Evaluating Hospital Efficiency Adjusting for Quality Indicators: an Application to Portuguese NHS Hospitals

The objective of this paper is to develop a methodology to incorporate measures of hospital quality in efficiency analysis, applied to Portuguese NHS hospitals, in order to assess whether there is a trade-off between efficiency and quality in Portuguese hospitals. We develop and compare two methodologies to compute DEA technical efficiency scores adjusted for output quality, for a sample of Portuguese NHS hospitals in 2009. When DEA efficiency scores are adjusted for output quality, the decision making units that lie on the technical efficiency frontier remain largely unaltered, even if a great weight is given to quality indicators over quantity indicators of output. Nevertheless, we find that outside of the frontier adjusting for quality does have an impact in efficiency scores.We conclude that the empirical evidence is not sufficient to identify a clear trade-off between efficiency and quality in the hospitals under review, implying the possibility that efficiency gains may achieved without a significant sacrifice of service quality. Nevertheless, there is enough evidence to conclude that analyzing hospital efficiency without consideration of differences in quality of service will generate biased results. When perceived quality is brought to the analysis, the gap between efficient and inefficient units tends to widen.Hospital efficiency, Hospital quality, Data Envelopment Analysis

The Effect of Incorporating End-User Customization into Additive Manufacturing Designs

In the realm of additive manufacturing there is an increasing trend among makers to create designs that allow for end-users to alter them prior to printing an artifact. Online design repositories have tools that facilitate the creation of such artifacts. There are currently no rules for how to create a good customizable design or a way to measure the degree of customization within a design. This work defines three types of customizations found in additive manufacturing and presents three metrics to measure the degree of customization within designs based on the three types of customization. The goal of this work is to ultimately provide a consistent basis for which a customizable design can be evaluated in order to assist makers in the creation of new customizable designs that can better serve end-user. The types of customization were defined by doing a search of Thingiverse’s online data base of customizable designs and evaluating commonalities between designs. The three types of customization defined by this work are surface, structure, and personal customization. The associated metrics are used to quantify the adjustability of a set of online designs which are then plot against the daily use rate and each other on separate graphs. The use rate data used in this study is naturally biased towards hobbyists due to where the designs used to create the data resides. A preliminary analysis is done on the metrics to evaluate their correlation with design use rate as well as the dependency of the metrics in relation to each other. The trends between the metrics are examined for an idea of how best to provide customizable designs. This work provides a basis for measuring the degree of customization within additive manufacturing design and provides an initial framework for evaluating the usability of designs based on the measured degree of customization relative to the three types of defined customizations

Towards the Multidimensional Measurement of Library Performance : User Experience Index

The User Experience Index (IUX) is a composite index aimed to measure the overall user experience of services supplied by a library. The user satisfaction is evaluated by calculating the sum of the selected attributes coming from the (scaled) responses to user surveys and weighted by the coefficients assigned by experts. The reason for using the composite index approach is to capture the aggregate effect of multiple factors influencing the overall user experience. The attributes of the IUX were derived from the responses to the National User Survey conducted in Finland over several years in the same format. Altogether seven attributes were selected. The weights of these attributes in relation to each other were defined in a library directors' workshop. The proposed composite index allows the libraries to follow a long-term development of the selected attributes through a single number encompassing their aggregate effect. At the same time, analysis of the individual attributes of the composite index can reveal components of the user experience that require special attention.Peer reviewe

Development and validation of an instrument to measure perceived service quality of an academic library in Costa Rica

Service management involves the responsibility of ensuring the effectiveness of business operations in terms of meeting customer requirements. A good service is judged not only by meeting customer requirements but also by the way the customers perceive and interpret the received service. To know how effective the service is, the quality of the service can be measured. For this aim it is necessary to target actual service elements to improve and to weigh the evaluation of service elements relative to the importance that customers place on them. The literature shows that service quality outcome and measurement are dependent on the type of service setting, situation, needs and other factors. General instruments to measure perceived service were developed in the context of main dimensions proposed by general service quality models. However, it is important to develop new instruments which are directly targeted to the context reality. Based upon conceptual models the goal of this study is to target actual service elements that customers from an academic library in Costa Rica deem important. Using the identified elements the dimensions of service quality are developed and validated to measure user perceived service. It was discussed how appropriable knowledge on quality service can spurred the innovative capacity to improve library services

Broker Positions in Task-Specific Knowledge Networks

In this paper we empirically investigate various benefits and costs associated with broker characteristics of individuals who operate in the account management system of financial service providers. We narrow our focus to broker positions in two specific task-specific knowledge networks that facilitate account management. We study the effect of broker positions on the contribution of individuals to organizational performance. We measure such a contribution by measuring the perceptions of others concerning a particular individual. We also explore how certain personal costs are associated with these task-specific broker positions. More specifically, we explore how these positions affect role ambiguity and role conflict, as self-perceived by that particular individual. To test the hypothesized effects we collect data for a network consisting of 55 individuals. We conclude with stating that service specification broker positions benefit organizations, but service delivery broker positions are detrimental to an organization and that they also invoke personal costs.social networks;account management;role stress;task-specific broker positions