11(2), 231-251.

Lapsley, I. (1999). Accounting and the new public management: instruments of substantive efficiency or a rationalising modernity?. Financial Accountability & Management, 15(3‐4), 201-207.

Linard, K., Basset, M., Dvorsky, L., & Yoon, J. (2000, August). A dynamic balanced scorecard template for public sector agencies. Proceeding of 19th international conference of the system dynamics society (pp. 23-27).

Lovaglio, P. (2010). Hospital effectiveness from administrative data: the Lombardy case. The TQM Journal, 22(5), 474-486.

Magherini, L., Lettieri, E., & Agasisti, T. (2016). Evaluating technical efficiency and the effect of innovative healthcare delivery on Italian hospitals: A two stage DEA approach. Documents from XXI Summer School “Francesco Turco”.

Mapelli, V., De Stefano, A., Compagnoni, V., Gambino, A., & Ceccarelli, A. (2007). I sistemi di governance dei Servizi sanitari regionali. Quaderni Formez, 57, 11-26.

Nuti, S., Seghieri, C., & Vainieri, M. (2013). Assessing the effectiveness of a performance evaluation system in the public health care sector: some novel evidence from the Tuscany region experience. Journal of Management & Governance, 17(1), 59-69.

Schiavone, A. (2008). Technical efficiency of Italian public hospitals (No. 29). Bank of Italy, Economic Research and International Relations Area. Available Online: http://dx.doi.org/10.2139/ssrn.1344286

Vainieri, M., & Nuti, S. (2011). Performance measurement features of the Italian regional healthcare systems: Differences and similarities. In K. Smigorski (Ed.), Health management: Different approaches and solutions (pp. 299–312). Rijeka: Intech.

Yang, M. C., & Tung, Y. C. (2006). Using path analysis to examine causal relationships among balanced scorecard performance indicators for general hospitals: The case of a public hospital system in Taiwan. Health care management review, 31(4), 280-288.

Zelman, W. N., Pink, G. H., & Matthias, C. B. (2003). Use of the balanced scorecard in health care. Journal of health care finance, 29(4), 1-16.

Zollo, L., Rialti, R., Ciappei, C., & Pellegrini, M. M. (2016a). Factors stimulating social innovation in entrepreneurship: an empirical evidence of inter-organizational alliances in Italy. International Journal of Business and Management, 11(5), 12.

Zollo, L., Faldetta, G., Pellegrini, M. M., & Ciappei, C. (2016b). Volunteers' Behavioral Intention in Non-profit Organizations Strategy: A Structural Equation Model. Academy of Management Proceedings 1, p. 12995.


Refbacks

  • There are currently no refbacks.