Efficiency in chronic illness care coordination: public-private collaboration models vs. traditional management
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(2020) 20:1044
RESEARCH ARTICLE
Open Access
Efficiency in chronic illness care coordination: public-private collaboration models vs. traditional management José Luis Franco Miguel1*† , Carmen Fullana Belda1†, José Manuel Cordero Ferrera2†, Cristina Polo2† and Roberto Nuño-Solinís3†
Abstract Background: The aim of this paper is to analyze the differences in the coordination of chronic illness care between the different public hospital management models coexisting in the Spanish region of Madrid (25 hospitals) during the period 2013–2017. Methods: The performance of hospitals might be affected by the characteristics of the population they serve and, therefore, this information should be taken into account when estimating efficiency measures. For this purpose, we apply the nonparametric Data Envelopment Analysis (DEA) conditioned to some contextual variables and adapted to a dynamic framework, so that we can assess hospitals during a five-year period. The outputs considered are preventable hospitalizations, readmissions for heart failure and readmissions for chronic obstructive pulmonary disease, whereas the inputs considered are the number of beds, personnel (physicians and other healthcare professionals) and total expenditure on goods and services. Results: The results suggest that the level of efficiency demonstrated by the public-private collaboration models of hospital management is higher than traditionally managed hospitals throughout the analyzed period. Nevertheless, we notice that efficiency differences among hospitals are significantly reduced when contextual factors were taken into account. Conclusions: Hospitals managed under public-private collaboration models are more efficient than those under traditional management in terms of chronic illness care coordination, being this difference attributable to more agile and flexible management under the collaborative models. Keywords: Care coordination, Efficiency, Hospital management, Data envelopment analysis, Chronic disease management
Background The welfare state has led to the establishment of very complex health systems with high care fragmentation [1]. In this context, one of the main priorities worldwide * Correspondence: [email protected] † José Luis Franco Miguel, Carmen Fullana Belda, José Manuel Cordero Ferrera, Cristina Polo, and Roberto Nuño-Solinís contributed equally to this work. 1 Comillas Pontifical University, C/ Alberto Aguilera 23, 28015 Madrid, Spain Full list of author information is available at the end of the article
is improving the quality, efficiency and coordination of the treatment for chronic conditions. In the specific case of the Spanish health system, this task is assumed by the regional governments, as they are responsible for the provision and management of healthcare services. In the last decade they have begun to implement different coordination of care strategies, primarily focused on integrated care innovations for patients with chronic conditions [2].
© The Author(s). 2020 Open Access This article is licensed
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