Greek health system efficiency and productivity: A window DEA and Malmquist method measurement

Abstract

To calculate the change in the values of efficiency and productivity of public hospitals in Greece during the period 2015 to 2019. The calculation of the efficiency values includes the technical, pure and scale efficiency using the window-DEA method and the productivity change using the Malmquist index. The source of the data used to calculate the change in the efficiency of Greek public hospitals is the statistical databases of the Greek Ministry of Health that have resulted from the collection of data through Information Systems in combination with data provided by the Greek Statistical Authority (ELSTAT). The design of the study was based on the realization of a Window DEA study and the calculation of the Malmquist index with its components. The study was designed to measure the change in efficiency and productivity but over a relatively long period of time. The data were obtained from the databases of both financial and operational data of Greek Public Hospitals held by the Greek Ministry of Health and located on the Ministry’s website. Also, additional data were requested and obtained from ELSTAT. The data were examined and those which were appropriate for the conduct of the study were selected. The technical efficiency of Greek hospitals follows a slightly upward trend with ups and downs. Their pure efficiency follows a steady course with ups and downs. Scale efficiency is on an upward course. Productivity exhibits an overall negligible change. The research’s fluctuation of the inputs and outputs determines the change in the values of efficiency and, in combination with technological change, of productivity. During the period under study, the best placement of Greek hospitals on the scale is achieved in terms of their size. Hospital management cannot achieve better utilization of resources. A parallel increase of some of the inputs and outputs prevents increase in the values of technical and pure efficiency. The change in efficiency constrains the change in productivity.