Efficiency and technological change in health care services in Ontario

Hedayet Chowdhury (Health System Performance Research Network, Department of Health Policy Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Canada)
Walter Wodchis (Department of Health Policy Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Canada)
Audrey Laporte (Department of Health Policy Management and Evaluation, Faculty of Medicine, University of Toronto, Toronto, Canada)

International Journal of Productivity and Performance Management

ISSN: 1741-0401

Publication date: 20 September 2011

Abstract

Purpose

The purpose of this paper is to present a productivity measure for hospital services in Ontario.

Design/methodology/approach

The study applied the Malmquist Productivity Index (MPI) to assess the efficiency of hospital services in Ontario, Canada, over the period 2003‐2006. The MPI was decomposed into efficiency change and technological change. Efficiency change was further decomposed into pure efficiency change and scale efficiency change. A bootstrapping technique was also used to obtain confidence intervals for the output oriented MPI and its decompositions.

Findings

By estimating confidence intervals it was found that a large number of hospitals did not achieve significant progress in terms of productivity. By taking geometric means of estimates for all years it was observed that while overall productivity and efficiency of hospitals in Ontario declined during the study period, technological progress increased at a rate of 5.95 percent on average.

Practical implications

The present study helps to understand the productivity and technological change and change in technical efficiency in this vital sector of the economy, which is important for policy making identifying improvement opportunities in resource allocation. It was observed that Ontario hospitals did not improve the efficiency with which they employed their inputs (i.e. staff and supplies) over the study period; they did achieve gains through application of technologies.

Originality/value

The paper provides a thorough study on productivity growth of health care services in Ontario using a non‐parametric framework with bootstrapping. It also provides a robust measurement and analysis of the contributions of technology, size of operation and use of inputs to the performance of hospitals in Ontario.

Keywords

Citation

Chowdhury, H., Wodchis, W. and Laporte, A. (2011), "Efficiency and technological change in health care services in Ontario", International Journal of Productivity and Performance Management, Vol. 60 No. 7, pp. 721-745. https://doi.org/10.1108/17410401111167807

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Publisher

:

Emerald Group Publishing Limited

Copyright © 2011, Emerald Group Publishing Limited

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