Study about Evaluation of Hospital Efficiency and Function Used by DPC Data Set

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  • Kawaguchi Hiroyuki
    Graduate School, International University of Health and Welfare
  • Hashimoto Hideki
    Graduate School of Medicine and Faculty of Medicine, University of Tokyo
  • Matsuda Shinya
    Public Health, School of Medicine, University of Occupational and Environmental Health

Bibliographic Information

Other Title
  • ＤＰＣデータを用いた効率性測定と病院機能評価に関する研究
  • DPC データ オ モチイタ コウリツセイ ソクテイ ト ビョウイン キノウ ヒョウカ ニ カンスル ケンキュウ

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This paper estimates the technical efficiency of hospitals using the DPC (Diagnosis Procedure Combination) data. This DPC data is a balanced panel of 127 hospitals in a three-year period between FY2005 and FY2007.<br>By using the DPC data, this study has the following three new points. First, in the efficiency estimation, the main output is measured by a number of inpatients weighted by case mix index from the DPC. This adjustment would improve the accuracy of the output measurement.<br>Second, we adopt “Hospital Standardized Mortality Ratio” as a quality control variable. Previous studies suffer from the lack of a quality variable and cannot control the quality of a medical service provided by hospitals.<br>Third, we adopted the “true fixed effect model” in Greene (2005) which distinguishes between inefficiency and heterogeneity of hospitals. This heterogeneity will be captured by a value of the fixed effect variable in the model.<br>As a result of efficiency estimation, the mean level of the efficiency is around 59%- 61%. This level is relatively low compared to previous studies. This would be caused by controlling the quality of medical service.<br>In addition, the value of the fixed effect variable has a 0.9 mean level and single peaked distribution. The results point out that fixed effect values would be a kind of indicator on the production or cost structure of hospitals.<br>The policy implication from these results is that the value of the fixed effect variable would be available to improve fairness among hospitals in the reimbursement system. This idea can apply to all kinds of Case Mix Groups and would require further examination.

Journal

  • Iryo To Shakai

    Iryo To Shakai 20 (1), 23-34, 2010

    The Health Care Science Institute

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