scholarly journals Equality of surgical fee schedule in Japan: a retrospective observational study

2021 ◽  
Author(s):  
Yoshinori Nakata ◽  
Yuichi Watanabe ◽  
Hiroshi Otake
Keyword(s):  
Data Envelopment Analysis ◽  
Efficiency Score ◽  
University Hospital ◽  
Academic Rank ◽  
Data Envelopment ◽  
Surgical Specialty ◽  
Gini Coefficients ◽  
Decision Making Unit ◽  
Significant Difference ◽  
Fee Schedule

Abstract Background The purpose of this study is to examine how the degree of inequality of Japanese surgical fee schedule changed during the study period by applying Gini coefficients for efficiency scores computed from data envelopment analysis. Methods All the surgeries that were performed in the main operating rooms of Teikyo University Hospital in 2013-18 were candidates used for the analysis of efficiency and equality of fee schedule. The decision making unit was defined as a surgeon with the highest academic rank in the surgery. Inputs were defined as (1) the number of assistants, and (2) the duration of operation. An output was defined as the surgical fee that was charged for reimbursement. Each surgeon’s efficiency score was calculated using data envelopment analysis. Using the medians of efficiency scores in each surgical specialty, the authors inferred Gini coefficients and their standard errors in each year and in each surgical fee schedule by the Bootstrap methods. Results The authors analyzed 16,307 surgical procedures during the study period of 2013-18. There was no statistically significant difference in the Gini coefficients between the years and between the surgical fee schedules (p > 0.05). Conclusions The authors demonstrated that the degree of inequality of Japanese surgical fee schedule remained constant from 2013 through 2018.

scholarly journals Equality of Surgical Fee Schedule in Japan: A Retrospective Observational Study

2021 ◽  
Vol 14 ◽  
pp. 117863292110481
Author(s):  
Yoshinori Nakata ◽  
Yuichi Watanabe ◽  
Hiroshi Otake
Keyword(s):  
Data Envelopment Analysis ◽  
Efficiency Score ◽  
University Hospital ◽  
Data Envelopment ◽  
Surgical Specialty ◽  
Gini Coefficients ◽  
Significant Difference ◽  
Using Data ◽  
Fee Schedule ◽  
Duration Of Operation

The authors had previously demonstrated that the Japanese surgical fee schedule had been unequal among surgical specialties in spite of its biannual revisions. This study examined how the degree of inequality of the fee schedule changed by estimating Gini coefficients for efficiency scores computed from data envelopment analysis. All the surgeries at Teikyo University Hospital in 2013 to 2018 were candidates used for the analysis of efficiency and equality of fee schedule. Inputs were defined as (1) the number of assistants, and (2) the duration of operation. An output was defined as the surgical fee. Each surgeon’s efficiency score was calculated using data envelopment analysis. Using the medians of efficiency scores in each surgical specialty, the authors inferred Gini coefficients and their standard errors in each year and in each surgical fee schedule. The authors analyzed 16 307 surgical procedures during the study period of 2013 to 2018. There was no statistically significant difference in the Gini coefficients between the years and between the surgical fee schedules ( P > .05). It was demonstrated that the degree of inequality of the Japanese surgical fee schedule remained constant from 2013 through 2018.

Predictors of surgeons’ efficiency in the operating rooms

2016 ◽  
Vol 30 (1) ◽  
pp. 16-21 ◽  
Author(s):  
Yoshinori Nakata ◽  
Yuichi Watanabe ◽  
Hiroto Narimatsu ◽  
Tatsuya Yoshimura ◽  
Hiroshi Otake ◽  
...  
Keyword(s):  
Statistical Significance ◽  
Personal Characteristics ◽  
Positive Association ◽  
Efficiency Score ◽  
University Hospital ◽  
Academic Rank ◽  
Data Envelopment ◽  
Surgical Specialty ◽  
Independent Variables ◽  
Fee Schedule

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.

Resource utilization in surgery after the revision of surgical fee schedule in Japan

2015 ◽  
Vol 28 (6) ◽  
pp. 635-643 ◽  
Author(s):  
Yoshinori Nakata ◽  
Tatsuya Yoshimura ◽  
Yuichi Watanabe ◽  
Hiroshi Otake ◽  
Giichiro Oiso ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Skin Incision ◽  
University Hospital ◽  
Academic Rank ◽  
Surgical Specialty ◽  
Content Type ◽  
Decision Making Unit ◽  
Using Data ◽  
Fee Schedule ◽  
Time Of Operation

Purpose – The purpose of this paper is to examine whether the current surgical reimbursement system in Japan reflects resource utilization after the revision of fee schedule in 2014. Design/methodology/approach – The authors collected data from all the surgical procedures performed at Teikyo University Hospital from April 1 through September 30, 2014. The authors defined the decision-making unit as a surgeon with the highest academic rank in the surgery. Inputs were defined as the number of medical doctors who assisted surgery, and the time of operation from skin incision to closure. An output was defined as the surgical fee. The authors calculated surgeons’ efficiency scores using data envelopment analysis. Findings – The efficiency scores of each surgical specialty were significantly different (p=0.000). Originality/value – This result demonstrates that the Japanese surgical reimbursement scales still fail to reflect resource utilization despite the revision of surgical fee schedule.

scholarly journals Association Between Surgeons’ Technical Efficiency and Hospital Revenue

2019 ◽  
Vol 56 ◽  
pp. 004695801988944
Author(s):  
Yoshinori Nakata ◽  
Yuichi Watanabe ◽  
Hiroshi Otake
Keyword(s):  
Regression Analysis ◽  
Multiple Regression Analysis ◽  
Multiple Regression ◽  
Technical Efficiency ◽  
Efficiency Score ◽  
University Hospital ◽  
Academic Rank ◽  
Surgical Volume ◽  
Surgical Specialty ◽  
Surgical Data

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.

scholarly journals Performance Assessment Based on the Relative Efficiency of Indian Opencast Coal Mines Using Data Envelopment Analysis and Malmquist Productivity Index

Energies ◽  
2020 ◽  
Vol 13 (18) ◽  
pp. 4902
Author(s):  
Biswaranjita Mahapatra ◽  
Chandan Bhar ◽  
Sandeep Mondal
Keyword(s):  
Data Envelopment Analysis ◽  
Technical Efficiency ◽  
Primary Source ◽  
Efficiency Score ◽  
Malmquist Productivity Index ◽  
Productivity Index ◽  
Scale Efficiency ◽  
Data Envelopment ◽  
Significant Difference ◽  
Using Data

Coal is the primary source of energy in India. Despite being the second-largest coal-producingcountry, there exists a significant difference in demand and production in India. In this study, the relativeefficiency of twenty-eight selected opencast mines from a large public sector undertaking coal companyin India for 2018–2019 was assessed and ranked by using data envelopment analysis (DEA). This studyused input-oriented DEA with efficiency decomposition to pure technical efficiency, technical efficiency,and scale efficiency. The result showed that 25% and 36% of mines were efficient in technical efficiencyand pure technical efficiency, respectively, whereas the eight mines scale efficiency was inefficient witha decreasing return to scale. Further, in this study, theMalmquist Productivity Index (MPI)was employedto measure the efficiency of the selected mines for three consecutive years (2016–2017 to 2018–2019).The result shows that in only three mines the efficiency is continuously improving from 2016–2017 to2018–2019, whereas in more than 20% of mines the efficiency score is decreasing. Comparing theMPIefficiency and productivity assessment throughout the years, changes in innovation and technology areincreasing from 2017–2018 to 2018–2019. Finally, the study concluded with a comprehensive evaluationof each variable with mines performance. The author formulated the strategies, which in turn help coalprofessionals to improve the efficiency of the mine.

Japanese surgical resource utilization in 2016

2019 ◽  
Vol 32 (6) ◽  
pp. 1013-1021
Author(s):  
Yoshinori Nakata ◽  
Yuichi Watanabe ◽  
Hiroto Narimatsu ◽  
Tatsuya Yoshimura ◽  
Hiroshi Otake ◽  
...  
Keyword(s):  
Resource Utilization ◽  
Electronic Medical Record System ◽  
Skin Incision ◽  
Efficiency Score ◽  
Academic Rank ◽  
Surgical Specialty ◽  
Record System ◽  
Content Type ◽  
Decision Making Unit ◽  
The Difference

Purpose The purpose of this paper is to examine from the viewpoint of resource utilization the Japanese surgical payment system which was revised in April 2016. Design/methodology/approach The authors collected data from surgical records in the Teikyo University electronic medical record system from April 1 till September 30, 2016. The authors defined the decision-making unit as a surgeon with the highest academic rank in the surgery. Inputs were defined as the number of medical doctors who assisted surgery, and the time of operation from skin incision to closure. An output was defined as the surgical fee. The authors calculated each surgeon’s efficiency score using output-oriented Charnes–Cooper–Rhodes model of data envelopment analysis. The authors compared the efficiency scores of each surgical specialty using the Kruskal–Wallis and the Steel method. Findings The authors analyzed 2,558 surgical procedures performed by 109 surgeons. The difference in efficiency scores was significant (p = 0.000). The efficiency score of neurosurgery was significantly greater than obstetrics and gynecology, general surgery, orthopedics, emergency surgery, urology, otolaryngology and plastic surgery (p<0.05). Originality/value The authors demonstrated that the surgeons’ efficiency was significantly different among their specialties. This suggests that the Japanese surgical reimbursement scales fail to reflect resource utilization despite the revision in 2016.

scholarly journals Measuring the Efficiency of Indian Real Estate Firms During the Pre- and Post-Demonetization Period by Adopting Data Envelopment Analysis

2019 ◽  
Vol 7 (1) ◽  
pp. 98-109 ◽  
Author(s):  
S.V.S. Raja Prasad
Keyword(s):  
Data Envelopment Analysis ◽  
Real Estate ◽  
Radical Change ◽  
Efficiency Score ◽  
Data Envelopment ◽  
Economic Policies ◽  
The Real Estate ◽  
Indian Economy ◽  
Significant Difference ◽  
Post Period

Abstract Indian real estate segment has been one of the utmost affected segments of economy contemplating the changes in economic policies. The Indian economy experienced a radical change as an outcome of demonetization and the consequences are perceived on the real estate segment. The current study has been proposed to evaluate the efficiency of Indian real estate firms by adopting the technique of data envelopment analysis during the pre- and post-period of demonetization. The aim of the research is to understand the effect of demonetization on the performance of the Indian real estate firms during the post-demonetization period compared to pre-demonetization period. Eight real estate firms have been considered for the analysis. The firms have been ranked on the basis of the efficiency score. It is evident from the results of the study that there is a significant difference between the ranks of the firms during the period of pre and post demonetization; and it can be elucidated that the demonetization has an impact on the performance of the firms.

scholarly journals Directional Slack-Based Measure for the Inverse Data Envelopment Analysis

2014 ◽  
Vol 2014 ◽  
pp. 1-9 ◽  
Author(s):  
Ali Mirsalehy ◽  
Mohd Rizam Abu Bakar ◽  
Lai Soon Lee ◽  
Azmi B. Jaafar ◽  
Maryam Heydar
Keyword(s):  
Decision Making ◽  
Data Envelopment Analysis ◽  
Efficiency Score ◽  
Data Envelopment ◽  
New Production ◽  
Production Possibility ◽  
Novel Technique ◽  
Decision Making Unit ◽  
Measure Model ◽  
Production Possibility Set

A novel technique has been introduced in this research which lends its basis to the Directional Slack-Based Measure for the inverse Data Envelopment Analysis. In practice, the current research endeavors to elucidate the inverse directional slack-based measure model within a new production possibility set. On one occasion, there is a modification imposed on the output (input) quantities of an efficient decision making unit. In detail, the efficient decision making unit in this method was omitted from the present production possibility set but substituted by the considered efficient decision making unit while its input and output quantities were subsequently modified. The efficiency score of the entire DMUs will be retained in this approach. Also, there would be an improvement in the efficiency score. The proposed approach was investigated in this study with reference to a resource allocation problem. It is possible to simultaneously consider any upsurges (declines) of certain outputs associated with the efficient decision making unit. The significance of the represented model is accentuated by presenting numerical examples.

Influence of the revision of surgical fee schedule on surgeons’ productivity in Japan: A cohort analysis of 7602 surgical procedures in 2013–2016

2017 ◽  
Vol 31 (1) ◽  
pp. 51-56 ◽  
Author(s):  
Yoshinori Nakata ◽  
Yuichi Watanabe ◽  
Hiroto Narimatsu ◽  
Tatsuya Yoshimura ◽  
Hiroshi Otake ◽  
...  
Keyword(s):  
Decision Making ◽  
Surgical Procedures ◽  
Technical Change ◽  
Cohort Analysis ◽  
University Hospital ◽  
Academic Rank ◽  
Efficiency Change ◽  
Surgical Operation ◽  
Decision Making Unit ◽  
Fee Schedule

The goal of this study is to evaluate the pure impact of the revision of surgical fee schedule on surgeons’ productivity. We collected data from the surgical procedures performed by the surgeons working in Teikyo University Hospital from 1 April through 30 September in 2013–2016. We employed non-radial and non-oriented Malmquist model. We defined the decision-making unit as a surgeon with the highest academic rank in surgery. Inputs were defined as (1) the number of doctors who assisted surgery and (2) the time of surgical operation. The output was defined as the surgical fee for each surgery. We focused on the revisions in 2014 and 2016. We first calculated each surgeon’s natural logarithms of the changes in productivity, technique and efficiency in 2013–2014, in 2014–2015 and in 2015–2016. Then, we subtracted the changes in 2014–2015 from the changes in 2013–2014 and in 2015–2016. We analyzed 62 surgeons who performed 7602 surgical procedures. The productivity changes were not significantly different from 0. Their efficiency change was significantly greater than 0, while their technical change was smaller than 0 in revision 2014. Their efficiency change was significantly smaller than 0, while their technical change was greater than 0 in revision 2016 (p < 0.05). This finding suggests that we could increase overall productivity through revision if we could increase both efficiency and technique.

Evaluating after-sales service units by developing inverse network data envelopment analysis model

2019 ◽  
Vol 27 (2) ◽  
pp. 695-707 ◽  
Author(s):  
Reza Farzipoor Saen ◽  
Seyed Shahrooz Seyedi Hosseini Nia
Keyword(s):  
Decision Making ◽  
Data Envelopment Analysis ◽  
Efficiency Score ◽  
Data Envelopment Analysis Model ◽  
Network Data ◽  
Data Envelopment ◽  
Analysis Model ◽  
Content Type ◽  
Network Data Envelopment Analysis ◽  
Decision Making Unit

Purpose The purpose of this paper is to develop an inverse network data envelopment analysis (INDEA) model to solve resource allocation problems. Design/methodology/approach The authors estimate inputs’ variations based on outputs so that the efficiencies of decision-making unit under evaluation (DMUo) and other decision-making units (DMUs) are constant. Findings The new INDEA model is developed to allocate resources such that inputs are not increased while efficiency scores of all DMUs remain constant. Furthermore, the authors obtain new combinations of inputs and outputs, together with a growth in efficiency score of DMUo such that efficiency scores of other DMUs are not changed. A case study is provided. Originality/value This paper proposes INDEA model to estimate inputs (outputs) without changing efficiency scores of DMUs.

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