title: Alternative methods to examine hospital efficiency: data envelopment analysis and stochastic frontier analysis.
abstract: There has been increasing interest in the ability of different methods to rank efficient hospitals over their inefficient counterparts. The UK Department of Health has used three cost indices to benchmark NHS hospitals (Trusts). This study uses the same dataset and compares the efficiency rankings from the cost indices with those obtained using Data Envelopment Analysis (DEA) and Stochastic Frontier Analysis (SFA). The paper concludes that the methods each have particular strengths and weaknesses and potentially measure different aspects of efficiency. Several specifications should be used to develop ranges of inefficiency to act as signalling devices rather than point estimates. It is argued that differences in efficiency scores across different methods may be due to random "noise" and reflect data deficiencies. The conclusions concur with previous findings that there are not truly large efficiency differences between Trusts and savings from bringing up poorer performers would in fact be quite modest.
authors.affiliation: Centre for Health Economics, University of York, Heslington, UK. rj3@york.ac.uk
authors.forename: R
authors.initials: R
authors.lastname: Jacobs
mesh_terms: D019985:Benchmarking / Q000379:methods*; D003625:Data Collection; D003661:Decision Support Techniques; D017598:Efficiency, Organizational / Q000706:statistics & numerical data*; D006302:Health Services Research / Q000379:methods; D006779:Hospitals, Public / Q000458:organization & administration*; D015233:Models, Statistical; D012107:Research Design; D013222:State Medicine / Q000458:organization & administration; D013269:Stochastic Processes; D006113:United Kingdom