J Med Syst - Primary care efficiency measurement using data envelopment analysis: a systematic review.

Tópicos

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{ studi(2440) review(1878) systemat(933) }
{ method(1557) propos(1049) approach(1037) }
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{ howev(809) still(633) remain(590) }
{ research(1085) discuss(1038) issu(1018) }
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{ system(1976) rule(880) can(841) }
{ framework(1458) process(801) describ(734) }
{ measur(2081) correl(1212) valu(896) }
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{ state(1844) use(1261) util(961) }
{ data(2317) use(1299) case(1017) }
{ age(1611) year(1155) adult(843) }
{ signal(2180) analysi(812) frequenc(800) }
{ group(2977) signific(1463) compar(1072) }
{ sampl(1606) size(1419) use(1276) }
{ gene(2352) biolog(1181) express(1162) }
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{ high(1669) rate(1365) level(1280) }
{ cancer(2502) breast(956) screen(824) }
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{ use(1733) differ(960) four(931) }
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Resumo

There is a gap between the demand and supply of efficiency analyses within primary care (PC), despite the threatening financial sustainability of health care systems. This paper provides a systematic literature review on PC efficiency analysis using Data Envelopment Analysis (DEA). We reviewed 39 DEA applications in PC, to understand how methodological frameworks impact results and influence the information provided to decision makers. Studies were combined using qualitative narrative synthesis. This paper reports data for each efficiency analysis on the: 1) evaluation context; 2) model specifications; 3) application of methods to test the robustness of findings; 4) presentation of results. Even though a consistent number of analyses aim to support policymakers and practice managers in improving the efficiency of their PC organizations, the results indicate that DEA--at least when applied to PC--is a methodology still in progress; it needs to be further advanced to meet the complexity that characterizes the production of PC outcomes. Future studies are needed to fill some gaps in this particular domain of research, such as on the standardization of methodologies and the improvement of outcome research in PC. Most importantly, further studies should include extensive uncertainty analyses and be based on good evidence-based rationales. We suggest a number of considerations to academics and researchers to foster the utility of efficiency measurement for the decision making purposes in PC.

Resumo Limpo

gap demand suppli effici analys within primari care pc despit threaten financi sustain health care system paper provid systemat literatur review pc effici analysi use data envelop analysi dea review dea applic pc understand methodolog framework impact result influenc inform provid decis maker studi combin use qualit narrat synthesi paper report data effici analysi evalu context model specif applic method test robust find present result even though consist number analys aim support policymak practic manag improv effici pc organ result indic deaat least appli pcis methodolog still progress need advanc meet complex character product pc outcom futur studi need fill gap particular domain research standard methodolog improv outcom research pc import studi includ extens uncertainti analys base good evidencebas rational suggest number consider academ research foster util effici measur decis make purpos pc

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