Production Efficiency of Physicians in Outpatient Consultation of Cardiovascular Cases
- Corresponding Author:
- Prof. Tomoyuki Takura, Ph.D
Department of Health Economics and Industrial Policy
Osaka University Graduate School of Medicine
2-2 Yamadaoka, Suita, Osaka, 565-0871, Japan
E-mail: [email protected]
Received Date: May 24, 2013; Accepted Date: June 17, 2013; Published Date: June 19, 2013
Citation: Takura T, Itoh H (2013) Production Efficiency of Physicians in Outpatient Consultation of Cardiovascular Cases. J Community Med Health Educ 3:218. doi:10.4172/2165-7904.1000218
Copyright: © 2013 Takura T, et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Background: We evaluated the production efficiency of physicians in outpatient consultation using Data Envelopment Analysis (DEA) to verify the applicability of this method in health care field.
Methods: Clinical accomplishment by outpatient consultation (number of complex cases) and economic contribution to health service income (fee claims) were defined as the contributions of physicians in medical institutions. We investigated consultations and fee claims of 963 outpatients (all aged: 72.9 ± 11.8 years, males aged: 72.0 ± 11.7 years / females aged: 74.0 ± 12.0 years, hypertension: 17.5% / angina: 13.1%) consulted by 15 physicians in a week at a medical institution specialized in cardiovascular disease. The physician’s fee claim per practice time was used as an index in production efficiency of each cardiovascular case. We determined production efficiency of physicians using both of total fee claim and number of complex cases per consultation time using DEA.
Results: There was no statistically significant difference between main disease of outpatients in consultation time (p=0.28). We showed a significant increment of physicians fee claim (point per min) according to the patient condition aggravated from mild to moderate cases in severity (71.4 ± 2.4: p=0.004). The production efficiency also significantly increased from the first consultation to follow-up (71.6 ± 2.4: p=0.048). There was a large variation among the 15 physicians in the consultations, and 4 physicians (26% of all subjects) formed a group with the most favorable production efficiency according to DEA.
Conclusion: We demonstrated evaluation of production efficiency of physicians using clinical and economic accomplishments. The production efficiency is significantly influenced by disease severity and consultation step. Our finding suggests that DEA may be applicable for evaluation of health care services.