Acta Univ. Agric. Silvic. Mendelianae Brun. 2015, 63(6), 2109-2118 | DOI: 10.11118/actaun201563062109

Efficiency Evaluation of Hospitals in the Environment of the Czech and Slovak Republic

Stanislav Sendek1, Zuzana Svitálková1, Katarína Angelovičová2
1 Department of Finance, Faculty of Business and Economics, Mendel University in Brno, Zemědělská 1, 613 00 Brno, Czech Republic
2 St. Elisabeth University of Health and Social Sciences in Bratislava, Palackého č. 1, P.O. Box 104, 810 00 Bratislava, Slovak Republic

The paper applies the Data Envelopment Analysis as a deterministic non-parametric method based on the linear programming, to measure the efficiency of Czech and Slovak hospitals based on input and output performance. Managing physician or hospital practice patterns is an important tool to reduce health care costs. State-run hospitals, as decision-making units working in an operating healthcare system, might have some excess resources in the process of providing care. Ehealth tools are expected to contribute to the cost containment in them, enhancing finally the quality of patient care in the overall assessment.

Keywords: Data Envelopment Analysis, radial BCC model, e-health, input-output analysis, hospital efficiency assessment, decreasing returns to scale
Grants and funding:

This is to express our gratitude to the National Health Information Center of the Slovak Republic and the Institute of Health Information and Statistics of the Czech Republic for giving the authors the authorization and access to the non-public internal statistical databases on health statistics for research purposes given in written as of 02/19/2013 and 06/26/2014 respectively, and the permission to which is still valid to date. Our gratitude shall be extended also to the Ministry of Health of the Slovak Republic, Section of Informatics, for co-approval of the permission. It is hereby declared that the views, findings or results presented in this report are those of the authors only and do not necessarily reflect those of either of the three institutions mentioned above. Neither the Ministry of Health of the Slovak Republic, nor the National Health Information Center of the Slovak Republic, nor the Institute of Health Information and Statistics of the Czech Republic or any person acting on behalf of either of the institutions is responsible for the information provided in this research paper.

Prepublished online: December 26, 2015; Published: January 1, 2016  Show citation

ACS AIP APA ASA Harvard Chicago IEEE ISO690 MLA NLM Turabian Vancouver
Sendek, S., Svitálková, Z., & Angelovičová, K. (2015). Efficiency Evaluation of Hospitals in the Environment of the Czech and Slovak Republic. Acta Universitatis Agriculturae et Silviculturae Mendelianae Brunensis, 63(6), 2109-2118. doi: 10.11118/actaun201563062109
Share...
Download citation
  • BibTeX (.bib)
  • Bookends (.ris)
  • EasyBib (.ris)
  • EndNote (.enw)
  • EndNote 8 (.xml)
  • ISI WoS (.isi)
  • Medlars (.medlars)
  • Mendeley (.ris)
  • MODS (.xml)
  • Papers (.ris)
  • RefWorks (.txt)
  • RefManager (.ris)
  • RIS (.ris)
  • MS Word (.xml)
  • Zotero (.ris)
    • Open full article

    References

    1. AMERICAN THORACIC SOCIETY. 2005. Guidelines for the Management of Adults with Hospital-acquired, Ventilator-associated, and Healthcare-associated pneumonia. [online]. Am. J. Respir. Crit. Care. Med., 171(4): 388-416. Available at: Go to original source...
    2. ANAP. 2010. Value creation through ICTs for healthcare structures - Knowledge synthesis [in French: Creation de valeur par les technologies de l'information et de la communication pour les structures de sante - Synthese des connaissances]. [online]. Paris: Agence Nationale d'Appui a la Performance des etablissements de sante et medico-sociaux. Available at: [Accessed: 2014, September 09].
    3. BANKER, R. D., CHARNES, A. and COOPER, W. W. 1984. Some models for estimating technical and scale ineffi ciencies in Data Envelopment Analysis.Management Science, 30(1984): 1078-1092. DOI: 10.1287/mnsc.30.9.1078 Go to original source...
    4. BANNICK, R. R. and OZCAN, Y. A. 1995. Efficiency analysis of federally funded hospitals: Comparison of DoD and VA hospitals using Data Envelopment Analysis. Health Services Management Research, 8: 73-85. DOI: 10.1177/095148489500800201 Go to original source...
    5. BATES, D. W. et al. 1997. The Costs of Adverse Drug Events in Hospitalized Patients. Jama, 1997(277): 307-311. DOI: 10.1001/jama.1997.03540280045032 Go to original source...
    6. BATES, D. W., CULLEN, D. J., LAIRD, N., PETERSEN, L. A., SMALL, S. D., SERVI, D. et al. 1995. Incidence of adverse drug events and potential adverse drug events: Implications for prevention. Jama, 274(1): 29-34. DOI: 10.1001/jama.1995.03530010043033 Go to original source...
    7. BITRAN, G. R., VALOR-SEBATIER, J. 1987. Some mathematical programming based measures of efficiency in health care institutions. Advances in Mathematical Programming and Financial Planning, 1(1987): 61-84.
    8. BLACK, A. D. et al. 2011. The Impact of eHealth on the Quality and Safety of Health Care. A Systematic Overview. [online]. PLoS Medicine, 8(1): e1000387. Available at: [Accessed: 2014, October 29]. DOI: 10.1371/journal.pmed.1000387 Go to original source...
    9. BUELL, J. M. 2007. Flexing their IT muscles. Healthcare executive, 22(5): 16-20, 22. [online]. Available at: [Accessed: 2014, December 15].
    10. CHARNES, A., COOPER, W. W. and RHODES, E. L. 1978. Measuring the effi ciency of decision-making units. European Journal of Operational Research, 2: 429-444. DOI: 10.1016/0377-2217(78)90138-8 Go to original source...
    11. CHILINGERIAN, J. A., SHERMAN, H. D. 1990.Managing physician effi ciency and effectiveness in providing hospital services. Health Service Management Research, 3: 3-15. DOI: 10.1177/095148489000300101 Go to original source...
    12. COELLI, T. J., RAO, D. S. P., O'DONNELL, C. J., BATTESE, G. E. 2005. An Introduction to Efficiency and Productivity Analysis. 2nd edition. New York, USA: Springer Service & Business Media, Inc.
    13. CROLL, P. R., CROLL, J. 2007. Investigating risk exposure in E-Health systems. International journal of medical informatics, 76: 460-465. DOI: 10.1016/j.ijmedinf.2006.09.013 Go to original source...
    14. DANSKY, K. H., THOMPSON, D., SANNER, T. 2009. A framework for evaluating eHealth research. Evaluation and Program Planning, 29: 397-404. DOI: 10.1016/j.evalprogplan.2006.08.009 Go to original source...
    15. DARKINS, A. et al. 2008. Care Coordination/Home Telehealth: the systematic implementation of health informatics, home telehealth, and disease management to support the care of veteran patients with chronic conditions. Telemed. J. E. Health. 14(10): 1118-26. doi: 10.1089/tmj.2008.0021. Go to original source...
    16. DEVARAJ, S., KOHLI, R. 2003. Performance Impacts of Information Technology. Is Actual Usage the Missing Link? [online]. Management Science, 49(3): 273-289. DOI: 10.1287/mnsc.49.3.273.12736 Go to original source...
    17. EMPIRICA, GmbH. et al. 2005. Study on Economic Impact of eHealth: Developing an evidence-based contextadaptive method of evaluation for eHealth. [online]. Available at: [Accessed: 2014, November 11].
    18. EUROPEAN COMMISSION. 2004. eHealth is Worth it. [online]. 2004-05-03. Available at: [Accessed 2015, January 22].
    19. GARTNER, THE MINISTRY OF HEALTH AND SOCIAL AFF AIRS IN SWEDEN. 2009. eHealth for a Healthier Europe. [online]. Available at: [Accessed: 2015, January 15].
    20. HARRISON, J. P. et al. 2004. Efficiency of Federal Hospitals in the United States. Journal of Medical Systems, 28(5): 411-422. DOI: 10.1023/B:JOMS.0000041168.28200.8c Go to original source...
    21. HEALTH POLICY INSTITUTE. 2013. Debts by 2013 are going to exceed €300 million [in Slovak: Dlhy do konca roka 2013 presiahnu uroveň 300 mil. &euro]. [online]. 2013-05-09. Available at: [Accessed: 2015, February 03].
    22. HEALTHCARE INFORMATICS. 2007. Real-time infection protection. [online]. Available at: [Accessed: 2015, February 05].
    23. JABLONSKÝ, J., DLOUHÝ, M. 2004. Eficiency assessment models for production units [in Czech: Modely hodnoceni efektivnosti produkčnich jednotek]. Professional Publishing.
    24. KAZLEY, A. S., OZCAN, Y. A. 2008. Electronic medical record use and efficiency. A DEA and windows analysis of hospitals. Socio-Economic Planning Sciences, 43(3): 209-216. DOI: 10.1016/j.seps.2008.10.001 Go to original source...
    25. KORST, L. M. et al. 2003. Nursing documentation time during implementation of an electronic medical record. Journal of Nursing Administration, 33(1): 24-30. DOI: 10.1097/00005110-200301000-00006 Go to original source...
    26. KUOSMANEN, T., POST, T. 1999. Robust efficiency measurement. Dealing with outliers in Data Envelopment Analysis. [online]. November 25, 1999. Available at: [Accessed: 2015, January 17].
    27. NUSCH, a. s. (NARODNÝ ÚSTAV SRDCOVÝCH A CIEVNYCH CHORÔB (NATIONAL INSTITUTE OF CARDIOVASCULAR DISEASES)). 2003. Failing hearts on rise in favour of better care [in Slovak: Zlyhavajucich sŕdc pribuda pre lepšiu liečbu]. [online]. 2013-10-21. Available at: [Accessed: 2015, January 26].
    28. NCZI. NATIONAL HEALTH INFORMATION CENTER. 2014. Statistical internal database of statistical surveys. 2013-10-29. Available at:
    29. OZCAN, Y. A., LUKE, R. D. and HAKSEVER, C. 1992. Ownership and organizational performance: A comparison of technical effi ciency across hospital types. Medical Care, 30(9): 781-794. DOI: 10.1097/00005650-199209000-00003 Go to original source...
    30. SENDEK, S. 2014. Efficiency Evaluation of Hospitals in the Environment of the Slovak Republic. Acta Universitatis Agriculturae et Silviculturae Mendelianae Brunensis, 62(4): 697-706. DOI: 10.11118/actaun201462040697 Go to original source...
    31. SHEKELLE, P., WACHTER, R., WINTERS, B. et al. 2013. Making healthcare safer II: an updated critical analysis of the evidence for patient safety practices. Evidence Report/Technology Assessment, 211: 1-945.
    32. SHOJANIA, K. G. et al. 2001. Making health care safer: a critical analysis of patient safety practices. Evid. Rep. Technol. Assess. (Summ)., 43: 1-668.
    33. SMITH, J. 2004. Building a Safer NHS for Patients: Improving Medication Safety. [online]. Available at: [Accessed: 2015, January 19].
    34. TONE, K., TSUTSUI, M. 2013. An epsilon-based measure of effi ciency in DEA. GRIPS - National Graduate Institute For Policy Studies. [online]. Discussion paper: 09-13. Tokyo: Policy Information Center. Available at: [Accessed: 2015, January 03].
    35. TERRY, K. 2002. EMRs boost efficiency, too. Medical Economics, 79(7): 38-40, 43.
    36. UZIS ČR - ÚSTAV ZDRAVOTNICKÝCH INFORMACÍ A STATISTIKY ČR. 2012. Hospitals in the Czech Republic in the 1st half of the 2012. [online]. Available at: [Accessed: 2015, January 15].
    37. WORLD HEALTH ORGANISATION. 2005. Preventing chronic diseases a vital investment. [online]. Available at: [Accessed: 2015, January 25].
    38. WORLD HEALTH ORGANISATION. 2000. World Health Report. [online]. Available at: [Accessed: 2015, January 25].

    This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License (CC BY NC ND 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.


    Return to the content