José Manuel Cordero1, Roberto Nuño-Solinís2, Juan F Orueta3, Cristina Polo1, Mario Del Río-Cámara4, Edurne Alonso-Morán5. 1. Departamento de Economía, Universidad de Extremadura, Badajoz, España. 2. Deusto Business School, Universidad de Deusto, Bilbao, España. Electronic address: roberto.nuno@deusto.es. 3. Centro de Salud de Astrabudua, Osakidetza, Erandio (Vizcaya), España. 4. O+berri, Instituto Vasco de Innovación Sanitaria, Sondika (Vizcaya), España. 5. Bioestadística Independiente, Bilbao, España.
Abstract
OBJECTIVE: To evaluate the technical efficiency of primary care units operating in the Basque Health Service during the period 2010-2013, corresponding to the implementation of a care integration strategy by health authorities. METHODS: This study included 11 of the 12 primary care units in the Basque Health Service during the period 2010-2013. Data envelopment analysis (DEA) was used to assess the technical efficiency of the units. In particular, we applied the extension DEA windows to analyse all units as if they were in a single period (33 observations) as well as a conditional model, which allowed incorporation of the effect of the characteristics of the population covered. The outputs considered were a quality index based on fulfilment of different requirements related to primary care delivery and the rate of avoidable hospitalizations (treated as an undesirable output). The inputs used were the number of physicians, the number of nurses and the costs of prescriptions. The morbidity index was included as an exogenous variable. RESULTS: The results showed that the efficiency of all the units improved during the study period. However, this improvement was not greater in the units incorporated in the integrated healthcare organisation. DISCUSSION: In a context of global transformation of care delivery in the Basque country in the study period, primary care units increased their efficiency. However, this effect was not larger in vertically integrated primary care providers.
OBJECTIVE: To evaluate the technical efficiency of primary care units operating in the Basque Health Service during the period 2010-2013, corresponding to the implementation of a care integration strategy by health authorities. METHODS: This study included 11 of the 12 primary care units in the Basque Health Service during the period 2010-2013. Data envelopment analysis (DEA) was used to assess the technical efficiency of the units. In particular, we applied the extension DEA windows to analyse all units as if they were in a single period (33 observations) as well as a conditional model, which allowed incorporation of the effect of the characteristics of the population covered. The outputs considered were a quality index based on fulfilment of different requirements related to primary care delivery and the rate of avoidable hospitalizations (treated as an undesirable output). The inputs used were the number of physicians, the number of nurses and the costs of prescriptions. The morbidity index was included as an exogenous variable. RESULTS: The results showed that the efficiency of all the units improved during the study period. However, this improvement was not greater in the units incorporated in the integrated healthcare organisation. DISCUSSION: In a context of global transformation of care delivery in the Basque country in the study period, primary care units increased their efficiency. However, this effect was not larger in vertically integrated primary care providers.
Authors: Pedro Antonio Martín Cervantes; Nuria Rueda López; Salvador Cruz Rambaud Journal: Int J Environ Res Public Health Date: 2019-07-03 Impact factor: 3.390
Authors: Nerea Almeda; Carlos Ramón García-Alonso; Helen Killaspy; Mencía R Gutiérrez-Colosía; Luis Salvador-Carulla Journal: PLoS One Date: 2022-03-17 Impact factor: 3.240