A Study on Quality-incorporating Models in Evaluation of Hospital Efficiency with Data Envelopment Analysis - An Analysis on National University Hospitals in Korea -

DEA에 의한 병원 효율성 평가에서 질적 측면 통합 모형에 관한 연구 - 국립대학교병원에 대한 분석을 중심으로 -

Rising healthcare cost is a global phenomenon that justifies governments' introduction of 'incentive regulation' plan for the improvement of hospital efficiency. A number of previous studies tried to evaluate the efficiency of healthcare organization by using Data Envelopment Analysis(DEA), a common efficiency benchmarking method. However, there is a concern that this kind of efficiency evaluation could induce "quantity-quality trade-off". Moreover, as quality aspect is especially important in terms of 'effectiveness' of health care, it should be considered in efficiency evaluation of healthcare organization. A number of different models were tried so far to incorporate quality aspect into DEA, however, none is universally recognized as a standard. Thus, in this study, previous quality-incorporating DEA models were categorized into 6 types according to the way of incorporating quality aspect, and strengths and limitations of each type were reviewed with a set of artificial data as an example. Based on this review, a new quality-incorporating efficiency evaluation model, named Quality-adjusted output DEA(QAO-DEA), was suggested. As an exploratory empirical analysis, technical efficiency of human resource were measured with different quality-incorporating DEA models, using 2004 data from National University Hospitals. In conclusion, Quality-adjusted output DEA(QAO-DEA) model seems to be one of the most desirable alternatives to incorporate quality aspect in efficiency evaluation of hospital, and deserves the consideration as a policy tool to induce simultaneous improvement of both efficiency and quality.