Scale, efficiency and organization in Norwegian psychiatric outpatient clinics for children

Vidar Hallsteinli, Sverre Kittelsen and Jon Magnussen
Additional contact information
Vidar Hallsteinli: SINTEF Unimed, Health Services Research, Postal: 7465 Trondheim, Norway
Jon Magnussen: SINTEF Unimed, Health Services Research, Postal: 7465 Trondheim, Norway

No 2001:8, HERO Online Working Paper Series from University of Oslo, Health Economics Research Programme

Abstract: In this paper, the authors examine the scale, efficiency and organization of Norwegian psychiatric outpatient clinics for children. Their question is whether there is room for improved performance in these clinics, and how much? Assuming that about 5 per cent of the Norwegian population under 18 years sometimes is in need of specialist psychiatric care, it is clear that this group will suffer when we know that psychiatric services were delivered to only 2.1 per cent of the whole Norwegian population (data from 1998). Based on a relatively low number of registered consultations per therapist (1,1 per therapist day) the ministry has stipulated that productivity can increase with as much as 50 per cent. Access to services can be improved by increasing capacity, but also by increasing the utilization of the existing capacity.

With an Data Envelopment Analysis (DEA) the authors estimate a best-practice production frontier. The potential for efficiency improvement is measured as the difference between actual and best-practice performance, while allowing for trade-offs between different staff groups and different mixes of service production. Based on 135 observations for the years 1997 to 1999, the DEA tests lead to a model with two inputs, two outputs and variable returns to scale. The outputs are number of hours spent on direct and indirect interventions, while neither the number of interventions nor the number of patients where found to be significant. The inputs are the number of university-educated staff and other staff, but disaggregating the latter group was not significant. The analysis show that a average of estimated clinic efficiencies is 71%. Mean estimated productivity is 64%, but many large clinics have considerably lower performance due mainly to scale inefficiency.

Keywords: Health Care; Productivity; Data Envelopment Analysis (search for similar items in EconPapers)
JEL-codes: C61 D24 I12 (search for similar items in EconPapers)
Pages: 29 pages
Date: 2009-06-30
New Economics Papers: this item is included in nep-eff and nep-hea
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1)

Downloads: (external link)
http://www.hero.uio.no/publicat/2001/HERO2001_8.pdf (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:hhs:oslohe:2001_008

Access Statistics for this paper

More papers in HERO Online Working Paper Series from University of Oslo, Health Economics Research Programme HERO / Department of Health Management and Health Economics P.O. Box 1089 Blindern, N-0317 Oslo, Norway. Contact information at EDIRC.
Bibliographic data for series maintained by Kristi Brinkmann Lenander ().