| |
|
Errors in Survey Based Quality Evaluation Variables in Efficiency Models of Primary Care Physicians
Av Kittelsen, Sverre A.C., Guri Galtung Kjæserud
and Odd Jarle Kvamme
Memorandum 24/2001
|
|
Sammendrag |
Efficiency analyses in the health care sector are often criticised for not incorporating quality variables. The definition of quality of primary health care has many aspects, and it is inevitably also a question of the patients’ perception of the services received. This paper uses variables derived from patient evaluation surveys as measures of the quality of the production of health care services. It uses statistical tests to judge if such measures have a significant impact on the
use of resources in various Data Envelopment Analysis (DEA) models. As the use of survey data implies that the quality variables are measured with error, the assumptions underlying a DEA model are not strictly fulfilled. This paper focuses on ways of correcting for biases that might result from the violation of selected assumptions. Firstly, any selection bias in the patient mix of each physician is controlled for by regressing the patient evaluation responses on the patient characteristics. The corrected quality evaluation variables are entered as outputs in the DEA model, and model specification tests indicate that out of 25 different quality variables, only waiting time has a systematic impact on the efficiency results. Secondly, the effect on the efficiency estimates of the remaining sampling error in the patient sample for each physician is accounted for by constructing confidence intervals based on resampling. Finally, as an alternative approach to including the quality variables in the DEA model, a regression model finds different variables significant, but not always with a trade-of between quality and quantity. |
| JEL Klassifikasjon:
|
C61, D24, I12 |
| Nøkkelord:
|
DEA, Health economics, Quality, Patient evaluation, Efficiency, Errors in
variables, Resampling, Bootstrap, Selection bias, Sampling error. |
| Prosjekt:
|
2102 Billigere og bedre? Kvalitet og effektivitetsanalyser i offentlig sektor
|
| Finansiering:
|
Norwegian Research Council through HERO and the project Quality and efficiency analysis in the
public sector |
| Kontakt:
|
sverre.kittelsen@frisch.uio.no |
| |
|
| |
[Full Text PDF]
|
Bestilling
Frischsenterets publikasjoner vil være tilgjengelig som full tekst Adobe Acrobat PDF-filer fra denne tjeneren.
Publikasjoner trykt som artikler eller bokkapitler vil av opphavsrettslige grunner ikke kunne lastes ned herfra.
For enkelte dokumenter trenger en å laste ned versjon 4 av gratisprogrammet Acrobat Reader.
Microsoft Internet Explorer har problemer med å åpne visse dokumenter. Problemet kan omgås ved å høyreklikke på linken
og velge "Save Target As", og deretter åpne den lagrede filen direkte i Adobe Acrobat.
Frischsenterets publikasjoner kan også leveres i papirversjon ved bestilling på telefon 22958820, fax 22958825,
eller epost frisch@frisch.uio.no
Abonner på vår informasjonspostliste dersom du ønsker å motta meldinger om nye publikasjoner
innefor ett eller flere temaområder.
For rapporter, arbeidsnotater eller særtrykk fra 1998 eller tidligere år mens Frischsenteret var SNF-Oslo, bruk SNFs WWW publikasjonssenter, eller
Tel: 55959500,
Fax: 55959439,
Post: SNF, Breiviksveien 40, 5045 Bergen,
E-post: publikasjon@snf.no
Endret
31.10.07, webmaster@frisch.uio.no.
|
|
