Productivity growth in outpatient child and adolescent mental health services: the impact of case-mix adjustment

Social Science & Medicine
Vidar HalsteinliJon Magnussen

Abstract

The performance of health service providers may be monitored by measuring productivity. However, the policy value of such measures may depend crucially on the accuracy of input and output measures. In particular, an important question is how to adjust adequately for case-mix in the production of health care. In this study, we assess productivity growth in Norwegian outpatient child and adolescent mental health service units (CAMHS) over a period characterized by governmental utilization of simple productivity indices, a substantial increase in capacity and a concurrent change in case-mix. We analyze the sensitivity of the productivity growth estimates using different specifications of output to adjust for case-mix differences. Case-mix adjustment is achieved by distributing patients into eight groups depending on reason for referral, age and gender, as well as correcting for the number of consultations. We utilize the nonparametric Data Envelopment Analysis (DEA) method to implicitly calculate weights that maximize each unit's efficiency. Malmquist indices of technical productivity growth are estimated and bootstrap procedures are performed to calculate confidence intervals and to test alternative specifications of outputs. The...Continue Reading

References

Sep 1, 2005·Health Policy·Miika LinnaJon Magnussen
Aug 16, 2006·Health Policy·Paul J M SteinbuschFrans J M Schaepkens
Sep 23, 2006·Health Economics·Bruce Hollingsworth, Andrew Street
Mar 21, 2007·Social Science & Medicine·Jon MagnussenOddvar M Kaarboe
Aug 22, 2007·Administration and Policy in Mental Health·Ketil Hanssen-BauerSonja Heyerdahl

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Citations

Dec 24, 2013·BMC Health Services Research·Cláudia FerreiraPaulo Nicola
May 17, 2011·International Archives of Medicine·Joses M KirigiaYankuba Bah
Jan 8, 2017·European Child & Adolescent Psychiatry·Julian Edbrooke-ChildsJessica Deighton
Dec 13, 2019·Health Policy and Planning·Peipei ChaiYohannes Kinfu
Mar 31, 2021·Quality Management in Health Care·Rubén Castro, Juan Tapia

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