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Journal of Medical Systems
Erschienen in: Journal of Medical Systems 5/2011

01.10.2011 | Original Paper

A Multiple Stage Approach for Performance Improvement of Primary Healthcare Practice

verfasst von: Martha T. Ramírez-Valdivia, Sergio Maturana, Sonia Salvo-Garrido

Erschienen in: Journal of Medical Systems | Ausgabe 5/2011

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Abstract

Chilean primary healthcare practice is analyzed using a Data Envelopment Analysis (DEA) multiple stage approach. We estimate the efficiency level of 259 municipalities nationwide. Since the efficiency score by itself is of limited value for decision making, we use a multivariate tool to help explain the effect of relevant factors. First, we use a cluster analysis to homogenize the units under study. Second, we use DEA to estimate the efficiency levels, which varies from 61% to 71% for urban municipalities, and from 51% to 56% in rural ones. Third, we use bootstrap to estimate confidence intervals for the efficiency scores, and a Biplot method to identify adequate variables to include in the Tobit Model, which is our last stage. We identify six factors associated with rural municipalities’ operational efficiency, and two with urban ones. Knowing the efficiency level of municipalities can help determine ways to improve their efficiency.
Fußnoten
1
Rates are estimated using different sources. Datasets available at: http://​www.​ine.​cl and htpp://​www.​sinim.​cl
 
3
Do not confuse the variables rur and urb with the variable used for urban and rural location in “Cluster analysis”. Any urban or rural municipality might have a mix of urban and/or rural health centers associated.
 
4
ipobre and denpob were included in the cluster analysis of “Cluster analysis”. However, since those variables were disregarded to form cluster groups we decided to include them in the Tobit analysis.
 
5
We do not include the CRS formulation since it is the same as the VRS minus Eq. 1.3.
 
6
gper = annual medical staff cost; gfunc = annual general service cost; gfarm = annual pharmacy cost
 
7
cons = annual number of medical visits; cont = annual number of medical check-up visits.
 
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Metadaten
Titel
A Multiple Stage Approach for Performance Improvement of Primary Healthcare Practice
verfasst von
Martha T. Ramírez-Valdivia
Sergio Maturana
Sonia Salvo-Garrido
Publikationsdatum
01.10.2011
Verlag
Springer US
Erschienen in
Journal of Medical Systems / Ausgabe 5/2011
Print ISSN: 0148-5598
Elektronische ISSN: 1573-689X
DOI
https://doi.org/10.1007/s10916-010-9438-7

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