Congresos y reuniones científicas
Conferencia; DEA 2012 Conference; 2012
The aim of this paper is to evaluate the technical efficiency in the expenditures to support public hospitals in the 23 provinces of Argentina and Buenos Aires (Ciudad Autónoma de Buenos Aires), through the methodology of DEA (Data Envelopment Analysis).Specifically we have used Classic DEA models CCR (Charnes, Cooper and Rhodes, 1978) and BCC (Banker, Charnes and Cooper, 1984). They are defined as variables of exit to the population without coverage of health, the expenditures of hospitable internments and the quantity of consultations attended by external doctor's offices in welfare public establishments. We have defined the outputs of the problem: the population without health assurance, expenses of hospitalizations and the number of cases handled by outpatient in public hospitals. The analysis allowed obtain the efficiency ratings of the units evaluated, identify radial technical efficiency, pure technical efficiency, scale efficiency and the return type of scale. The results obtained showed that the provinces of Buenos Aires and Corrientes are serving public health scale of maximum productivity. Through both models, eleven provinces are below the system average, this indicates that 48% of the provinces have performed significantly inefficient. Furthermore, it was observed in provinces such as San Luis and Catamarca performing relatively well, as far as to eliminate the effect of increasing scale on which it is operating. Something similar happens in the unit of Tierra del Fuego; however, in this case the results should be taken with reservations by the small magnitude of the values of inputs and outputs of this province. In this case, the fact of being inefficient CCR and BCC efficient, not justified to assume that this is only a problem of scale, but the nature of the BCC model assumptions can be evaluated efficiently, this being just one of the particularities of the BCC model to be taken into account when the DMUs have these characteristics (values of inputs and / or outputs far removed from other causes include DMUs as efficient). We emphasize that the test results are not absolute, in order to consider that the hospital product is not clearly defined. When measured in terms of expenditures, there is no weighting for diagnosis related groups (DRGs), hospital discharges and number of inquiries includes various diseases, which in turn have different ways of using resources. We believe that the indicators used in the study are only approximations and may be defined if the hospital product from the point of view of DRGs, other results appear. It should be noted that there is no country in the DRG classification level hospitals, whose aggregation is obtained at the provincial level a very good measure of hospital products. Something similar happens at the level of inputs, since no observations are available regarding use of medical equipment, medicine, labor and other materials that allow a better assessment of inflows. Based on these results, the possibilities of progress in determining the efficiency of resources used by the provinces in the health sector should undergo a careful analysis of the data used for a better definition of inputs and outputs through a weighting of the output variables or by an estimation of homogenous groups of interventions such as variable output. It would also be important to analyze the temporal variations of the members of the boundaries of efficiency and, as tested production units are an important aggregation of dispersed units, carry out an efficiency analysis at the level of a representative set of hospitals of each province.