Measuring intra-hospital clinic efficiency and productivity : an application to a Greek university general hospital

In this paper we use Data Envelopment Analysis and the Malmquist Productivity Index and its decompositions to assess the productive efficiency and productivity of the in-patient clinics of a large Greek University General Hospital. Clinics are represented by means of a simple model whereby they use inputs (labor and capital) to produce outputs (in-patient days and patient discharges). The efficiency model is input oriented and assumes constant returns to scale. Model validation analyses showed that this model appears to be externally valid. The framework proposed here is a simple and useful tool for informing intra-hospital management decisions.peer-reviewe

Health care services performance measurement : theory, methods and empirical evidence

Despite the growing international literature in the field of efficiency and productivity measurement there are very limited Greek applications partly due to inadequate and incomplete datasets. The aim of this article is to illustrate the main methodologies for health care services efficiency and productivity measurement, to present their strengths and weaknesses and to discuss the existing evidence from applications in other countries. Notwithstanding the fact that the related methodologies have been recently developed these methods may help practitioners and health care decisions makers in improving health care management in Greece.peer-reviewe

Measuring across hospital efficiency and productivity : the case of second regional health authority of Attica

The purpose of the study is to investigate technical efficiency and productivity change of a sample of Greek Hospitals over the period 1998 - 2005. Efficiency and productivity measurement became a crucial issue in Greece after the launching of health reforms in 2001, with the legislative Act No. 2889, aiming at cost containment and improvements in hospital efficiency. Applying the linear programming method of Data Envelopment Analysis we investigate how efficiently the hospital resources are used to obtain the maximum possible outcome, before and after the reforms. Hospital output is modelled in terms of interventions, laboratory examinations, outpatient and inpatient cases. Inputs considered include beds, doctors, nurses and rest personnel and operational expenses. The analysis indicates that the reforms have generated efficiency gains when only input and output quantities are considered. During the period 1998- 2002 an overall efficiency regress is observed followed by an upturn, after the launching of managerial reforms. However, when the running costs of the hospitals are considered, then the sample experiences significant regress, implying relatively higher production costs over time. We conclude that DEA is a useful technique to assess relative efficiency and optimum hospital performance across hospitals.peer-reviewe

Results of the COVID-19 mental health international for the general population (COMET-G) study.

INTRODUCTION: There are few published empirical data on the effects of COVID-19 on mental health, and until now, there is no large international study. MATERIAL AND METHODS: During the COVID-19 pandemic, an online questionnaire gathered data from 55,589 participants from 40 countries (64.85% females aged 35.80 ± 13.61; 34.05% males aged 34.90±13.29 and 1.10% other aged 31.64±13.15). Distress and probable depression were identified with the use of a previously developed cut-off and algorithm respectively. STATISTICAL ANALYSIS: Descriptive statistics were calculated. Chi-square tests, multiple forward stepwise linear regression analyses and Factorial Analysis of Variance (ANOVA) tested relations among variables. RESULTS: Probable depression was detected in 17.80% and distress in 16.71%. A significant percentage reported a deterioration in mental state, family dynamics and everyday lifestyle. Persons with a history of mental disorders had higher rates of current depression (31.82% vs. 13.07%). At least half of participants were accepting (at least to a moderate degree) a non-bizarre conspiracy. The highest Relative Risk (RR) to develop depression was associated with history of Bipolar disorder and self-harm/attempts (RR = 5.88). Suicidality was not increased in persons without a history of any mental disorder. Based on these results a model was developed. CONCLUSIONS: The final model revealed multiple vulnerabilities and an interplay leading from simple anxiety to probable depression and suicidality through distress. This could be of practical utility since many of these factors are modifiable. Future research and interventions should specifically focus on them

Surgical safety checklist in Greek hospitals

The purpose of this study was to evaluate the knowledge and applicability of the surgical safety checklist in Greek operating rooms

Evaluation of the Efficiency in Public Health Centers in Greece Regarding the Human Resources Occupied: A Bootstrap Data Envelopment Analysis Application

In this paper, the overall efficiency of health centers in Greece is measured by applying the input-oriented model of Data Envelopment Analysis. In addition, four different models were subjected to the input-oriented Data Envelopment Analysis to investigate the contribution of each category of human resources to the efficiency results of the health centers. The bootstrap technique was performed to generate confidence intervals for the models. Data for 155 health centers in Greece were provided by the Ministry of Health. The health centers submitted in the analysis obtained an average efficiency value of 0.932. The average results of the partial models in terms of each input show that the efficiency values achieved by the health centers are mostly influenced by the number of physicians and the number of managers employed. The second factor influencing the efficiency values of the health centers are the number of nursing staff occupied in the health centers. Non-medical staff employed in the health centers had the least contribution to the efficiencies measured. This paper provides important information for the stakeholders and the Government of Greece so as to better allocate the personnel employed in primary health care according to the efficiencies attained by the health centers

Systematic review of the cost-effectiveness of transcatheter interventions for valvular heart disease

Transcatheter aortic valve implantation (TAVI) and transcatheter mitral valve repair (TMVR) are increasingly used for managing patients with valvular heart disease to whom surgery presents a high-risk. As these are costly procedures, a systematic review of studies concerned with their economic assessment was undertaken. The search was performed in PubMed and the Cochrane Library and followed recommended methodological steps. Studies were screened and their data were retrieved and were synthesized using a narrative approach. Twenty-four, good to high quality, evaluations were identified, representing different viewpoints, modelling techniques and willingness-to-pay thresholds. Studies show that in high-risk patients with symptomatic aortic stenosis, TAVI may be cost-effective compared with medical management (MM) across many health care settings. In contrast, studies of TAVI compared with surgical aortic valve replacement (SAVR) yield conflicting and inconclusive results. The limited data available show that TMVR may also be cost-effective relative to MM in mitral valve disease. Existing evidence indicates that transcatheter techniques may be cost-effective options, relative to MM, in high-risk patients with valvular disease. Nonetheless, more research is needed to establish their economic value further, to investigate the drives of cost-effectiveness, and to evaluate surgical with transcatheter techniques in aortic valvular disease

Measuring technical efficiency of health centers in Greece : a data envelopment analysis application for the primary health system of Greece

PURPOSE: In this paper Data Envelopment Analysis will be applied to investigate the technical efficiency of 196 Heath Centers in Greece. The analysis is referred at their efficiency in the year 2018.DESIGN/METHODOLOGY/APPROACH: Data were collected by the Ministry of Health and were analyzed by performing quality tests to ensure validity and avoid bias. The method used is the non-parametric Data Envelopment Analysis and more specifically the input-oriented, onestage VRS model. Tobit regression analysis was performed to analyze the effect of the Health Region in the efficiency of the Health Centers.FINDINGS: The results of the paper indicate the efficient Health Centers in Greece, which construct the efficient frontier. The inefficient Health Centers in Greece lie beneath the efficient frontier. Moreover, the 196 Health Centers included in the research were classified depending on the Health Region they belong to, to investigate the effect of the Health Regions in the efficiency measured.PRACTICAL IMPLICATIONS: This study highlights the importance of measuring the efficiency of Primary Health Care. Taking into consideration the contribution of Health Centers to the National Health System, the results may be used as a guide for improvements for the efficiency of the Health Centers.ORIGINALITY/VALUE: The research focus on the underestimated field of Primary Health Care and its importance. The application of Data Envelopment Analysis combined with the Tobit Regression Model reveals a new approach for measuring the efficiency.peer-reviewe

O R I G I N A L P A P E R .r . Organizational Commitment of the Nursing Personnel in a Greek National Health System Hospital

Abstract Background: The existence of organizational commitment in nurses' personality is a determining factor that secures the effectiveness and the efficiency in hospitals' function. Taking this for granted, we examined the level of this parameter in a nursing community. Aims: The study investigates the dimension of organizational commitment of nursing personnel who work in a public hospital in the Athens district in Greece. Methodology: The questionnaire of the study consisted of two sections and was distributed in three hundred nurses of the public hospital. Eventually, one hundred seventy two were filled in (response rate 57.33%). The statistical analysis was implemented by the statistical program SPSS for Windows (version 19.0). Results: Nurses appear to have developed their commitment to the organization that they work for, in contrast to their dedication to the profession that seems to be low according to the findings. Conclusions: The findings of the study are in agreement with relevant studies that have been conducted in the past both in Greece and abroad