Migration, Risk-Adjusted Mortality, Varieties of Congestion and Patient Satisfaction in Turkish Provincial General Hospitals

Nurhan Davutyan (), Murat Bilsel () and Menderes Tarcan ()
Additional contact information
Murat Bilsel: Marmara University
Menderes Tarcan: Osmangazi University

No 13-7, GIAM Working Papers from Galatasaray University Economic Research Center

Abstract: We analyze the operational performance of 330 Turkish provincial general hospitals. To help improve performance on both input and output space, we adopt a directional distance approach. We treat a mortality based variable as bad output. Congested hospitals are those for whom the switch from strong to weak disposability of mortality is costly. Thus we are able to address the “quality or adequacy of care” issue. We identify congested hospitals using 3 different direction vectors and derive the associated congestion inefficiency scores. For each case, we show these scores are negatively related to patient satisfaction. We separate congested hospitals into two groups: (i) efficient ones requiring uniform sacrifice of good outputs and/or extra inputs in order to reduce mortality, and (ii) inefficient hospitals that do not. The latter ones free up some inputs in addition to requiring extra amounts of other inputs and/or produce more of some outputs but less of others as the price of reducing mortality. The first group can be said to operate at “capacity” whereas the latter can be said to display “negative marginal productivity”. Patient dissatisfaction is demonstrably higher in the latter group of hospitals, whereas mortality reduction is positively related to patient satisfaction in “capacity constrained” hospitals. The efficient group is more likely to be located in emigrating whereas the inefficient one in immigrating regions.

Keywords: Directional distance; bad outputs; hospital quality (search for similar items in EconPapers)
JEL-codes: D21 I11 (search for similar items in EconPapers)
Pages: 22 pages
Date: 2013-07-09
New Economics Papers: this item is included in nep-ara, nep-hea and nep-nps
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Citations: View citations in EconPapers (1)

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Related works:
Journal Article: Migration, Risk-Adjusted Mortality, Varieties of Congestion and Patient Satisfaction in Turkish Provincial General Hospitals (2015)
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Persistent link: https://EconPapers.repec.org/RePEc:ris:giamwp:2013_007

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