Measuring the productivity growth and quality changes of teaching and non-teaching hospitals in Taiwan
RAIRO. Operations Research, Tome 55 (2021), pp. S1823-S1831

The objective of this study was to compare productivity growth and quality changes in teaching and non-teaching hospitals in Taiwan using a quality-based Malmquist productivity index under a metafrontier framework. Researchers have argued that teaching hospitals are more costly than non-teaching hospitals. Whether Taiwanese teaching hospitals operate with higher productivity than non-teaching hospitals is important to determine given increasing financial pressure on hospitals. The results of this study show that, among the Taiwanese teaching and non-teaching hospitals in the study sample, both types of institutions increased in productivity and improved in quality from 2008 to 2014. However, non-teaching hospitals saw much greater positive developments in productivity and quality than teaching hospitals. Therefore, additional teaching and research duties may influence the performance of teaching hospitals in provision of direct patient care.

DOI : 10.1051/ro/2020047
Classification : 62, 65, 90
Keywords: Teaching hospital, quality, Malmquist productivity index (MPI), metafrontier analysis, data envelopment analysis (DEA) 
@article{RO_2021__55_S1_S1823_0,
     author = {Chen, Kuan-Chen and Lin, Chung-I and Hsiao, Yu-Jen},
     title = {Measuring the productivity growth and quality changes of teaching and non-teaching hospitals in {Taiwan}},
     journal = {RAIRO. Operations Research},
     pages = {S1823--S1831},
     year = {2021},
     publisher = {EDP-Sciences},
     volume = {55},
     doi = {10.1051/ro/2020047},
     language = {en},
     url = {https://www.numdam.org/articles/10.1051/ro/2020047/}
}
TY  - JOUR
AU  - Chen, Kuan-Chen
AU  - Lin, Chung-I
AU  - Hsiao, Yu-Jen
TI  - Measuring the productivity growth and quality changes of teaching and non-teaching hospitals in Taiwan
JO  - RAIRO. Operations Research
PY  - 2021
SP  - S1823
EP  - S1831
VL  - 55
PB  - EDP-Sciences
UR  - https://www.numdam.org/articles/10.1051/ro/2020047/
DO  - 10.1051/ro/2020047
LA  - en
ID  - RO_2021__55_S1_S1823_0
ER  - 
%0 Journal Article
%A Chen, Kuan-Chen
%A Lin, Chung-I
%A Hsiao, Yu-Jen
%T Measuring the productivity growth and quality changes of teaching and non-teaching hospitals in Taiwan
%J RAIRO. Operations Research
%D 2021
%P S1823-S1831
%V 55
%I EDP-Sciences
%U https://www.numdam.org/articles/10.1051/ro/2020047/
%R 10.1051/ro/2020047
%G en
%F RO_2021__55_S1_S1823_0
Chen, Kuan-Chen; Lin, Chung-I; Hsiao, Yu-Jen. Measuring the productivity growth and quality changes of teaching and non-teaching hospitals in Taiwan. RAIRO. Operations Research, Tome 55 (2021), pp. S1823-S1831. doi: 10.1051/ro/2020047

G. E. Battese and D. S. P. Rao, Technology gap, efficiency, and a stochastic metafrontier function. Int. J. Bus. Econ. 1 (2002) 87–93.

G. E. Battese, D. S. P. Rao and C. J. O’Donnell, A metafrontier production function for estimation of technical efficiencies and technology gaps for firms operating under different technologies. J. Prod. Anal. 21 (2004) 91–103. | DOI

L. G. Burke, A. B. Frakt, D. Khullar, E. J. Orav and A. K. Jha, Association between teaching status and mortality in U.S. hospitals. JAMA 317 (2017) 2105–2113. | DOI

L. G. Burke, D. Khullar, J. Zheng, A. B. Frakt, E. J. Orav and A. K. Jha, Comparison of costs of care for medicare patients hospitalized in teaching and nonteaching hospitals. JAMA Netw Open. 2 (2019) e195229. | DOI

J. M. Cameron, The indirect costs of graduate medical education. New England J. Med. 312 (1985) 1233–1238. | DOI

C. Campbell, K. Gillespie and J. Romeis, The effects of residency training programs on the financial performance of veterans affairs medical centers. Inquiry 28 (1991) 288–299.

K. Carey and J. F. Burgess, Jr., On measuring the hospital cost-quality trade-off. Health Econ. 8 (1999) 509–520. | DOI

S. J. Chang, H. C. Hsiao, L. H. Huang and H. Chang, Taiwan quality indicator project and hospital productivity growth. Omega 39 (2011) 14–22. | DOI

K. H. Chen and H. Y. Yang, A cross-country comparison of productivity growth using the generalised metafrontier Malmquist productivity index: with application to banking industries in Taiwan and China. J. Prod. Anal. 35 (2011) 197–212. | DOI

K. C. Chen, L. N. Chien, Y. H. Hsu and M. M. Yu, Metafrontier frameworks for studying hospital productivity growth and quality changes. Int. J. Qual. Health Care 28 (2016) 650–656.

R. Färe, S. Grosskopf, M. Norris and Z. Zhang, Productivity growth, technical progress, and efficiency change in industrialized countries. Am. Econ. Rev. 84 (1994) 66–83.

R. Färe, S. Grosskoph and P. Roos, Productivity and quality changes in Swedish pharmacies. Int. J. Prod. Econ. 39 (1995) 137–144. | DOI

M. Farsi, Changes in hospital quality after conversion in ownership status. Int. J. Health Care Finance Econ. 4 (2004) 211–230. | DOI

G. D. Ferrier and J. S. Trivitt, Incorporating quality into the measurement of hospital efficiency: a double DEA approach. J. Prod. Anal. 40 (2013) 337–355. | DOI

A. Flokou, V. Aletras and D. Niakas, A window-DEA based efficiency evaluation of the public hospital sector in Greece during the 5-year economic crisis. PLoS One 12 (2017) e0177946. | DOI

S. Grosskopf, D. Margaritisb and V. Valdmanis, The effects of teaching on hospital productivity. Soc.-Econ. Planning Sci. 35 (2001) 189–204. | DOI

S. Grosskopf, D. Margaritisb and V. Valdmanis, Comparing teaching and non-teaching hospitals: a frontier approach (teaching vs. non-teaching hospitals). Health Care Manage. Sci. 4 (2001) 83–90. | DOI

A. J. Hartz, M. S. Gottlieb, E. M. Kuhn and A. A. Rimm, The relationship between adjusted hospital mortality and the results of peer review. Health Serv. Res. 27 (1993) 765–777.

G. Jensen and M. Morrisey, The role of physicians in hospital production. Rev. Econ. Stat. 68 (1986) 432–441. | DOI

S. Kumar and R. R. Russell, Technological change, technological catch-up, and capital deepening: relative contributions to growth and convergence. Am. Econ. Rev. 92 (2002) 527–548. | DOI

S. C. Kumbhakar and H. J. Wang, Estimation of growth convergence using a stochastic production frontier approach. Econ. Lett. 88 (2005) 300–305. | MR | Zbl | DOI

P. Nayar, Y. A. Ozcan, F. Yu, A. T. Nguyen, Benchmarking urban acute care hospitals. Health Care Manage. Rev. 38 (2013) 137–145. | DOI

S. Nuti, T. Grillo Ruggieri and S. Podetti, Do university hospitals perform better than general hospitals? A comparative analysis among Italian regions. BMJ Open. 6 (2016) e011426. | DOI

C. J. O’Donnell, D. S. P. Rao and G. E. Battese, Metafrontier frameworks for the study of firm-level efficiencies and technology ratios. Empir. Econ. 34 (2008) 231–255. | DOI

H. Pardes, The future of medical schools and teaching hospitals in the era of managed care. Acad. Med. 72 (1997) 97–102. | DOI

E. Rich, G. Gifford, M. Luxenberg and B. Dowd, The relationship of house staff experience to the cost and quality of inpatient care. J. Am. Med. Assoc. 263 (1990) 953–957. | DOI

D. M. Shahian, P. Nordberg, G. S. Meyer, B. B. Blanchfield, E. A. Mort, D. F. Torchiana and S. L. Normand, Contemporary performance of U.S. teaching and nonteaching hospitals. Acad Med. 87 (2012) 701–708. | DOI

F. Sloan, R. Feldman and B. Steinwald, Effects of teaching on hospital productivity. J. Health Econ. 2 (1983) 1–23. | DOI

V. Valencia, V. M. Arora, S. R. Ranji, C. Meza and C. Moriates, A comparison of laboratory testing in teaching vs nonteaching hospitals for 2 common medical conditions. JAMA Intern Med. 178 (2018) 39–47. | DOI

B. Walheer, Aggregation of metafrontier technology gap ratios: the case of European sectors in 1995–2015. Eur. J. Oper. Res. 269 (2018) 1013–1026. | MR | DOI

J. Yang and W. Zeng, The trade-offs between efficiency and quality in the hospital production: some evidence from Shenzhen, China. Chin. Econ. Rev. 31 (2014) 166–184. | DOI

Cité par Sources :