Efficienza ospedaliera: come spendere meno assicurando la qualità

Translated title of the contribution: [Autom. eng. transl.] Hospital efficiency: how to spend less by ensuring quality

Maria Lucia Specchia, Gualtiero Ricciardi, Paolo Campanella, Elena Azzolini, Concetta De Meo, Daniele Ignazio La Milia, Ferruccio Pelone, A Izzi

Research output: Chapter in Book/Report/Conference proceedingConference contribution

Abstract

[Autom. eng. transl.] INTRODUCTION: The recent economic crisis has had a negative impact on the availability of resources for the health system and is progressively bringing all governments to an urgent rationalization of resources. The purpose of the study is to provide, through the application of the Data Envelopment Analysis (DEA) approach, a useful methodological framework for analyzing the technical efficiency of the hospital care provided. 50 Italian public hospital companies (AOS) were compared to assess their relative efficiency and, subsequently, if and how this was possibly influenced by various exogenous factors. MATERIALS AND METHODS: To implement the efficiency analysis model, the following measures were taken as model input using the DEA technique: number of beds, number of doctors and number of nurses, normalized then by volume of patients discharged from single structure. As output measures, instead, the following indicators were considered: adjusted mortality risk at 30 days for IMA, for heart failure and for COPD. The Bootstrapping technique was used to carry out a probabilistic sensitivity analysis. Through the Tobit regression technique, the possible impact of some non-controllable variables by the hospital management was then assessed, at least in the short term, on the level of efficiency (case-mix and entropy indices, the location in a given geographical area, if the structure is located in a region with a special statute, an index of aging, a level of regional, public and private health spending as a percentage of GDP, and some avoidable hospitalization rates). RESULTS: On average, the Italian hospital companies considered reported an efficiency score of 88% (DS: 0.12). 18 of the 50 structures achieved the maximum efficiency score, while the lowest score was 60%. Sensitivity analysis using the bootstrap method demonstrated the robustness of the model, demonstrating low variability. The results of the regression then show a positive association between the level of efficiency and the geographical location in the north of the country, the presence of a special regional statute and a greater level of public expenditure. CONCLUSIONS: Data Envelopment Analysis can be a useful and objective tool to evaluate the efficiency of healthcare organizations and to support hospital management and policy makers in making decisions, developing improvement processes and managing the available resources in the best possible way.
Translated title of the contribution[Autom. eng. transl.] Hospital efficiency: how to spend less by ensuring quality
Original languageItalian
Title of host publicationAtti del 47° Congresso Nazionale della Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI)-Poster
Pages372
Number of pages1
Publication statusPublished - 2014
Event47° Congresso Nazionale della Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI) - Riccione
Duration: 1 Oct 20144 Oct 2014

Conference

Conference47° Congresso Nazionale della Società Italiana di Igiene, Medicina Preventiva e Sanità Pubblica (SItI)
CityRiccione
Period1/10/144/10/14

Keywords

  • Healthcare Quality
  • Hospital Efficiency

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