Measuring the productive efficiency and clinical quality of institutional long-term care for the elderly

TitleMeasuring the productive efficiency and clinical quality of institutional long-term care for the elderly
Publication TypeJournal Article
Year of Publication2005
AuthorsLaine J., Linna M., Hakkinen U., Noro A.
JournalHealth Economics
Volume14
Issue3
Pagination245-256
Keywords*elderly care, *health care quality, *institutional care, Aged, antidepressant agent/dt [Drug Therapy], article, decubitus/dt [Drug Therapy], depression, Finland, Human, hypnotic agent/dt [Drug Therapy], long term care, Prevalence, priority journal, productivity, Quality of Life, rating scale, residential home, statistical analysis, stochastic model
Abstract

The authors consider the association between productive efficiency and clinical quality in institutional long-term care for the elderly. Cross-sectional data were collected from 122 wards in health-centre hospitals and residential homes in Finland in 2001. Productive efficiency was measured in terms of technical efficiency, which was defined as the unit's distance from the (best practice) production frontier. The analysis employed stochastic production frontier estimation, where technical inefficiency in the production function was specified to be a function of ward characteristics and clinical quality of care. Several quality indicators based on the Resident Assessment Instrument, such as prevalence of pressure ulcers and depression with no treatment, were used in the analysis. The results did not reveal systematic association between technical efficiency and clinical quality of care. However, the prevalence of pressure ulcers, indicating poor quality of care was associated with technical efficiency, a fact which highlights the importance of including quality measures in the assessment of efficiency in long-term care. Copyright © 2004 John Wiley & Sons, Ltd.

DOI10.1002/hec.926