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The evaluation of case-mix adjusted efficiency scores the case of the South African private hospital industry

Includes abstract.

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Bibliographic Details
Main Author: Dreyer, Kathryn Ann
Other Authors: Ramjee, Shivani
Format: Thesis
Language:English
Published: Division of Actuarial Science 2014
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access_status_str Open Access
author Dreyer, Kathryn Ann
author2 Ramjee, Shivani
author_browse Dreyer, Kathryn Ann
Ramjee, Shivani
author_facet Ramjee, Shivani
Dreyer, Kathryn Ann
author_sort Dreyer, Kathryn Ann
collection Thesis
description Includes abstract.
format Thesis
id oai:open.uct.ac.za:11427/5813
institution University of Cape Town (South Africa)
language eng
last_indexed 2026-06-10T12:32:54.720Z
license_str Not specified — see source repository
provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
publishDate 2014
publishDateRange 2014
publishDateSort 2014
publisher Division of Actuarial Science
publisherStr Division of Actuarial Science
record_format dspace
source_str UCTD — University of Cape Town Open Access Repository
spelling oai:open.uct.ac.za:11427/5813 The evaluation of case-mix adjusted efficiency scores the case of the South African private hospital industry Dreyer, Kathryn Ann Ramjee, Shivani Actuarial Science Includes abstract. Includes bibliographical references. There is little existing South African literature relating to hospital efficiency that allows for differences in case mix across hospitals. One of the primary motivations for this dissertation is to help fill this gap in the literature by examining the impact that adjusting for differences in case mix has on efficiency scores. Data Envelopment Analysis (DEA) is chosen as the efficiency measurement method because of its exibility and ease of handling multiple inputs and outputs. A number of DEA models are applied to a sample of South African private hospitals for the years 2008 to 2011 inclusive. Three different case-mix adjustment techniques are investigated and their ability to capture differences in case mix is assessed. The three techniques investigated are: a case-mix adjustment factor (constructed using Diagnosis-Related Groups (DRGs)) to adjust outputs; including the case-mix adjustment factor as an additional output; and disaggregating hospital admissions into broad categories which are used as outputs. A comparison of the unadjusted model with the case-mix adjusted model reveals that omitting the adjustment can have a considerable impact on efficiency scores. Whilst little difference is noted in average efficiency scores for the group of hospitals, 90% for the unadjusted model and 92% for the adjusted model in 2011, there are substantial differences between the adjusted and unadjusted efficiency scores of individual hospitals. On comparison of the three different techniques investigated, it is evident that if there is sufficient data to construct a case-mix adjustment factor, case-mix adjusted admissions should be used, rather than using the factor as an additional output variable. In the case where insufficient data is available, disaggregating admissions does capture some of the differences in case mix but a substantial amount of power is lost as a result of increasing the number of output variables. 2014-07-31T12:30:07Z 2014-07-31T12:30:07Z 2013 Master Thesis Masters MBusSc http://hdl.handle.net/11427/5813 eng application/pdf Division of Actuarial Science Faculty of Commerce University of Cape Town
spellingShingle Actuarial Science
Dreyer, Kathryn Ann
The evaluation of case-mix adjusted efficiency scores the case of the South African private hospital industry
thesis_degree_str Master's
title The evaluation of case-mix adjusted efficiency scores the case of the South African private hospital industry
title_full The evaluation of case-mix adjusted efficiency scores the case of the South African private hospital industry
title_fullStr The evaluation of case-mix adjusted efficiency scores the case of the South African private hospital industry
title_full_unstemmed The evaluation of case-mix adjusted efficiency scores the case of the South African private hospital industry
title_short The evaluation of case-mix adjusted efficiency scores the case of the South African private hospital industry
title_sort evaluation of case mix adjusted efficiency scores the case of the south african private hospital industry
topic Actuarial Science
url http://hdl.handle.net/11427/5813
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