• Data Envelopment Analysis Online Software


    DEA and Health Care

    On this page, we have provided all the information about DEA and Health care that may be interesting and useful to users. This page contains the following sections:

    1. Background

    2. Key papers

    3. New interesting papers

    4. Related subject

    5. Statistics

    6. References







    Data envelopment analysis (DEA), as a linear programming technique, serves several benefits in comparison with the other techniques for performance measurement. DEA requires no preference articulation on priority of inputs/ outputs, and can estimate the production function as a non-parametric approach. DEA determines the efficient DMUs among others, and suggests the projection of efficiency for the inefficient DMUs. There are several successful applications of DEA models in the healthcare systems. Most of the papers studied hospital performance, although nursing homes, primary care, and care programs are among many other subjects of study. 

    Two independent studies, Nunamaker (1983) and Sherman (1984), lead the DEA study in the health care area. Nunamaker was the first published paper in the health care sector, focusing on nursing service efficiency. Sherman analyzed factors like budget, day beds, number of full-time physicians, +65 years old patients, -65 years old patients, instructed nurses and interns as inputs and outputs. Several studies are concerned about method comparison. Banker (1986) applied and compared the translog and DEA models using a sample of North Carolina hospitals. Linna (1998) and Giuffrida and Gravelle (2001) investigated the efficiency of hospital and primary care services, respectively, with both the DEA and stochastic frontier analyses. Two studies are a survey type of literature. Worthington (2004) reviewed the health care literature that applies frontier efficiency measurement. Hollingsworth (2008) summarized the latest development of DEA application in the health care category. Overall, as pointed out in Hollowgsworth, the techniques used in efficiency studies in the health care area are mainly based on DEA, but there is some usage of parametric stochastic frontier analysis.


    This section introduces key papers in the DEA and health care. These papers have had a significant impact on the DEA and its application in health care sector.


    Abstract: This article provides an illustrative application of Data Envelopment Analysis (DEA) methodology to the measurement of routine nursing service efficiency at a group of Wisconsin hospitals. The DEA efficiency ratings and cost savings estimates are then compared to those resulting from application of Medicare's routine cost limitation to the sample data. DEA is also used to determine if any changes in the potential for efficient operations occurred during the 1978-1979 period. Empirical results were representative of the fundamental differences existing between the DEA and cost per patient day approaches. No evidence was found to support the notion that the overall potential for efficient delivery of routine services by the sample institutions was greater in one year than another.



    Author: H. David Sherman
    Journal: Medical Care
    Published: 1984
    Abstract: A new technique for identifying inefficient hospitals, Data Envelopment Analysis (DEA), is field tested by application to a group of teaching hospitals. DEA is found to provide meaningful insights into the location and nature of hospital inefficiencies as judged by the opinion of a panel of hospital experts. DEA provides insights about hospital efficiency not available from the widely used efficiency evaluation techniques of ratio analysis and econometric-regression analysis. DEA is, therefore, suggested as a means to help identify and measure hospital inefficiency as a basis for directing management efforts toward increasing efficiency and reducing health care costs.


    A comparative application of data envelopment analysis and translog methods—an illustrative study of hospital production
    Authors: R.D. Banker, R.F. Conrad, R.P. Strauss
    Journal: Management Science
    Published: 1986
    Abstract: This paper compares inferences about hospital cost and production correspondences from two different estimation models: (1) the econometric modelling of the translog cost function, examples of the application of each approach to empirical data, this paper provides insights into the relative strengths of the estimation methods by applying both models to the same data. The translog results suggest that constant returns are operant, whereas the DEA results suggest that both increasing and decreasing returns to scale may be observed in different segments of the production correspondence, in turn suggesting that the translog model may be 'averaging' diametrically opposite behaviour. On the other hand, by examining the rate of output transformation, both models agree that patient days devoted to care of children are more resource intensive than those devoted to adults or to the elderly. In addition, we compare estimates of technical efficiencies of individual hospitals obtained from the two methods. The DEA estimates are found to be highly related to the capacity utilization, but no search relationship was found for the translog estimates. This comparative application of different estimation models to the same data to obtain inferences about the nature of underlying cost and production correspondences sheds interesting light on the strengths of each approach, and suggests the need for additional research comparing estimation models using real as well as simulated data.
    Measuring hospital cost efficiency with panel data models
    Author: M. Linna
    Journal: Health Economics
    Published: 1998
    Abstract: This paper investigated the development of hospital cost efficiency and productivity in Finland in 1988–1994 using a comparative application of parametric and non-parametric panel models. Stochastic cost frontier models with a time-varying inefficiency component were used as parametric methods. As non-parametric methods various DEA models were employed to calculate efficiency scores and the Malmquist productivity index. The results revealed a 3–5% annual average increase in productivity, half of which was due to improvement in cost efficiency and half due to technological change. The results by parametric and non-parametric methods compared well with respect to individual efficiency scores, time-varying efficiency and technological change. The state subsidy reform of 1993 did not seem to have any observable effects on the hospital efficiency.

    Measuring performance in primary care: econometric analysis and DEA
    Authors: A. Giuffrida, H. Gravelle
    Journal: Applied Economics
    Published: 2001
    Abstract: We use data from the Health Service Indicators database to compare different methods of measuring the performance of English Family Health Services Authorities (FHSAs) in providing primary care. A variety of regression and data envelopment analysis methods are compared as summary efficiency measures of individual FHSA performance. The correlation of the rankings of FHSAs across DEA and regression methods, across two years of data and across three different specifications of the technology of primary care are examined. Efficiency scores are highly correlated within variants of the two methods, and across years for a given method. Inter method correlations are smaller and correlations across different specifications of the primary care production process are negligible and sometime negative.


    Frontier efficiency measurement in health care: a review of empirical techniques and selected applications
    Author: A.C. Worthington
    Journal: 2004
    Published: Medical Care Research and Review
    Abstract: Healthcare institutions worldwide are increasingly the subject of analyses aimed at defining, measuring and improving organizational efficiency. However, despite the importance of efficiency measurement in healthcare services, it is only relatively recently that the more advanced econometric and mathematical programming frontier techniques have been applied to hospitals, nursing homes, health management organisations and physician practices, amongst others. This paper provides a synoptic survey of the comparatively few empirical analyses of frontier efficiency measurement in healthcare services. Both the measurement of efficiency in a range of healthcare services and the posited determinants of healthcare efficiency are examined.

    The measurement of efficiency and productivity of health care delivery
    Author: B. Hollingsworth
    Journal: 2008
    Published: Health Economics
    Abstract: The measurement of efficiency and productivity of health service delivery has become a small industry. This is a review of 317 published papers on frontier efficiency measurement. The techniques used are mainly based on nonparametric data envelopment analysis, but there is increasing use of parametric techniques, such as stochastic frontier analysis. Applications to hospitals and other health care organizations and areas are reviewed and summarised, and some meta-type analysis undertaken. Cautious conclusions are that public provision may be potentially more efficient than private, in certain settings. The paper also considers conceptualizations of efficiency, and points to dangers and opportunities in generating such information. Finally, some criteria for assessing the use and usefulness of efficiency studies are established, with a view to helping both researchers and those assessing whether or not to act upon published results.


    The using of the DEA technique in the health care sector is increasing over time. This section introduces new articles that present a new method or significant results in this area.

    Development of intuitionistic fuzzy super-efficiency slack based measure with an application to health sector
    Authors: Alka Arya, Shiv Prasad Yadav
    Journal: Computers &Industrial Engineering
    Published: 2018
    Abstract: Data envelopment analysis (DEA) is a linear programming based technique, which determines the performance efficiencies of homogeneous decision making units (DMUs). Slack based measure (SBM) model finds the performance efficiency, and it deals with the input excesses and output shortfalls of DMUs. In conventional SBM, the data is crisp. But it fluctuates in the real world applications. Such data can take the form of fuzzy/intuitionistic fuzzy (IF) number. In this paper, we propose an IF slack based measure (IFSBM) model to determine the efficiency of DMUs and IF super efficiency SBM (IFSESBM) model to determine the efficiency of efficient DMUs for α in (0,1] and β in [0,1). Also, we propose a ranking method for intuitionistic fuzzy interval numbers (IFINs) based on α and β-cuts. Finally, a health sector application of the proposed model is presented with two IF inputs: (i) number of beds (ii) number of doctors and two IF outputs: (i) number of pathology operations (ii) number of minor surgeries.

    Analyzing hotel efficiency from a regional perspective: The role of environmental determinants
    Authors: Ricardo Sellers-Rubio, Ana B.Casado-Díaz
    Journal: International Journal of Hospitality Management
    Published: 2018

    Abstract: With the development of the tourism industry over the last three decades, there has been growing interest in evaluating the efficiency of the hotel industry from a regional perspective. This paper joins this stream of research and assesses the performance of the Spanish hotel industry using a two-stage double bootstrap data envelopment analysis methodology. Additionally, we extend research on the impact of environmental variables on efficiency by examining the impact of four variables: length of stay, number of international tourists, destination quality, and the sun and sand tourism model. The results show a high degree of hotel inefficiency for Spanish regions and a significant effect of the environmental variables considered. These results give policymakers more accurate information for future strategic decisions, especially because that tourism constitutes a 
     strategic sector of Spain’s national economy.

    The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals
    Authors: Sebastian Kohl, Jan Schoenfelder, Andreas Fügener, Jens O. Brunner
    Journal: Health Care Management Science
    Published: 2018
    Abstract: The healthcare sector in general and hospitals in particular represent a main application area for Data Envelopment Analysis (DEA). This paper reviews 262 papers of DEA applications in healthcare with special focus on hospitals and therefore closes a gap of over ten years that were not covered by existing review articles. Apart from providing descriptive statistics of the papers, we are the first to examine the research purposes of the publications. These research goals can be grouped into four distinct clusters according to our proposed framework. The four clusters are (1) “Pure DEA efficiency analysis”, i.e. performing a DEA on hospital data, (2) “Developments or applications of new methodologies”, i.e. applying new DEAy approaches on hospital data, (3) “Specific management question”, i.e. analyzing the effects of managerial specification, such as ownership, on hospital efficiency, and (4) “Surveys on the effects of reforms”, i.e. researching the impact of policy making, such as reforms of health systems, on hospital efficiency. Furthermore, we analyze the methodological settings of the studies and describe the applied models. We analyze the chosen inputs and outputs as well as all relevant downstream techniques. A further contribution of this paper is its function as a roadmap to important methodological literature and publications, which provide crucial information on the setup of DEA studies. Thus, this paper should be of assistance to researchers planning to apply DEA in a hospital setting by providing information on a) what has been published between 2005 and 2016, b) possible pitfalls when setting up a DEA analysis, and c) possible ways to apply the DEA analysis in practice. Finally, we discuss what could be done to advance DEA from a scientific tool to an instrument that is actually utilized by managers and policymakers.



    In this section, we list a series of selected descriptive statistics involving the numbers and distributions of papers, journals and keywords of DEA and health care related articles.

    1. Statistics involving publications by year

    The following chart shows the distribution of DEA and health care articles published by year. The greatest number of articles is in 2018. It shows that the using of DEA technique in the health care sector is increasing.




    2. Statistics involving publications by journal
    The following chart shows ten journals that have published the greatest number of DEA tourism papers in the past years. Journals such as European Journal of Operational Research, Health Policy and Socio-Economic Planning Sciences are the most utilized.


    3. Statistics involving keywords used

    The following table lists the most popular keywords by number of publications.



    131. Potential energy saving via overall efficiency relying on quality of life
    Reza Nadimi, Koji Tokimatsu
    Applied Energy, Volumes 233–234, Pages 283-299
    1 January 2019

    130. A novel multi-objective fuzzy model for optimization of oil sludge management by considering Health, Safety and Environment (HSE) and resiliency indicators in a gas refinery
    Maryam Roudneshin, Ali Azadeh
    Journal of Cleaner Production, Volume 206, Pages 559-571
    1 January 2019

    129. An integrated fuzzy clustering cooperative game data envelopment analysis model with application in hospital efficiency
    Hashem Omrani, Khatereh Shafaat, Ali Emrouznejad
    Expert Systems with Applications, Volume 114, Pages 615-628
    30 December 2018

    128. Optimization of energy consumption and environmental impacts of arecanut production through coupled data envelopment analysis and life cycle assessment
    Venkatesh Paramesh, Vadivel Arunachalam, Amin Nikkhah, Bappa Das, Sami Ghnimi
    Journal of Cleaner Production, Volume 203, Pages 674-684
    1 December 2018

    127. Doctors, nurses, and the optimal scale size in the Portuguese public hospitals
    Diogo Cunha Ferreira, Alexandre Morais Nunes, Rui Cunha Marques
    Health Policy, Volume 122, Issue 10, Pages 1093-1100
    October 2018

    126. A novel mixed sustainability-resilience framework for evaluating hospital information systems
    S. Motevali Haghighi, S. Ali Torabi
    International Journal of Medical Informatics, Volume 118, Pages 16-28
    October 2018

    125. Refinement and Analysis of the Mature Zika Virus Cryo-EM Structure at 3.1 Å Resolution
    Madhumati Sevvana, Feng Long, Andrew S. Miller, Thomas Klose, Michael G. Rossmann
    Structure, Volume 26, Issue 9, Pages 1169-1177.e3
    4 September 2018

    124. The trade-off between equity and efficiency in population health gain: Making it real
    P. Sandiford, D. Vivas Consuelo, P. Rouse, D. Bramley
    Social Science & Medicine, Volume 212, Pages 136-144
    September 2018

    123. Do the most efficient accountable care organizations earn shared savings?
    Socio-Economic Planning Sciences, Volume 63, September 2018, Pages 12-17
    Jennifer R. Palazzolo, Yasar A. Ozcan

    122. A multistage model to evaluate the efficiency the bar industry
    Laura Parte, Pilar Alberca
    International Journal of Hospitality Management, In press, corrected proof
    Available online 28 August 2018

    121. An intelligent algorithm for determination and optimization of productivity factors in upstream oil projects
    A. Azadeh, M. Pourebrahim Ahvazi, S. Motevali Haghighi
    Journal of Petroleum Science and Engineering, Volume 167, Pages 375-395
    August 2018

    120. Pregnancy care in Germany, France and Japan: an international comparison of quality and efficiency using structural equation modelling and data envelopment analysis
    A. Rump, O. Schöffski
    Public Health, Volume 160, Pages 129-142
    July 2018

    119. Treatment outcomes and patient-reported quality of life after orthognathic surgery with computer-assisted 2- or 3-dimensional planning: A randomized double-blind active-controlled clinical trial
    Martin Bengtsson, Gert Wall, Pernilla Larsson, Jonas P. Becktor, Lars Rasmusson
    American Journal of Orthodontics and Dentofacial Orthopedics, Volume 153, Issue 6, Pages 786-796
    June 2018

    118. Assessment of the efficiency of dental services in Turkey
    Bayram Şahin, Gülnur İlgün
    Health Policy and Technology, Volume 7, Issue 2, Pages 173-181
    June 2018

    117. Revisiting the LCA+DEA method in fishing fleets. How should we be measuring efficiency?
    Jara Laso, Ian Vázquez-Rowe, María Margallo, Ángel Irabien, Rubén Aldaco
    Marine Policy, Volume 91, Pages 34-40
    May 2018

    116. Energy use characteristics and benchmarking for higher education buildings
    Maryam Khoshbakht, Zhonghua Gou, Karine Dupre
    Energy and Buildings, Volume 164, Pages 61-76
    1 April 2018

    115. Efficiency evaluation of industrial waste gas control in China: A study based on data envelopment analysis (DEA) model
    Weixin Yang, Lingguang Li
    Journal of Cleaner Production, Volume 179, Pages 1-11
    1 April 2018

    114. Investigating the effectiveness of safety costs on productivity and quality enhancement by means of a quantitative approach
    Gh. A. Shirali, V. Salehi, R. Savari, K. Ahmadiangali
    Safety Science, Volume 103, Pages 316-322
    March 2018

    113. The comprehensive environmental efficiency of socioeconomic sectors in China: An analysis based on a non-separable bad output SBM
    Qi He, Ji Han, Dabo Guan, Zhifu Mi, Qiang Zhang
    Journal of Cleaner Production, Volume 176, Pages 1091-1110
    1 March 2018

    112. A DEA-centric decision support system for evaluating Ciclovía-Recreativa programs in the Americas
    Sepideh Abolghasem, Juliana Gómez-Sarmiento, Andrés L. Medaglia, Olga L. Sarmiento, Enrique Jacoby
    Socio-Economic Planning Sciences, Volume 61, Pages 90-101
    March 2018

    111. HSE risk prioritization using robust DEA-FMEA approach with undesirable outputs: A study of automotive parts industry in Iran
    Samuel Yousefi, Arash Alizadeh, Jamileh Hayati, Majid Baghery
    Safety Science, Volume 102, Pages 144-158
    February 2018

    110. Eco-efficiency assessment of Polish regions: Joint application of life cycle assessment and data envelopment analysis
    Magdalena Rybaczewska-Błażejowska, Aneta Masternak-Janus
    Journal of Cleaner Production, Volume 172, Pages 1180-1192
    20 January 2018

    109. Development of intuitionistic fuzzy super-efficiency slack based measure with an application to health sector
    Alka Arya, Shiv Prasad Yadav
    Computers & Industrial Engineering, Volume 115, Pages 368-380
    January 2018

    108. Efficiency in the generation of social welfare in Mexico: A proposal in the presence of bad outputs
    Víctor Giménez, Francisco Javier Ayvar-Campos, José César Lenin Navarro-Chávez
    Omega, Volume 69, Pages 43-52
    June 2017

    107. A DEA-based incentives system for centrally managed multi-unit organisations
    Mohsen Afsharian, Heinz Ahn, Emmanuel Thanassoulis
    European Journal of Operational Research, Volume 259, Issue 2, Pages 587-598
    1 June 2017

    106. Physician payment schemes and physician productivity: Analysis of Turkish healthcare reforms
    Burcay Erus, Ozan Hatipoglu
    Health Policy, Volume 121, Issue 5, Pages 553-557
    May 2017

    105. Productivity growth, case mix and optimal size of hospitals. A 16-year study of the Norwegian hospital sector
    Kjartan Sarheim Anthun, Sverre Andreas Campbell Kittelsen, Jon Magnussen
    Health Policy, Volume 121, Issue 4, Pages 418-425
    April 2017

    104. Análisis de la eficiencia técnica en los hospitales del Sistema Nacional de Salud español
    Carmen Pérez-Romero, M. Isabel Ortega-Díaz, Ricardo Ocaña-Riola, José Jesús Martín-Martín
    Gaceta Sanitaria, Volume 31, Issue 2, Pages 108-115
    March–April 2017

    103. Assessing eco-efficiency: A metafrontier directional distance function approach using life cycle analysis
    Mercedes Beltrán-Esteve, Ernest Reig-Martínez, Vicent Estruch-Guitart
    Environmental Impact Assessment Review, Volume 63, Pages 116-127
    March 2017

    102. Assessing physician productivity following Norwegian hospital reform: A panel and data envelopment analysis
    Karl Arne Johannessen, Sverre A. C. Kittelsen, Terje P. Hagen
    Social Science & Medicine, Volume 175, Pages 117-126
    February 2017

    101. A literature study for DEA applied to energy and environment
    Toshiyuki Sueyoshi, Yan Yuan, Mika Goto
    Energy Economics, Volume 62, Pages 104-124
    February 2017


    100. Comparison and Evaluation of Concepts for a Future Recycling Process Regarding Attrited Lead Anodes Used in the Electrowinning Process of Non-ferrous Metals
    Christoph Rosebrock, Stefan Bracke
    Procedia Manufacturing, Volume 8, Pages 627-634

    99. Are more resources always the answer? A supply and demand analysis for public health services in Brazilian municipalities
    Fabiana Rocha, Janete Duarte, Plínio Portela de Oliveira, Luis Felipe Vital Nunes Pereira, Sérgio Ricardo de Brito Gadelha
    EconomiA, Volume 18, Issue 1, Pages 98-116
    January–April 2017

    98. Network-like DEA approach for environmental assessment: Evidence from U.S. manufacturing sectors
    Yu Yu, Weiwei Zhu, Qinfen Shi, Qian Zhang
    Journal of Cleaner Production, Volume 139, Pages 277-286
    15 December 2016

    97. Technology acquisition and efficiency in Dubai hospitals
    Alessandro Ancarani, Carmela Di Mauro, Simone Gitto, Paolo Mancuso, Ali Ayach
    Technological Forecasting and Social Change, Volume 113, Part B, Pages 475-485
    December 2016

    96. Identifying the scope for savings at inpatient episode level: An illustration applying DEA to chronic obstructive pulmonary disease
    Emmanuel Thanassoulis, Maria Silva Portela, Mike Graveney
    European Journal of Operational Research, Volume 255, Issue 2, Pages 570-582
    1 December 2016

    95. An intelligent framework for productivity assessment and analysis of human resource from resilience engineering, motivational factors, HSE and ergonomics perspectives
    Ali Azadeh, Mansour Zarrin
    Safety Science, Volume 89, Pages 55-71
    November 2016

    94. Public resource usage in health systems: a data envelopment analysis of the efficiency of health systems of autonomous communities in Spain
    M. S. Campos, A. Fernández-Montes, J. M. Gavilan, F. Velasco
    Public Health, Volume 138, Pages 33-40
    September 2016

    93. Medida de la eficiencia de la atención primaria en Barcelona incorporando indicadores de calidad
    José Romano, Álvaro Choi
    Gaceta Sanitaria, Volume 30, Issue 5, Pages 359-365
    September–October 2016

    92. A DEA based composite measure of quality and its associated data uncertainty interval for health care provider profiling and pay-for-performance
    Michael Shwartz, James F. Burgess, Joe Zhu
    European Journal of Operational Research, Volume 253, Issue 2, Pages 489-502
    1 September 2016

    91. Disentangling the efficiency drivers in country-level global health programs: An empirical study
    Gemma Berenguer, Ananth V. Iyer, Prashant Yadav
    Journal of Operations Management, Volume 45, Pages 30-43
    July 2016

    90. Changes in technical efficiency after quality management certification: A DEA approach using difference-in-difference estimation with genetic matching in the hospital industry
    Ivonne Lindlbauer, Jonas Schreyögg, Vera Winter
    European Journal of Operational Research, Volume 250, Issue 3, Pages 1026-1036
    1 May 2016

    89. Evaluación de la eficiencia técnica de la atención primaria pública en el País Vasco, 2010-2013
    José Manuel Cordero, Roberto Nuño-Solinís, Juan F. Orueta, Cristina Polo, Edurne Alonso-Morán
    Gaceta Sanitaria, Volume 30, Issue 2, Pages 104-109
    March–April 2016

    88. Does integration of HIV and sexual and reproductive health services improve technical efficiency in Kenya and Swaziland? An application of a two-stage semi parametric approach incorporating quality measures
    Carol Dayo Obure, Rowena Jacobs, Lorna Guinness, Susannah Mayhew, Anna Vassall
    Social Science & Medicine, Volume 151, Pages 147-156
    February 2016

    87. The interplay between regulation and efficiency: Evidence from the Austrian hospital inpatient sector
    Margit Sommersguter-Reichmann, Adolf Stepan
    Socio-Economic Planning Sciences, Volume 52, Pages 10-21
    December 2015

    86. An integrated experiment for identification of best decision styles and teamworks with respect to HSE and ergonomics program: The case of a large oil refinery
    A. Azadeh, Z. Mokhtari, Z. Jiryaei Sharahi, M. Zarrin
    Accident Analysis & Prevention, Volume 85, Pages 30-44
    December 2015

    85. Eficiencia técnica de los hospitales públicos y de las empresas públicas hospitalarias de Andalucía
    Luis Herrero Tabanera, José Jesús Martín Martín, Ma del Puerto López del Amo González
    Gaceta Sanitaria, Volume 29, Issue 4, Pages 274-281
    July–August 2015

    84. Human development and data envelopment analysis: A structured literature review
    Enzo Barberio Mariano, Vinicius Amorim Sobreiro, Daisy Aparecida do Nascimento Rebelatto
    Omega, Volume 54, Pages 33-49
    July 2015

    83. An Efficient Taguchi Approach for the Performance Optimization of Health, Safety, Environment and Ergonomics in Generation Companies
    Ali Azadeh, Mohammad Sheikhalishahi
    Safety and Health at Work, Volume 6, Issue 2, Pages 77-84
    June 2015

    82. Combining stochastic DEA with Bayesian analysis to obtain statistical properties of the efficiency scores: An application to Greek public hospitals
    Panagiotis Mitropoulos, Μichael A. Talias, Ioannis Mitropoulos
    European Journal of Operational Research, Volume 243, Issue 1, Pages 302-311
    16 May 2015

    81. Selection of Waste Disposal Firms Using Grey Theory Based Multi-criteria Decision Making Technique
    Vikas Thakur, A. Ramesh
    Procedia - Social and Behavioral Sciences, Volume 189, Pages 81-90
    15 May 2015

    80. China's regional sustainability and diversified resource allocation: DEA environmental assessment on economic development and air pollution
    Toshiyuki Sueyoshi, Yan Yuan
    Energy Economics, Volume 49, Pages 239-256
    May 2015

    79. Evaluation of system efficiency using the Monte Carlo DEA: The case of small health areas
    Mercedes Torres-Jiménez, Carlos R. García-Alonso, Luis Salvador-Carulla, Vicente Fernández-Rodríguez
    European Journal of Operational Research, Volume 242, Issue 2, Pages 525-535
    16 April 2015

    78. A flexible ANN-GA-multivariate algorithm for assessment and optimization of machinery productivity in complex production units
    A. Azadeh, H. Shams Mianaei, S. M. Asadzadeh, M. Saberi, M. Sheikhalishahi
    Journal of Manufacturing Systems, Volume 35, Pages 46-75
    April 2015

    77. Congestion analysis to evaluate the efficiency and appropriateness of hospitals in Sicily
    Domenica Matranga, Francesca Sapienza
    Health Policy, Volume 119, Issue 3, Pages 324-332
    March 2015

    76. A dynamic benchmarking system for assessing the recovery of inpatients: Evidence from the neurorehabilitation process
    Xiaopeng Yang, Danheng Zheng, Tammy Sieminowski, Joseph C. Paradi
    European Journal of Operational Research, Volume 240, Issue 2, Pages 582-591
    16 January 2015

    75. Efficiency assessment of primary care providers: A conditional nonparametric approach
    José Manuel Cordero, Edurne Alonso-Morán, Roberto Nuño-Solinis, Juan F. Orueta, Regina Sauto Arce
    European Journal of Operational Research, Volume 240, Issue 1, Pages 235-244
    1 January 2015

    74. A framework for guiding the management of urban stream health
    H. K. Millington, J. E. Lovell, C. A. K. Lovell
    Ecological Economics, Volume 109, Pages 222-233
    January 2015

    73. Estimating the technical efficiency of health care systems: A cross-country comparison using the directional distance function
    Gang Cheng, Panagiotis D. Zervopoulos
    European Journal of Operational Research, Volume 238, Issue 3, Pages 899-910
    1 November 2014

    72. Economic and environmental performance of wastewater treatment plants: Potential reductions in greenhouse gases emissions
    María Molinos-Senante, Francesc Hernández-Sancho, Manuel Mocholí-Arce, Ramón Sala-Garrido
    Resource and Energy Economics, Volume 38, Pages 125-140
    November 2014

    71. Optimization of HSE in maintenance activities by integration of continuous improvement cycle and fuzzy multivariate approach: A gas refinery
    A. Azadeh, Z. Gaeini, B. Moradi
    Journal of Loss Prevention in the Process Industries, Volume 32, Pages 415-427
    November 2014

    70. How advanced are Italian regions in terms of public e-services? The construction of a composite indicator to analyze patterns of innovation diffusion in the public sector
    Luigi Reggi, Davide Arduini, Marco Biagetti, Antonello Zanfei
    Telecommunications Policy, Volume 38, Issues 5–6, Pages 514-529
    June–July 2014

    69. Photodynamic inactivation of enveloped virus in protein plasma preparations by solid-phase fullerene-based photosensitizer
    I. M. Belousova, I. M. Kislyakov, T. D. Muraviova, A. M. Starodubtsev, V. V. Zarubaev
    Photodiagnosis and Photodynamic Therapy, Volume 11, Issue 2, Pages 165-170
    June 2014

    68. Multi-scale enveloping order spectrogram for rotating machine health diagnosis
    Jinjiang Wang, Robert X. Gao, Ruqiang Yan
    Mechanical Systems and Signal Processing, Volume 46, Issue 1, Pages 28-44
    3 May 2014

    67. Analysis of productivity, efficiency and technological changes in hospital services in Ontario: How does case-mix matter?
    Hedayet Chowdhury, Valentin Zelenyuk, Audrey Laporte, Walter P. Wodchis
    International Journal of Production Economics, Volume 150, Pages 74-82
    April 2014

    66. Using DEA to estimate potential savings at GP units at medical specialty level
    Emmanuel Thanassoulis, Maria C. A. Silva Portela, Mike Graveney
    Socio-Economic Planning Sciences, Volume 48, Issue 1, Pages 38-48
    March 2014

    65. A new approach to assess the performance of the Brazilian National Immunization Program (NIP)
    M. S. Castro Lobo, M. P. Estellita Lins, I. A. Menegolla
    Socio-Economic Planning Sciences, Volume 48, Issue 1, Pages 49-56
    March 2014

    64. Measuring the Institutional Efficiency Using DEA and AHP: the Case of a Mexican University
    A. Altamirano-Corro, R. Peniche-Vera
    Journal of Applied Research and Technology, Volume 12, Issue 1, Pages 63-71
    February 2014

    63. A Data Envelopment Analysis for Evaluating Romania's Health System
    Cristian Popescu, Laura Asandului, Puiu Fatulescu
    Procedia - Social and Behavioral Sciences, Volume 109, Pages 1185-1189
    8 January 2014

    62. Current Trends of Economic Modelling of Sustainable Corporate Performance and Reporting – Review and Research Agenda
    Jiří Hřebíček, Jana Soukopová, Oldřich Trenz
    Procedia Economics and Finance, Volume 12, Pages 234-242

    61. The Efficiency of Healthcare Systems in Europe: A Data Envelopment Analysis Approach
    Laura Asandului, Monica Roman, Puiu Fatulescu
    Procedia Economics and Finance, Volume 10, Pages 261-268

    60. Continuous performance assessment and improvement of integrated HSE and maintenance systems by multivariate analysis in gas transmission units
    A. Azadeh, M. Madine, S. Motevali Haghighi, E. Mirzaei Rad
    Journal of Loss Prevention in the Process Industries, Volume 27, Pages 32-41
    January 2014

    59. Environmental efficiency and the impact of regulation in dryland organic vine production
    Ana M. Aldanondo-Ochoa, Valero L. Casasnovas-Oliva, Amaia Arandia-Miura
    Land Use Policy, Volume 36, Pages 275-284
    January 2014

    58. Health insurance reform and efficiency of township hospitals in rural China: An analysis from survey data
    Martine Audibert, Jacky Mathonnat, Aurore Pelissier, Xiao Xian Huang, Anning Ma
    China Economic Review, Volume 27, Pages 326-338
    December 2013

    57. The efficiency of government spending on health: Evidence from Europe and Central Asia
    Yi-Chung Hsu
    The Social Science Journal, Volume 50, Issue 4, Pages 665-673
    December 2013

    56. Identifying efficient dairy heifer producers using production costs and data envelopment analysis
    A. J. Heinrichs, C. M. Jones, S. M. Gray, P. A. Heinrichs, R. C. Goodling
    Journal of Dairy Science, Volume 96, Issue 11, Pages 7355-7362
    November 2013

    55. Environmental efficiency of alternative dairy systems: A productive efficiency approach
    L. Toma, M. March, A. W. Stott, D. J. Roberts
    Journal of Dairy Science, Volume 96, Issue 11, Pages 7014-7031
    November 2013

    54. A survey of DEA applications
    John S. Liu, Louis Y. Y. Lu, Wen-Min Lu, Bruce J. Y. Lin
    Omega, Volume 41, Issue 5, Pages 893-902
    October 2013

    53. International comparisons of the technical efficiency of the hospital sector: Panel data analysis of OECD countries using parametric and non-parametric approaches
    Yauheniya Varabyova, Jonas Schreyögg
    Health Policy, Volume 112, Issues 1–2, Pages 70-79
    September 2013

    52. An international comparison of efficiency of inpatient mental health care systems
    Valerie Moran, Rowena Jacobs
    Health Policy, Volume 112, Issues 1–2, Pages 88-99
    September 2013

    51. Combining DEA with location analysis for the effective consolidation of services in the health sector
    Panagiotis Mitropoulos, Ioannis Mitropoulos, Ioannis Giannikos
    Computers & Operations Research, Volume 40, Issue 9, Pages 2241-2250
    September 2013


    50. Analyzing the ambiguous relationship between efficiency, quality and patient satisfaction in healthcare services: The case of public hospitals in Turkey
    Mehmet Sahin Gok, Bulent Sezen
    Health Policy, Volume 111, Issue 3, Pages 290-300
    August 2013

    49. Electronic health record implementation and hospitals' total factor productivity
    Timothy R. Huerta, Mark A. Thompson, Eric W. Ford, William F. Ford
    Decision Support Systems, Volume 55, Issue 2, Pages 450-458
    May 2013

    48. The Government Expenditure Efficiency towards the Human Development
    Ahmad Danu Prasetyo, Ubaidillah Zuhdi
    Procedia Economics and Finance, Volume 5, Pages 615-622

    47. Analysis of hospital technical efficiency in China: Effect of health insurance reform
    Hsin-Hui Hu, Qinghui Qi, Chih-Hai Yang
    China Economic Review, Volume 23, Issue 4, Pages 865-877
    December 2012

    46. The measurement of relative efficiency of general practice and the implications for policy makers
    Ferruccio Pelone, Dionne Sofia Kringos, Luca Valerio, Alessandro Romaniello, Antonio Giulio de Belvis
    Health Policy, Volume 107, Issues 2–3, Pages 258-268
    October 2012

    45. Desempenho dos municípios paulistas: uma avaliação de eficiência da atenção básica à saúde
    Patrícia Siqueira Varela, Gilberto de Andrade Martins, Luiz Paulo Lopes Fávero
    Revista de Administração, Volume 47, Issue 4, Pages 624-637
    October–December 2012

    44. Uncover the predictive structure of healthcare efficiency applying a bootstrapped data envelopment analysis
    Arianna De Nicola, Simone Gitto, Paolo Mancuso
    Expert Systems with Applications, Volume 39, Issue 12, Pages 10495-10499
    15 September 2012

    43. Estimating the scope for savings in referrals and drug prescription costs in the general Practice units of a UK primary care trust
    Emmanuel Thanassoulis, Maria C. A. Silva Portela, Mike Graveney
    European Journal of Operational Research, Volume 221, Issue 2, Pages 432-444
    1 September 2012

    42. Performance assessment and optimization of HSE management systems with human error and ambiguity by an integrated fuzzy multivariate approach in a large conventional power plant manufacturer
    A. Azadeh, A. Hasani Farmand, Z. Jiryaei Sharahi
    Journal of Loss Prevention in the Process Industries, Volume 25, Issue 3, Pages 594-603
    May 2012

    41. Efficiency of the medical care industry: Evidence from the Italian regional system
    Roberto Ippoliti, Greta Falavigna
    European Journal of Operational Research, Volume 217, Issue 3, Pages 643-652
    16 March 2012

    40. A conditional nonparametric analysis for measuring the efficiency of regional public healthcare delivery: An application to Greek prefectures
    George E. Halkos, Nickolaos G. Tzeremes
    Health Policy, Volume 103, Issue 1, Pages 73-82
    November 2011

    39. The productive efficiency of Chinese hospitals
    Ying Chu Ng
    China Economic Review, Volume 22, Issue 3, Pages 428-439
    September 2011

    38. The economics of social computing: Some preliminary findings on healthcare organizations
    Ricky C. Leung, Kalyan S. Pasupathy
    Journal of Computational Science, Volume 2, Issue 3, Pages 253-261
    August 2011

    37. Analyzing performance in addiction treatment: An application of data envelopment analysis to the state of Maryland system
    Rafael A. Corredoira, Jon A. Chilingerian, John R. Kimberly
    Journal of Substance Abuse Treatment, Volume 41, Issue 1, Pages 1-13
    July 2011

    36. Determinants of efficiency in the provision of municipal street-cleaning and refuse collection services
    Bernardino Benito-López, María del Rocio Moreno-Enguix, José Solana-Ibañez
    Waste Management, Volume 31, Issue 6, Pages 1099-1108
    June 2011

    35. Improving energy use efficiency of canola production using data envelopment analysis (DEA) approach
    Seyed Hashem Mousavi-Avval, Shahin Rafiee, Ali Jafari, Ali Mohammadi
    Energy, Volume 36, Issue 5, Pages 2765-2772
    May 2011

    34. Efficiency measurement using independent component analysis and data envelopment analysis
    Ling-Jing Kao, Chi-Jie Lu, Chih-Chou Chiu
    European Journal of Operational Research, Volume 210, Issue 2, Pages 310-317
    16 April 2011

    33. A model to measure the efficiency of hospital performance
    María Caballer-Tarazona, Ismael Moya-Clemente, David Vivas-Consuelo, Isabel Barrachina-Martínez
    Mathematical and Computer Modelling, Volume 52, Issues 7–8, Pages 1095-1102
    October 2010

    32. Rural vs urban hospital performance in a ‘competitive’ public health service
    Javier Garcia-Lacalle, Emilio Martin
    Social Science & Medicine, Volume 71, Issue 6, Pages 1131-1140
    September 2010

    31. A two-stage DEA model to evaluate the overall performance of Canadian life and health insurance companies
    Zijiang Yang
    Mathematical and Computer Modelling, Volume 43, Issues 7–8, Pages 910-919
    April 2006

    30. Balancing efficiency of health services and equity of access in remote areas in Greece
    Nick Kontodimopoulos, Panagiotis Nanos, Dimitris Niakas
    Health Policy, Volume 76, Issue 1, Pages 49-57
    March 2006

    29. Measurement and sources of overall and input inefficiencies: Evidences and implications in hospital services
    Andrew Chen, Yuhchang Hwang, Benjamin Shao
    European Journal of Operational Research, Volume 161, Issue 2, Pages 447-468
    1 March 2005

    28. The utility of returns to scale in DEA programming: An analysis of Michigan rural hospitals
    Timothy W. Butler, Ling Li
    European Journal of Operational Research, Volume 161, Issue 2, Pages 469-477
    1 March 2005

    27. Hospital ownership and operating efficiency: Evidence from Taiwan
    Hsihui Chang, Mei-Ai Cheng, Somnath Das
    European Journal of Operational Research, Volume 159, Issue 2, Pages 513-527
    1 December 2004

    26. Health care regulation and the operating efficiency of hospitals: Evidence from Taiwan
    Hsihui Chang, Wen-Jing Chang, Somnath Das, Shu-Hsing Li
    Journal of Accounting and Public Policy, Volume 23, Issue 6, Pages 483-510
    November–December 2004

    25. Technical efficiency in the use of health care resources: a comparison of OECD countries
    Donna Retzlaff-Roberts, Cyril F Chang, Rose M Rubin
    Health Policy, Volume 69, Issue 1, Pages 55-72
    July 2004

    24. Technological change and efficiency in the presence of quasi-fixed inputs: A DEA application to the hospital sector
    Pierre Ouellette, Valérie Vierstraete
    European Journal of Operational Research, Volume 154, Issue 3, Pages 755-763
    1 May 2004

    23. Objective measurement of efficiency: applying single price model to rank hospital activities
    Enrique Ballestero, José A. Maldonado
    Computers & Operations Research, Volume 31, Issue 4, Pages 515-532
    April 2004

    22. Mesure de la performance économique en réanimation
    B. Dervaux, H. Leleu, É. Minvielle, P. Aegerter, B. Guidet
    Réanimation, Volume 12, Supplement 2, Pages s42-s46
    November 2003

    21. Technical efficiency-based selection of learning cases to improve forecasting accuracy of neural networks under monotonicity assumption
    Parag C. Pendharkar, James A. Rodger
    Decision Support Systems, Volume 36, Issue 1, Pages 117-136
    September 2003

    20. Advances in physician profiling: the use of DEA
    Janet M. Wagner, Daniel G. Shimshak, Michael A. Novak
    Socio-Economic Planning Sciences, Volume 37, Issue 2, Pages 141-163
    June 2003

    19. Application of DEA to medical clinics
    S. V. Birman, P. E. Pirondi, E. Y. Rodin
    Mathematical and Computer Modelling, Volume 37, Issues 9–10, Pages 923-936
    May 2003

    18. Social and health determinants of the efficiency of cotton farmers in Northern Côte d’Ivoire
    Martine Audibert, Jacky Mathonnat, Marie-Claire Henry
    Social Science & Medicine, Volume 56, Issue 8, Pages 1705-1717
    April 2003

    17. Technical and cost efficiency of oral health care provision in Finnish health centres
    Miika Linna, Anne Nordblad, Matti Koivu
    Social Science & Medicine, Volume 56, Issue 2, Pages 343-353
    January 2003

    16. A variable returns to scale data envelopment analysis model for the joint determination of efficiencies with an example of the UK health service
    P. F. Tsai, C. Mar Molinero
    European Journal of Operational Research, Volume 141, Issue 1, Pages 21-38
    16 August 2002

    15. La Atención Primaria de Salud: descentralización y eficiencia
    M. Pinillos, F. Antoñanzas
    Gaceta Sanitaria, Volume 16, Issue 5, Pages 401-407

    14. Comparisons and evaluations of alternative approaches to the treatment of congestion in DEA
    W. W. Cooper, Bisheng Gu, Shanling Li
    European Journal of Operational Research, Volume 132, Issue 1, Pages 62-74
    1 July 2001

    13. Greek hospitals: how well their resources are used
    Dimitris I. Giokas
    Omega, Volume 29, Issue 1, Pages 73-83
    February 2001

    12. An analysis of the financial performance of defense business segments using data envelopment analysis
    William F. Bowlin
    Journal of Accounting and Public Policy, Volume 18, Issues 4–5, Pages 287-310
    Winter 1999

    11. Determinants of Hospital Efficiency: the Case of Central Government-owned Hospitals in Taiwan
    Hsi-hui Chang
    Omega, Volume 26, Issue 2, Pages 307-317
    1 April 1998

    10. Siting efficiency of long-term health care facilities
    HomeéF. E. Shroff, Th. R. Gulledge, Kingsley E. Haynes, Molly K. O'Neill
    Socio-Economic Planning Sciences, Volume 32, Issue 1, Pages 25-43
    March 1998

    9. The Economic and Social Performance of Nations: Efficiency and Returns to Scale
    Socio-Economic Planning Sciences, Volume 31, Issue 3, Pages 191-204
    September 1997

    8. A data envelopment analysis approach to clustering operating units for resource allocation purposes
    E. Thanassoulis
    Omega, Volume 24, Issue 4, Pages 463-476
    August 1996

    7. A comparison of data envelopment analysis and ratio analysis as tools for performance assessment
    E. Thanassoulis, A. Boussofiane, R. G. Dyson
    Omega, Volume 24, Issue 3, Pages 229-244
    June 1996

    6. Efficiency of hospital service production in local markets: The balance sheet of U.S. medical armament
    Yasar A. Ozcan
    Socio-Economic Planning Sciences, Volume 29, Issue 2, Pages 139-150
    June 1995

    5. Evaluating physician efficiency in hospitals: A multivariate analysis of best practices
    Jon A. Chilingerian
    European Journal of Operational Research, Volume 80, Issue 3, Pages 548-574
    2 February 1995

    4. Exploring output quality targets in the provision of perinatal care in England using data envelopment analysis
    E Thanassoulis, A Boussofiane, R. G Dyson
    European Journal of Operational Research, Volume 80, Issue 3, Pages 588-607
    2 February 1995

    3. Getting something for nothing: Estimating service level improvements possible in hospitals
    Richard C. Morey, Donna L. Retzlaff-Roberts, David J. Fine
    International Transactions in Operational Research, Volume 1, Issue 3, Pages 285-292
    July 1994

    2. Performance assessment for the English community dental services screening programme
    M. Gietzmann
    Management Accounting Research, Volume 1, Issue 2, Pages 125-137
    June 1990

    1. Models, extensions, and applications of data envelopment analysis: A selected reference set
    Lawrence M. Seiford
    Computers, Environment and Urban Systems, Volume 14, Issue 2, Pages 171-175


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