Predictors of surgeons' efficiency in the operating rooms.
The sustainability of the Japanese healthcare system is questionable because of a huge fiscal debt. One of the solutions is to improve the efficiency of healthcare. The purpose of this study is to determine what factors are predictive of surgeons' efficiency scores. The authors collected data from all the surgical procedures performed at Teikyo University Hospital from April 1 through September 30 in 2013-2015. Output-oriented Charnes-Cooper-Rhodes model of data envelopment analysis was employed to calculate each surgeon's efficiency score. Seven independent variables that may predict their efficiency scores were selected: experience, medical school, surgical volume, gender, academic rank, surgical specialty, and the surgical fee schedule. Multiple regression analysis using random-effects Tobit model was used for our panel data. The data from total 8722 surgical cases were obtained in 18-month study period. The authors analyzed 134 surgeons. The only statistically significant coefficients were surgical specialty and surgical fee schedule (p = 0.000 and p = 0.016, respectively). Experience had some positive association with efficiency scores but did not reach statistical significance (p = 0.062). The other coefficients were not statistically significant. These results demonstrated that the surgical reimbursement system, not surgeons' personal characteristics, is a significant predictor of surgeons' efficiency.
1 Graduate School of Public Health, Teikyo University, Tokyo, Japan.
Yoshinori
Y
Nakata
1 Graduate School of Public Health, Teikyo University, Tokyo, Japan.
Yuichi
Y
Watanabe
2 Kanagawa Cancer Center Research Institute, Yokohama, Japan.
Hiroto
H
Narimatsu
3 Shin-Yurigaoka General Hospital, Kawasaki, Japan.
Tatsuya
T
Yoshimura
4 School of Medicine, Showa University, Tokyo, Japan.
Hiroshi
H
Otake
5 Medical Information and System Research Center, Teikyo University, Tokyo, Japan.
Tomohiro
T
Sawa
D004526:Efficiency; D005260:Female; D006785:Hospitals, University; D006801:Humans; D008297:Male; D009873:Operating Rooms; D066231:Surgeons
efficiency; fee schedule; surgeon