ANALYSIS OF THE EFFICIENCY OF THE PUBLIC OF THE VALENCIAN
COMMUNITY HOSPITALS

ABSTRACT

The health sector is one of the most important sectors of both its social importance socio-economic system, since it is the sector that ensures the health of citizens, and its economic importance, given the large proportion of resources absorbing economic.

That is why one of the fundamental goals that today is pursued in most of the countries is to improve the health system, both the quality of their services, and the efficiency and the degree of utilization of resources.

It is precisely in this context that is the aim of this doctoral thesis, which is to characterize and differentiate the hospitals in Valencia, on aspects relating to the production of sanitation and consumption of resources (economic and sanitary), and may thus classify them and detect the different areas that affect its efficiency and production capacity.

The methodology consists of a first part, in obtaining all statistical information on hospital activities, provided by the Department of Health of the Generalitat Valenciana, during the year 2004. Previously, according to various criteria of inclusion, hospitals should be selected for the studies were determined.

Then, through statistical methods and description of the principal components analysis is performed; from the latter, regression models are developed; finally the type input and output variables are identified.
Subsequently, was the hierarchical cluster analysis to group and classify evenly hospitals of the Valencian Community. The results were three clusters, highlighting that the first contains only a single reference that by its size variables hospital activity and make performance constitute a single group. The second cluster is made up of hospitals in reference and the third cluster by hospitals, and area hospitals.

Applying non-Stochastic methods, (DEA) data enveloping analysis is used, to classify hospitals in efficient and inefficient, globally and by units specific to areas, hospital and ambulatory surgical and emergency.

Analysis shows performed DEA global area hospitals are as efficient as the reference, but at the same time, some hospitals, not proved to be as efficient, the amount of output generated in relation to the amount of input.

At the analysis by specific units, the results show that referral hospitals are located very close to the border of the efficiency level surgical and hospital, since their degree of complexity is destined for the area of specialized care, while some area hospitals have the most efficient at ambulatory level, because its activity is focused to primary care and to a lesser extent to the specialized care.

Finally, note that this thesis shows how the DEA is a good method to estimate the relative efficiency of hospitals, although it converges very slowly to the absolute efficiency. That is, with this technique you can tell how well a unit is working compared to its benchmark, but not against a theoretical maximum.