(18.210.12.229) 您好!臺灣時間:2021/03/05 12:48
字體大小: 字級放大   字級縮小   預設字形  
回查詢結果

詳目顯示:::

我願授權國圖
: 
twitterline
研究生:MunkhsaikhanSodnom
研究生(外文):Munkhsaikhan Sodnom
論文名稱:TechnicalEfficiencyofPublicHospitalsinMongolia:AnApplicationofDateEnvelopmentAnalysis
論文名稱(外文):Technical Efficiency of Public Hospitals in Mongolia:An Application of Date Envelopment Analysis
指導教授:張明正張明正引用關係
指導教授(外文):Ming-Cheng Chang
學位類別:碩士
校院名稱:亞洲大學
系所名稱:健康管理研究所
學門:商業及管理學門
學類:醫管學類
論文種類:學術論文
論文出版年:2007
畢業學年度:96
語文別:英文
論文頁數:55
外文關鍵詞:public hospital in Mongoliatechnical efficiencyDEA model
相關次數:
  • 被引用被引用:0
  • 點閱點閱:64
  • 評分評分:系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔系統版面圖檔
  • 下載下載:0
  • 收藏至我的研究室書目清單書目收藏:0
The purpose of this thesis was to evaluate the technical efficiency of public hospitals in Mongolia. Another purpose of this thesis was to study the link between technical efficiency and various factors such as level of hospital, location of hospital and time period observed. In this thesis nonparametric Data Envelopment Analyses was used to assess the technical efficiency of hospitals. Sensitivity analysis was used to evaluate the stability of efficiency scores of the DEA model. The relationships between technical efficiency of hospitals and other factors were then examined using appropriate parametric and non-parametric tests.
The purpose of this thesis was to evaluate the technical efficiency of public hospitals in Mongolia. Another purpose of this thesis was to study the link between technical efficiency and various factors such as level of hospital, location of hospital and time period observed. In this thesis nonparametric Data Envelopment Analyses was used to assess the technical efficiency of hospitals. Sensitivity analysis was used to evaluate the stability of efficiency scores of the DEA model. The relationships between technical efficiency of hospitals and other factors were then examined using appropriate parametric and non-parametric tests.

The data for this study were obtained for the years 2004, 2005 and 2006, from the Ministry of Health, National Center for Health Development and Health Department of Ulaanbaatar City. The original set consisted of almost all secondary and tertiary level public hospitals in Mongolia. Specialized and private hospitals were excluded in order to have a homogenous group of hospitals.

The DEA results in this research provide efficiency scores for each of the hospitals through three year of period. For each inefficient hospital the reductions in inputs and/or increases in outputs needed to bring the hospital up to full efficiency. The findings of this research indicate that the secondary level hospitals in provinces on average are less efficient (p=0.022) than secondary level hospitals in cities. Decision-makers should reevaluate hospital performance and reallocate resources among across regions based on needs and necessities to maximize system-wide efficiency.
ABSTRACT iv
TABLE OF CONTENTS v
LIST OF TABLES viii
LIST OF FIGURES ix
Chapter
1 INTRODUCTION 1
11 Introduction 1
12 Purpose of the Study 2
13 The Importance of this Study 3
131 Significance of Measuring Hospital Technical Efficiency 3
132 Hospital Efficiency in Mongolia 3
14 Demographic and Health Data in Mongolia 4
141 Population 4
142 Medical Services 6
15 Research Questions and Hypotheses 8
2 LITERATURE REVIEW 9
21 Hospital Efficiency 9
211 Technical Efficiency of Hospitals 10
212 Measurement of Hospitals Efficiency 11
22 Data Envelopment Analysis (DEA) 13
221 Advantages of DEA 15
222 Limitations of DEA 17
v
3 METHODOLOGY 19
31 Research Framework 19
32 Study Scope and Data Sources 20
321 Study scope 20
322 Data Sources 21
33 Data Envelopment Analysis 21
331 General Features of the DEA Models 21
332 Return to Scale 22
333 Optimization Model 23
334 Input and Output Measures 24
3341 Measurement of Hospital Outputs 25
3342 Measurement of Hospital Inputs 29
335 Formulation of the DEA Model 30
336 Sensitivity Analysis and Superefficiency model 32
34 Determinants of Hospital Efficiency 34
4 DATA ANALYSIS AND EMPIRICAL RESULTS 35
41 Descriptive Analysis of the Data 35
42 Analysis of the Empirical Results 38
421 Evaluating the Robustness of DEA Using Sensitivity Analysis 38
422 Evaluating Technical E fficiency of Hospitals 40
4221 Efficiency of Hospitals in Mongolia 40
4222 Evaluating Secondary and Tertiary Level Hospitals 42
4223 Evaluating City and Province Hospitals 43
4224 Evaluating Hospital Efficiency Over Time Period 44

vi
5 CONCLUSIONS AND SUGGESTIONS FOR FUTURE RESEARCH 46
51 Conclusions 46
52 Limitations of the Study 47
53 Suggestions for Future Research 48
BIBLIOGRAPHY 50
APPENDIX
List of Abbreviations and Acronyms 55
vii
LIST OF FIGURES
11 Administrative map of Mongolia 4
31 Data sets 20
LIST OF TABLES
11 The demographic indicators by selected years 5
12 Health Facilities and Utilization of Hospital Beds, 2006 7
41 Descriptive Analysis of Raw Data Arranged by Hospital Level and Location 36
42 Descriptive Analysis of Raw Data Arranged by Year 37
43 Efficiency-Stability During Hospital Omission 39
44 Efficiency Difference During Hospital Omission 40
45 Efficiency of Hospitals 41
46 Efficiency Score Arranged by Hospital Level and Location 42
47 The Results of Testing the Hypothesis 1 43
48 The Results of Testing the Hypothesis 2 44
49 Efficiency Score Arranged by Year 44
410 The Results of Testing the Hypothesis 3 45
Anderson P., and Petersen N., A Procedure for Ranking Efficient Units in Data Envelopment Analysis, Management Science, Vol. 39, October, 1993, pp. 1261-1264.

Aday L.A., Begley C. E., Lairson D. R., Slater C.H., Evaluating The Medical Care System: Effectiveness, Efficiency and Equity, Health Administration Press Ann Arbor, Michigan, 1993.

Banker R., Charnes A., and Cooper W., Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis, Management Science, Vol. 30. 1984, pp. 1078-1092.

Byrnes, P., Valdmanis, V., Analyzing Technical and Allocative Efficiency of Hospitals, Academic Publishers, USA, 1996.

Charnes A., Cooper W., and Rhodes E ., Measuring the Efficiency of Decision Making Units, European Journal of Operations Research, Vol. 2, November, 1978, pp. 429-444.

Cooper, W.W., R.G. Thompson, & Thrall, R.M., Extensions and New Developments in DEA. Annals of Operations Research. 1996, 66, 3-45.

Fare, R., S.Grosskopf, Profit Efficiency, Farrell Decompositions and the Mahler Inequality, Economics Letters, 1997, 57, 283-287.

Farrell M.J., The Measurement of Productive Efficiency, Journal of the Royal Statistical Society, Series A General, 1957, 120(3), 253-281.

Folland, S., Goodman, A., and Stano, M., The Economics of Health and Health Care. Macmillan Publishing Company, New York, 1993.

Giuffrida A., Gravelle H., Measuring performance in primary care: econometric analysis and DEA, Applied Economics 2001, 33:163-175.

Grtffiths D., Implementing Quality with a Customer Focus, Milwaukee, WI, ASQC quality Press, 1990.

Grosskopf S., Valdmanis V., Measuring Hospital Performance: A Nonparametric Approach, Journal of Health Economics No. 6, 1987, pp. 89-107.

Harris J, Ozgen H, Ozcan YA: Do mergers enhance the performance of hospital efficiency? Journal of the Operational Research Society, 2000, 51:801-811

Harrison, J., M. N. Coppola, and M. D. Wakefield, Efficiency of federal hospitals in the United States, Journal of Medical Systems, 2004, 28 (5): 411¡V22.

Harrison, J., and C. Sexton, The paradox of the not-for profit hospital, The Health Care Manager, 2004, 23 (3): 192¡V204.

Hofmarcher MM., Lietz C., Schnabl A., Inefficiency in Austrian Inpatient Care:Identifying Ailing Providers Based on DEA Results, Central European Journal of Operations Research 2005, 13(4):341-363.

Hofmarcher MM., Paterson I., Riedel M., Measuring hospital efficiency in Austria: A DEA approach, Health Care Management Science 2002, 5:7-14.

Hollingsworth, B., Non-parametric and parametric applications measuring efficiency in health care, Health Care Management Science, 2003, 6: 203¡V18.

Jacobs R., Alternative methods to examine hospital efficiency: Data envelopment analysis and stochastic frontier analysis, Health Care Management Science, 2001, 4:103-115.

Jan P. Clement, Vivian G. Valdmanis, Gloria J. Bazzoli, Mei Zhao, Askar Chukmaitov, Is more better? An analysis of hospital outcomes and efficiency with a DEA model of output congestion, Health Care Management Science, Bussum: March, 2008. Vol. 11, Iss.
1; p. 67

Kirigia JM., Emrouznejad A., Sambo LG, Munguti N., Liambila W., Using Data Envelopment Analysis to Measure the Technical Efficiency of Public Health Centers in Kenya, Journal of Medical Systems 2004, 28(2):155-166.

KonSi Ltd, Data Envelopment Analysis for Benchmarking, http://www.dea-analysis.com, 2006.

Laurie J. Bates, Kankana Mukherjee, Rexford E. Santerre, Market Structure and Technical Efficiency in the Hospital Services Industry: A DEA Approach, Medical Care Research and Review, Thousand Oaks: Aug 1, 2006. Vol. 63, Iss. 4; p. 499.

Linna M., Nordblad A., Koivu M., Technical and cost-efficiency of oral health care provision in Finnish health centres. Social Science and Medicine 2002, 56:343-353.

Lovell, C.A.K., Schmidt, S.S., The Measurement of Productive Efficiency, Oxford University Press, New York 1993.

Magnussen, J., Efficiency Measurement and the Operationalization of Hospital Produc-tion. Health Services Research. Vol. 31, No. 1, April, 1996, pp. 21-37.

Maria M. Hofmarcher, Christine Lietz, Alexander Schnabl, Inefficiency in Austrian Inpatient Care: Identifying Ailing Providers Based on DEA Results, Central European Journal of Operations Research 2005; 13, 4; p. 341.

Matthias Staat, Efficiency of hospitals in Germany: a DEA-bootstrap approach, Applied Economics, London: Oct 20, 2006. Vol. 38, Iss. 19; p. 2255

MoH and NCHD, Health indicators 2004, Ulaanbaatar, Ministry of Health and National Centre for Health Development 2005.

MoH and NCHD, Health indicators 2005, Ulaanbaatar, Ministry of Health and National Centre for Health Development 2006.

MoH and NCHD, Health indicators 2006, Ulaanbaatar, Ministry of Health and National Centre for Health Development 2007.

National Statistical Office, Mongolian statistical yearbook 2004, Ulaanbaatar, National Statistical Office 2005.

National Statistical Office, Mongolian statistical yearbook 2005, Ulaanbaatar, National Statistical Office 2006.

National Statistical Office, Mongolian statistical yearbook 2006, Ulaanbaatar, National Statistical Office 2007.

Nemoto J., Goto M., Measurement of Dynamic Efficiency in Production: An Application of Data Envelopment Analysis to Japanese Electric Utilities, Journal of Productivity Analysis, 2003, 19, 191-210.

Ouellette, P., Vierstraete V., Technological Change and Efficiency in the Presence of Quasi-fixed Inputs: A DEA Application to the Hospital Sector, European Journal of Operational Research, 2004, 154.

Pai C-W., Ozcan Y.A., Jiang H.J., Regional variation in physician practice pattern: an examination of technical and cost-efficiency for treating sinusitis, Journal of Medical Systems, 2000, 24(2):103-117.

Pink G, Murray M, McKillop I., Hospital efficiency and patient satisfaction, Health Serv. Manage Res., 2003; 16: 24-38.

Rosko M., Measuring technical efficiency in health care organizations, Journal of Medical Systems, 1990, 14, 307-22.

Silva, E., Stefanou S.E., Nonparametric Dynamic Production Analysis and the Theory of Cost, Journal of P roductivity Analysis, 2003, 19, 5-32.

Simar L., Wilson PW., Estimation and inference in two-stage, semi-parametric models of production processes, Journal of Econometrics 2007, 136:31-64.

Shafere S., Bradford J., Efficiency Measurement of Alternative Machine Component Grouping Solutions Via Data Envelopment Analysis, IE EE Transactions on Engineering Management, 1995, Vol. 22(10), 922 - 938.

Sherman H., Hospital Efficiency Measurement and Evaluation Empirical Test of a New Technique, Medical Care, Vol. 22, No. 10. October 1984, pp. 922-938.

White K., Ozcan Y., Church Ownership and Hospital Efficiency, Hospital and Health Services Administration, Vol. 41, No. 3, Fall, 1996, pp. 297-310.

Yan Li, Investment and dynamic DEA: With an application to Chinese hospitals, Universite du Quebec a Montreal (Canada), 2005, AAT NR09508

Zavras A.I., Tsakos G., Economou C., Kyriopoulos J., Using DEA to evaluate efficiency and formulate policy within a Greek national primary health care network, Journal of Medical Systems 2002, 26(4):285-292.

Zere E., McIntyre D., Addison T., Technical efficiency and productivity of Public sector hospitals in three South African provinces, South African Journal of Economics 2001, 69:336-358.
QRCODE
 
 
 
 
 
                                                                                                                                                                                                                                                                                                                                                                                                               
第一頁 上一頁 下一頁 最後一頁 top
系統版面圖檔 系統版面圖檔