Assessment of Relative Technical Efficiency of Small Mental Health Areas in Bizkaia (Basque Country, Spain)

Nerea Almeda, Carlos García-Alonso, José Alberto Salinas-Pérez, Mencía R. Gutiérrez-Colosía, Luis Salvador-Carulla

2017

Abstract

Mental disorders cause an enormous burden to society. Considering the current economic context, an efficient use of scarce inputs, with an appropriate outcome production, is crucial. This situation defines a classical Relative Technical Efficiency (RTE) problem. A well-known methodology to assess RTE is the Data Envelopment Analysis, although it presents some limitations. These may be overcome through a hybrid strategy that integrates Monte-Carlo simulation and artificial intelligence. This study aims to (1) design of a Decision Support System for the assessment of RTE of Small Mental Health Areas based on DEA; and (2) analyse 19 mental health areas of the Bizkaian Healthcare System (Spain) to classify them and to identify potential management improvements. The results have showed higher global RTE in the output-oriented orientation than in the input-oriented one. This suggests that a decision strategy based on improving the input management, within the ranges of the expert-driven model of community healthcare, could be appropriate. A future research line will focus our attention on the validation process through the analysis of micromanagement interventions and their potential impacts in the real system.

References

  1. Alirezaee, M.R., Howland, M. & Van de Panne, C., 1998. Sampling size and efficiency bias in data envelopment analysis. Journal of Applied Mathematics and Decision Sciences, 2(1), pp.51-64.
  2. Burns, L.R., Goldsmith, J.C. & Sen, A., 2013. Horizontal and vertical integration of physicians: a tale of two tails. Advances in health care management, 15, pp.39-117.
  3. Cordero, J.M. et al., 2016. Technical efficiency assessment of public primary care providers in the Basque Country (Spain), 2010-2013. Gaceta Sanitaria, 30(2), pp.104- 109. Available at: http://www.scopus.com/inward/record.url?eid=2-s2.0- 84959099383&partnerID=40&md5=3043220dd'9be 1b3dd178769affd73c.
  4. Dash, U., Vaishnavi, S.D. & Muraleedharan, V.R., 2010. Technical Efficiency and Scale Efficiency of District Hospitals: A Case Study. Journal of Health Management, 12(3), pp.231-248. Available at: http://www.scopus.com/inward/record.url?eid=2-s2.0- 77955896077&partnerID=tZOtx3y1 [Accessed March 14, 2016].
  5. Dyson, R.G. et al., 2001. Pitfalls and protocols in {DEA}. European Journal of Operational Research, 132(2), pp.245-259. Available at: http://www.sciencedirect.com/science/article/pii/S037 7221700001491.
  6. Färe, R. et al., 2008. Evaluating health care efficiency. Advances in health economics and health services research, 18, pp.209-228. Available at: https://www.scopus.com/inward/record.uri?eid=2- s2.0- 58849144444&partnerID=40&md5=0156be57de9f25 4a68436a2db8b6d62f.
  7. Garavaglia, G. et al., 2011. Efficiency and quality of care in nursing homes: An Italian case study. Health Care Management Science, 14(1), pp.22-35. Available at: https://www.scopus.com/inward/record.uri?eid=2- s2.0- 79551530621&partnerID=40&md5=eddb9c7279a145 d0f1c32c9181972ff9.
  8. Gibert, K., Garcia-Alonso, C. & Salvador-Carulla, L., 2010. Integrating clinicians, knowledge and data: expertbased cooperative analysis in healthcare decision support. Health research policy and systems / BioMed Central, 8, p.28.
  9. Gobierno Vasco. (2010). Estrategia para afrontar el reto de la cronicidad en Euskadi, Bilbao, Eusko JaurlaritzaGobierno Vasco.
  10. Gutierrez-Recacha, P. et al., 2006. Cost-effectiveness of different clinical interventions for reducing the burden of schizophrenia in Spain. Acta psychiatrica Scandinavica. Supplementum, (432), pp.29-38.
  11. Hollingsworth, B., 2008. The measurement of efficiency and productivity of health care delivery. Health economics, 17(10), pp.1107-1128.
  12. Hollingsworth, B. & Parkin, D., 2001. The efficiency of the delivery of neonatal care in the UK. Journal of public health medicine, 23(1), pp.47-50.
  13. Kaya Samut, P. & Cafri, R., 2015. Analysis of the Efficiency Determinants of Health Systems in OECD Countries by DEA and Panel Tobit. Social Indicators Research. Available at: https://www.scopus.com/inward/record.uri?eid=2- s2.0- 84941367202&partnerID=40&md5=77b2c000e68c3d 32218b73040f075a46.
  14. Kirigia, J.M. et al., 2011. Technical efficiency of primary health units in Kailahun and Kenema districts of Sierra Leone. International archives of medicine, 4, p.15.
  15. Kleinsorge, I.K. & Karney, D.F., 1992. Management of nursing homes using data envelopment analysis. Socioeconomic planning sciences, 26(1), pp.57-71.
  16. Ministerio de Sanidad, Política e Igualdad (2011). Estrategia en Salud Mental del Sistema Nacional de Salud 2009-2013 [pdf] España. Avaliable at http://www.aepcp.net/arc/SaludMental2009-2013.pdf [Accessed 24 Oct. 2016]
  17. Mogha, S.K., Yadav, S.P. & Singh, S.P., 2015. Slack based measure of efficiencies of public sector hospitals in Uttarakhand (India). Benchmarking: An International Journal, 22(7), pp.1229-1246. Available at: http://www.scopus.com/inward/record.url?eid=2-s2.0- 84942784709&partnerID=tZOtx3y1 [Accessed March 14, 2016].
  18. Moran, V. & Jacobs, R., 2013. An international comparison of efficiency of inpatient mental health care systems. Health policy (Amsterdam, Netherlands), 112(1-2), pp.88-99. Available at: http://www.scopus.com/inward/record.url?eid=2-s2.0- 84885191198&partnerID=tZOtx3y1 [Accessed March 14, 2016].
  19. [OECD] Organisation for Economic Co-operation and Development. (2010). Health expenditures and financing. [online] Available at: https://stats.oecd.org/Index.aspx?DataSetCode=SHA [Accessed 20 Oct. 2016]
  20. [OECD] Organisation for Economic Co-operation and Development. (2016). Mental Health and work. [online] Available at: https://www.oecd.org/els/emp/mental-health-andwork.htm [Accessed 20 Oct. 2016]
  21. Pares-Badell, O. et al., 2014. Cost of disorders of the brain in Spain. PloS one, 9(8), p.e105471.
  22. Pelone, F. et al., 2012. The measurement of relative efficiency of general practice and the implications for policy makers. Health policy (Amsterdam, Netherlands), 107(2-3), pp.258-68. Available at: http://www.scopus.com/inward/record.url?eid=2-s2.0- 84865970504&partnerID=tZOtx3y1 [Accessed March 14, 2016].
  23. Pereira, C., Gutiérrez-Colosía, M. and Salinas-Perez, J. (Eds.). (2013). Mental Health Atlas of Bizkaia. Bilbao: Osakidetza.
  24. Salvador-Carulla, L., Dimitrov, H., Weber, G., McDaid, D., Venner, B., Šprah, L., ... and Johnson, S. (2011). DESDE-LTC: Evaluation and Classification of Services for Long Term Care in Europe. Spain: Psicost and Caixa Catalunya.
  25. Salvador-Carulla, L. et al., 2007. Use of an operational model of community care to assess technical efficiency and benchmarking of small mental health areas in Spain. The journal of mental health policy and economics, 10(2), pp.87-100.
  26. Shen, G.C. & Snowden, L.R., 2014. Institutionalization of deinstitutionalization: a cross-national analysis of mental health system reform. International journal of mental health systems, 8(1), p.47.
  27. Sherman, H.D., 1984. Hospital efficiency measurement and evaluation. Empirical test of a new technique. Medical care, 22(10), pp.922-938.
  28. Staat, M., 2001. The Effect of Sample Size on the Mean Efficiency in DEA: Comment. Journal of Productivity Analysis, 15(2), pp.129-137. Available at: http://dx.doi.org/10.1023/A:1007826405826.
  29. Torres-Jiménez, M. et al., 2015. Evaluation of system efficiency using the Monte Carlo DEA: The case of small health areas. European Journal of Operational Research, 242(2), pp.525-535. Available at: http://www.scopus.com/inward/record.url?eid=2-s2.0- 84920716285&partnerID=tZOtx3y1 [Accessed March 14, 2016].
  30. Tyler, L.H., Ozcan, Y.A. & Wogen, S.E., 1995. Mental health case management and technical efficiency. Journal of medical systems, 19(5), pp.413-423.
  31. United Nations. (1991). The protection of person with mental illness and the improvements of mental health care. [online] Available at http://www.un.org/documents/ga/res/46/a46r119.htm [Accessed 25 Oct. 2016].
  32. World Health Organization. (2003). Investing in MENTAL HEALTH [online] Available at http://www.who.int/mental_health/en/investing_in_mn h_final.pdf [Accessed 25 Oct. 2016].
  33. World Health Organization. (2005). Mental health policy, plans and programmes. Mental Health Policy and Service Guidance Package. [online] Available at http://www.who.int/mental_health/policy/services/esse ntialpackage1v1/en/ [Accessed 25 Oct. 2016].
  34. World Health Organization. (2013). Mental Health Action Plan 2013 - 2020. [online] Available at http://www.who.int/mental_health/publications/action _plan/en/ [Accessed 25 Oct. 2016].
  35. World Health Organization. (2016). Mental disorders. [online] Available at http://www.who.int/mediacentre/factsheets/fs396/en/ [Accessed 25 Oct. 2016].
  36. Zhu, J., 2003. Imprecise data envelopment analysis (IDEA): A review and improvement with an application. European Journal of Operational Research, 144(3), pp.513-529.
Download


Paper Citation


in Harvard Style

Almeda N., García-Alonso C., Alberto Salinas-Pérez J., R. Gutiérrez-Colosía M. and Salvador-Carulla L. (2017). Assessment of Relative Technical Efficiency of Small Mental Health Areas in Bizkaia (Basque Country, Spain) . In Proceedings of the 6th International Conference on Operations Research and Enterprise Systems - Volume 1: ICORES, ISBN 978-989-758-218-9, pages 377-384. DOI: 10.5220/0006195603770384


in Bibtex Style

@conference{icores17,
author={Nerea Almeda and Carlos García-Alonso and José Alberto Salinas-Pérez and Mencía R. Gutiérrez-Colosía and Luis Salvador-Carulla},
title={Assessment of Relative Technical Efficiency of Small Mental Health Areas in Bizkaia (Basque Country, Spain)},
booktitle={Proceedings of the 6th International Conference on Operations Research and Enterprise Systems - Volume 1: ICORES,},
year={2017},
pages={377-384},
publisher={SciTePress},
organization={INSTICC},
doi={10.5220/0006195603770384},
isbn={978-989-758-218-9},
}


in EndNote Style

TY - CONF
JO - Proceedings of the 6th International Conference on Operations Research and Enterprise Systems - Volume 1: ICORES,
TI - Assessment of Relative Technical Efficiency of Small Mental Health Areas in Bizkaia (Basque Country, Spain)
SN - 978-989-758-218-9
AU - Almeda N.
AU - García-Alonso C.
AU - Alberto Salinas-Pérez J.
AU - R. Gutiérrez-Colosía M.
AU - Salvador-Carulla L.
PY - 2017
SP - 377
EP - 384
DO - 10.5220/0006195603770384