Association Between Surgeons' Technical Efficiency and Hospital Revenue.

Abstract

To evaluate surgeons’ performance, health care managers often use the revenues that surgeons make for the hospital. The purpose of this study is to determine the relationship between surgeons’ technical efficiency and their revenues by using multiple regression analysis on surgical data. The authors collected data from all the surgical procedures performed at University Hospital from April 1 through September 30 in 2013-2018. Output-oriented Charnes-Cooper-Rhodes model of data envelopment analysis was employed to calculate each surgeon’s technical efficiency. Seven independent variables were selected; revenue, experience, medical school, surgical volume, sex, academic rank, and surgical specialty. Multiple regression analysis using Tobit model was used for our data. The data from a total of 17 227 surgical cases were obtained in the 36-month study period. The authors performed multiple regression on 222 surgeons. Revenue had significantly positive association with mean efficiency score (P = .000). Surgical volume had significantly negative association with mean efficiency score (P = .000). The other coefficients were statistically insignificant. An increase in revenue by 1% was associated with 0.46% to 0.52% increases in efficiency score. We demonstrated that surgeons’ revenue can serve as a proxy variable for their technical efficiency.