ArticleHealth care management science2018
Technical and scale efficiency in public and private Irish nursing homes - a bootstrap DEA approach.
Article in Health care management science, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 1 of them a synthesis that pooled it.
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Who cites it
9 citing papers in PubMed, 1 synthesis or guideline pooled it.
- A Systematic Literature Review of Efficiency Measurement in Nursing Homes.International journal of environmental research and public health · 2019Pooled it
- Team Size and Composition in Home Healthcare: Quantitative Insights and Six Model-Based Principles.Healthcare (Basel, Switzerland) · 2023Article
- Healthcare Service Efficiency: An Empirical Study on Healthcare Capacity in Various Counties and Cities in Taiwan.Healthcare (Basel, Switzerland) · 2023Article
- Levels, trends, and determinants of effectiveness on the hierarchical medical system in China: Data envelopment analysis and bootstrapping truncated regression analysis.Frontiers in public health · 2022Article
- Investigating the link between medical urgency and hospital efficiency - Insights from the German hospital market.Health care management science · 2020Article
- Measuring productivity of healthcare services under environmental constraints: evidence from China.BMC health services research · 2020Article
- Provision of health care services and regional diversity in Germany: insights from a Bayesian health frontier analysis with spatial dependencies.The European journal of health economics : HEPAC : health economics in prevention and care · 2020Article
- Road map for progress and attractiveness of Iranian hospitals by integrating self-organizing map and context-dependent DEA.Health care management science · 2019Article
- What Counts in Nursing Homes' Quality and Efficiency? Results From Data Envelopment Analysis in Italy.Inquiry : a journal of medical care organization, provision and financingArticle
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Authors and funding
3 authors.
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Abstract
This article provides methodological and empirical insights into the estimation of technical efficiency in the nursing home sector. Focusing on long-stay care and using primary data, we examine technical and scale efficiency in 39 public and 73 private Irish nursing homes by applying an input-oriented data envelopment analysis (DEA). We employ robust bootstrap methods to validate our nonparametric DEA scores and to integrate the effects of potential determinants in estimating the efficiencies. Both the homogenous and two-stage double bootstrap procedures are used to obtain confidence intervals for the bias-corrected DEA scores. Importantly, the application of the double bootstrap approach affords true DEA technical efficiency scores after adjusting for the effects of ownership, size, case-mix, and other determinants such as location, and quality. Based on our DEA results for variable returns to scale technology, the average technical efficiency score is 62 %, and the mean scale efficiency is 88 %, with nearly all units operating on the increasing returns to scale part of the production frontier. Moreover, based on the double bootstrap results, Irish nursing homes are less technically efficient, and more scale efficient than the conventional DEA estimates suggest. Regarding the efficiency determinants, in terms of ownership, we find that private facilities are less efficient than the public units. Furthermore, the size of the nursing home has a positive effect, and this reinforces our finding that Irish homes produce at increasing returns to scale. Also, notably, we find that a tendency towards quality improvements can lead to poorer technical efficiency performance.
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