Đo lường tính không đồng nhất trong năng suất bệnh viện: một phương pháp hồi quy phân vị

Springer Science and Business Media LLC - Tập 59 - Trang 15-43 - 2022
Galina Besstremyannaya1, Sergei Golovan2
1National Research University, Higher School of Economics, Moscow, Russia
2New Economic School, Moscow, Russia

Tóm tắt

Bài báo này tập trung vào các bệnh viện công địa phương chăm sóc cấp cứu tại Nhật Bản và đánh giá những khác biệt trong công nghệ bệnh viện, thể hiện qua năng suất của các chuyên ngành lao động, vốn vật lý và thuốc men, cùng với tác động của các hoạt động giảng dạy và các đặc điểm khác của bệnh viện đến sản lượng bệnh viện. Chúng tôi sử dụng hồi quy phân vị dữ liệu bảng với hiệu ứng cố định để mô hình hóa một loạt công nghệ cho hàm sản lượng đa sản phẩm của các bệnh viện. Phân tích cho thấy sự không đồng nhất công nghệ giữa các bệnh viện có sản lượng cao và thấp. Chúng tôi phát hiện ra sự phối hợp không hợp lý giữa lao động/vốn và lao động/thuốc, cũng như nhiều cơ hội đáng kể để tiết kiệm chi phí. Các kết quả đóng góp vào tài liệu thực nghiệm hạn chế về sự biến thiên trong sản xuất bệnh viện.

Từ khóa

#bệnh viện #năng suất #hồi quy phân vị #công nghệ #chăm sóc cấp cứu

Tài liệu tham khảo

Acemoglu D, Autor D (2011) Skills, tasks and technologies: implications for employment and earnings. In Card D, Ashenfelter O (eds.) Handbook of labor economics, vol 4, Part B. Elsevier, Amsterdam, p 1043–1171 Acemoglu D, Finkelstein A (2008) Input and technology choices in regulated industries: Evidence from the health care sector. J Political Econ 116:837–880 Aigner D, Lovell C, Schmidt P (1977) Formulation and estimation of stochastic frontier production function models. J Econom 6:21–37 Baumgardner JR (1988) The division of labor, local markets, and worker organization. J Political Econ 96:509–527 Baumgardner JR (1988) Physicians’ services and the division of labor across local markets. J Political Econ 96:948–982 Becker GS, Murphy KM (1994) The division of labor, coordination costs, and knowledge. In Becker GS (ed.) Human capital: a theoretical and empirical analysis with special reference to education, 3rd ed. The University of Chicago Press, p 299–322 Bernini C, Freo M, Gardini A (2004) Quantile estimation of production function. Empir Econ 29:373–381 Besstremyannaya G (2013) The impact of Japanese hospital financing reform on hospital efficiency. Jpn Econ Rev 64:337–362 Besstremyannaya G, Golovan S (2019) Reconsideration of a simple approach to quantile regression for panel data. Econom J 22:292–308 Biørn E, Hagen TP, Iversen T, Magnussen J (2003) The effect of activity-based financing on hospital efficiency: A panel data analysis of DEA efficiency scores 1992–2000. Health Care Manag Sci 6:271–283 Blank JLT, Valdmanis VG (2008) Evaluating hospital policy and performance: Contributions from hospital policy and productivity research, Amsterdam: Elsevier JA Blank JLT, Valdmanis VG (2010) Environmental factors and productivity of Dutch hospitals: A semi-parametric approach. Health Care Manag Sci 13:27–34 Blank JLT, van Hulst BL (2017) Balancing the health workforce: Breaking down overall technical change into factor technical change for labour: An empirical application to the Dutch hospital industry. Hum Resour Health 15:1–14 Bloom N et al. (2017) What drives differences in management? Working Paper, National Bureau of Economic Research Bloom N et al. (2019) What drives differences in management practices? Am Econ Rev 109:1648–83 Bloom N, Dorgan S, Dowdy J, Van Reenen J (2007) Management practice and productivity: Why they matter. Working Paper, McKinsey&Company, LSE. https://cep.lse.ac.uk/management/Management_Practice_and_Productivity.pdf Bloom N, Propper C, Seiler S, Van Reenen J (2015) The impact of competition on management quality: Evidence from public hospitals. Rev Econ Stud 82:457–489 Bloom N, Sadun R, Van Reenen J (2014) Does management matter in healthcare? In Chandra A, Cutler D, Huckman R, Martinez E (eds) Hospital organization and productivity. NBER Conference. https://prod-edxapp.edx-cdn.org/assets/courseware/v1/dd428dcc44daa742d5c5c91aeb9dcd21/c4x/HarvardX/PH555x/asset/Management_Healthcare_June2014.pdf Bofinger E (1975) Optimal condensation of distributions and optimal spacing of order statistics. J Am Stat Assoc 70:151–154 Boisvert RN (1982) The translog production function: Its properties, its several interpretations and estimation problems. Working Paper, Charles H. Dyson School of Applied Economics and Management, Cornell University Campbell J, Ikegami N (1998) The art of balance in health policy. Maintaining Japan’s low-cost, egalitarian system. Cambridge University Press, Cambridge Canay I (2011) A simple approach to quantile regression for panel data. Econom J 14:368–386 Charnes A, Cooper W, Rhodes E (1978) Measuring the efficiency of decision making units. Eur J Oper Res 2:429–444 Chen L, Huo Y (2020) A simple estimator for quantile panel data models using smoothed quantile regressions. Econom J 24:247–263 Chernozhukov V (2005) Extremal quantile regression. Ann Stat 33:806–839 Chiang AC (1984) Fundamental methods of mathematical economics. McGraw-Hill Christensen EW (2004) Scale and scope economies in nursing homes: A quantile regression approach. Health Econ 13:363–377 Cleverley WO, Harvey RK (1992) Competitive strategy for successful hospital management. J Healthc Manag 37:53 Coelli T, Perelman S (1999) A comparison of parametric and non-parametric distance functions: With application to European railways. Eur J Oper Res 117:326–339 Coelli T, Perelman S (2000) Technical efficiency of European railways: A distance function approach. Appl Econ 32:1967–1976 Dhaene G, Jochmans K (2015) Split-panel jackknife estimation of fixed-effect models. Rev Econ Stud 82:991–1030 Doi S, Ryubori M, Umetsuna K, Hayashi S (2005) DPC dounyu-ga oyobosu kyuuseikibyouin-no eikyou-to kongo-no kadai [The impact of DPC introduction on emergency hospitals and future issues. in Japanese]. Nihon Byouin Gakkaishi 52:72–79 Dorgan S et al. (2010) Management in healthcare: Why good practice really matters. Working Paper, McKinsey&Company, LSE. https://cep.lse.ac.uk/textonly/_new/research/productivity/management/PDF/Management_in_Healthcare_Report.pdf Feldstein M (1974) Econometric studies of health economics., in Frontiers of Quantitative Econometrics, vol. 2, eds. Intriligator M, Kendrick D, Amsteram: North-Holland, 377–434 Ferrier GD, Valdmanis V (1996) Rural hospital performance and its correlates. J Product Anal 7:63–80 Fujii A (2001) Stochastic cost frontier and cost inefficiency of Japanese hospitals: A panel data analysis. Appl Econ Lett 8:801–812 Galvao AF, Kato K (2016) Smoothed quantile regression for panel data. J Econom 193:92–112 Hames DS (1991) Productivity-enhancing work innovations: Remedies for what ails hospitals? J Healthc Manag 36:545 Harding M, Lamarche C (2014) Estimating and testing a quantile regression model with interactive effects. J Econom 178:101–113 Harding M, Lamarche C (2016) Penalized quantile regression with semiparametric correlated effects: An application with heterogeneous preferences. J Appl Econ 32:342–358 Hendricks W, Koenker R (1992) Hierarchical spline models for conditional quantiles and the demand for electricity. J Am Stat Assoc 87:58–68 Higuchi S (2010) Chuusho jichitai byouin-no genjo-to kadai (current situation and tasks for small and medium local public hospitals). J Jpn Hosp Assoc 5:95–101 Hisamichi S (2010) Byouin keiei koto hajime. Byouin jigyou kanri-no tachiba kara. (Starting hospital management. Point of view of a hospital manager). J Jpn Hosp Assoc 2:98–119 Hollingsworth B (2008) The measurement of efficiency and productivity of health care delivery. Health Econ 17:1107–1128 Hollinsworth B, Peacock S (2008) Efficiency measurement in health and health care. Routledge Hsu A, Dass AR, Berta W, Coyte P, Laporte A (2017) Efficiency estimation with panel quantile regression: An application using longitudinal data from nursing homes in Ontario, Canada. Working Paper No. 170003. Canadian Centre for Health Economics Ikegami N (ed.) (2014) Universal health coverage for inclusive and sustainable development: Lessons from Japan. The World Bank Ikegami N, Buchan J (2014) Licensed practical nurses: One option for expanding the nurses workforce in Japan. In Ikegami N (ed.) Universal health coverage for inclusive and sustainable development: Lessons from Japan. The World Bank, p 133–148 Ikegami N, Campbell JC (1999) Health care reform in Japan: The virtues of muddling through. Health Aff 18:56–75 Ikegami N et al. (2011) Japanese universal health coverage: Evolution, achievements, and challenges. Lancet 378:1106–1115 Iwane T (1976) Wa-ga kuni-no kouritsu byouin-ni tsuite. Byouin koudou-no riron-to jisshotekikenkyu (on the public hospitals in Japan: a behavior model of hospitals and some empirical studies). Osaka Economic Papers. p 35–54 Jacobs R, Smith P, Street A (2006) Measuring efficiency in health care. Analytic techniques and health policy. Cambridge University Press Jensen GA, Morrisey MA (1986) Medical staff specialty mix and hospital production. J Health Econ 5:253–276 Kanagawa Y (2008) Chiikiiryouwo Mamoru. Jichitaibyouin Keiei Bunseki. (Defending Local Health Care. Management Analysis of Local Public Hospitals). Jichitai kenkyusha, Tokyo Kaneko K, Onozuka D, Shibuta H, Hagihara A (2018) Impact of electronic medical records (EMRs) on hospital productivity in Japan. Int J Med Inform 118:36–43 Kato K, Galvao Jr AF, Montes-Rojas GV (2012) Asymptotics for panel quantile regression models with individual effects. J Econom 170:76–91 Kawabuchi K, Kajitani K (2003) Time of changes–health care reform in Japan. Jpn Hosp 22:11–18 Kawaguchi H, Tone K, Tsutsui M (2014) Estimation of the efficiency of Japanese hospitals using a dynamic and network data envelopment analysis model. Health Care Manag Sci 17:101–112 Kawaguchi K (2008) Iryo-no Koritsusei Sokutei. Keisoushobou [Estimating Healthcare Efficiency, in Japanese]. Keisoshobo Publishing House, Tokyo Knox K, Blankmeyer E, Stutzman J (2007) Technical efficiency in Texas nursing facilities: A stochastic production frontier approach. J Econ Finance 31:75–86 Kodera T, Yoneda K (2019) Efficiency and the quality of management and care: Evidence from Japanese public hospitals. App Econ Lett 26:1418–1423 Koenker R (2004) Quantile regression for longitudinal data. J Multivar Anal 91:74–89 Koenker R (2005) Quantile regression. Cambridge University Press Koenker R, Bassett G (1978) Regression quantiles. Econometrica 46:33–50 Koenker R, Machado JA (1999) Goodness of fit and related inference processes for quantile regression. J Am Stat Assoc 94:1296–1310 Kumazawa M (2010) Kouei-kara minei-he. Ayumi-no shokai. (From public to private management. Description of the change). J Jpn Hosp Assoc 5:88–95 Lee J, McCullough JS, Town RJ (2013) The impact of health information technology on hospital productivity. RAND J Econ 44:545–568 Li H, Lindsay BG, Waterman RP (2003) Efficiency of projected score methods in rectangular array asymptotics. J R Stat Soc Series B (Stat Methodol) 65:191–208 Liu C, Laporte A, Ferguson BS (2008) The quantile regression approach to efficiency measurement: Insights from Monte Carlo simulations. Health Econ 17:1073–1087 Liu J, Tone K (2008) A multistage method to measure efficiency and its application to Japanese banking industry. Socio-Econ Plan Sci 42:75–91 Machado JAF, Santos Silva JMC (2019) Quantiles via moments. J Econom 213:145–173 Mandai N, Watanabe M (2019) Relationship between current account balance ratio and salary ratio in Japanese municipal hospitals. Health 11:1591–1597 Martin C, Jérôme T (2016) Cost (in) efficiency and institutional pressures in nursing home chains. Eur Account Rev 25:687–718 Mas-Colell A, Whinston MD, Green JR (1995) Microeconomic theory. Oxford University Press Ministry of Health, Labor and Welfare (2012) Heisei 24nendo sinryouhoushuu kaitei-niokeru DPC seido (DPC/PDPS)-no taiyou-nitsuite (gaiyou) (An outline of DPC/PDPS system within the 2012 revision of fee schedule, Mar 28). http://www.mhlw.go.jp/stf/shingi/2r98520000025zci-att/2r98520000025zn7.pdf Ministry of Internal Affairs and Communications (2007) Kouritsubyouin kaikaku gaidorain [Guidelines for the reform of local public hospitals, in Japanese]. https://www.soumu.go.jp/main_sosiki/c-zaisei/hospital/guidline.html Ministry of Internal Affairs and Communications (2015) Shinkouritsubyouin kaikaku gaidorain [New guidelines for the reform of local public hospitals, in Japanese]. https://www.soumu.go.jp/main_sosiki/c-zaisei/hospital/guidline.html Morikawa M (2010) Economies of scale and hospital productivity: An empirical analysis of medical area level panel data. RIETI Discussion Paper Series 10-E-050. The Research Institute of Economy, Trade and Industry Motohashi H (2009) Productivity of medical services: TFP (total factor productivity) and DEA (data envelopment analysis) of Japanese hospitals. ESRI Discussion Paper Series 210, Economic and Social Research Institute Cabinet Office Nabemi K (2010) Seimei kagayakasou nihon-no byouincho. (Head of Japanese hospital, which lights up the life). J Jpn Hosp Assoc 1:29–38 Nawata K, Nitta A, Watanabe S, Kawabuchi K (2006) An analysis of the length of stay and effectiveness of treatment for hip fracture patients in japan: Evaluation of the 2002 revision of the medical service fee schedule. J Health Econ 25:722–739 Otto AK (1996) Management style, decision processes, and hospital effectiveness. PhD thesis. Kent State University Panzar JC, Willig RD (1977) Economies of scale in multi-output production. Q J Econ 91:481–493 Pauly M (1980) Doctors and their workshops: Economic models of physician behavior. University of Chicago Press, A National Bureau of Economic Research Monograph Rosko M, Mutter R (2008) Stochastic frontier analysis of hospital inefficiency. A review of empirical issues and an assessment of robustness. Med Care Res Rev 65:131–166 Rosko MD (1999) Impact of internal and external environmental pressures on hospital inefficiency. Health Care Manag Sci 2:63–74 Rosko MD (2004) Performance of us teaching hospitals: a panel analysis of cost inefficiency. Health Care Manag Sci 7:7–16 Saito J (2007) DPC-to kyuuseiki byouin-no iryou (DPC and health care at acute hospitals). J Jpn Hosp Assoc 4:12–26 Shima Y et al. (2006) DPCdounyugo-no shinryouhouyshuu seikyuu-no genjou-to mondaiten [Current situation and issues with the fee schedule claims after the introduction of DPCs, in Japanese]. Nihon Byouin Gakkaishi 53:67–71 Stigler GJ (1951) The division of labor is limited by the extent of the market. J Political Econ 59:185–193 Suwabe A (2004) Our efforts on DPC in Iwate Medical University hospital. Rinsho Byouri 52:1011–1014 Takatsuka N, Nishimura S (2008) Oderingu shistemu ga byoinseisansei, kouristusei nioyobosu eikyono hyouka. (Effect of order entry system on hospital productivity and efficiency for inpatient care in Japan). Jpn J Health Econ Policy 20:15–33 Tersigni AR (1992) The effect of leadership styles on hospital labor productivity. PhD thesis. Western Michigan University Thurston NK, Libby AM (2002) A production function for physician services revisited. Rev Econ Stat 84:184–191 Tomioka T, Mano T, Yamada Y (2008) Medico-economic evaluation on efficient management of large acute care hospitals [in Japanese]. Nihon Iryou Byouin Kanri Gakkaishi 45:55–63 Tsionas EG (2002) Stochastic frontier models with random coefficients. J Appl Econ 17:127–147 Vita MG (1990) Exploring hospital production relationships with flexible functional forms. J Health Econ 9:1–21 Wang H, He X (2007) Detecting differential expressions in GeneChip microarray studies: A quantile approach. J Am Stat Assoc 102:104–112 Weisbrod BA (1992) Productivity and incentives in the medical care sector. Scand J Econ 94:S131–S145 Wooldridge J (2007) Quantile methods. NBER Summer Institute, Lecture Notes 14. http://www.nber.org/WNE/lect_14_quantile.pdf Worthington A (2004) Frontier efficiency measurement in healthcare: A review of empirical techniques and selected applications. Med Care Res Rev 61:135–170 Yamada T, Yamada T, Kim C, Noguchi H (1997) Efficiency and costs in hospitals: A stochastic frontier approach. Discussion Paper 748. University of Tsukuba, Institute of Policy and Planning Sciences Zhang X, Tone K, Lu Y (2018) Impact of the local public hospital reform on the efficiency of medium-sized hospitals in Japan: An improved slacks-based measure data envelopment analysis approach. Health Serv Res 53:896–918