Output-oriented technical efficiency

Divides the output a unit actually produces by the maximum output that the estimated frontier says is feasible from the same inputs. The shortfall from 1 is the proportion by which output could rise without extra inputs. It measures waste in the production process only and says nothing about whether the right services are produced.

Signature

TE_O = y / y_max
Inputs
InputsDefinitionUnit
yOutput the unit produced in the period, such as consultations or case-mix adjusted episodesunits of output per period
y_maxOutput on the estimated frontier for the unit's observed inputs, greater than zerounits of output per period
Output
TE_OObserved output as a share of the maximum feasible output from the same inputsscore from 0 to 1

Function

Frontier efficiency measurement function

Maps a decision-making unit's observed inputs, outputs and costs, and a production or cost frontier estimated for comparable units, to efficiency scores between 0 and 1. A score of 1 places the unit on the estimated frontier. The frontier itself is usually estimated by data envelopment analysis, a linear programming method, or by stochastic frontier analysis, a parametric method that separates inefficiency from random noise.

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Implementations

  • Excel

    Technical efficiency score from frontier output

    With observed output in ObservedOutput and frontier output in FrontierOutput, Excel returns the score.

    =ObservedOutput/FrontierOutput

Assumptions

  • Frontier estimated from comparable units

    y_max comes from a frontier estimated for units with comparable case mix, quality and technology. It is the best performance observed in the data under the model, not an absolute maximum.

  • Output measured consistently

    Outputs are defined and adjusted in the same way for every unit, so that a higher count reflects more of the same service and not easier patients or lower quality.

Worked examples

  • Outpatient clinic below its frontier

    A clinic delivers 10,000 consultations a year, and the frontier estimated from comparable clinics puts the maximum from its staff and budget at 12,500. Output-oriented technical efficiency is 0.8. The figures are illustrative.

    y = 10000; y_max = 12500; TE_O = 0.8

Common errors

  • Reading a productivity ratio as technical efficiency

    Consultations per pound compares output with input but not with the maximum feasible output, so a higher ratio can reflect easier patients, lower quality or omitted inputs rather than less waste.

Sources

  • Definitions of technical efficiency in health care

    Palmer S, Torgerson DJ. Economic notes: definitions of efficiency. BMJ. 1999;318(7191):1136. Technical efficiency as the maximum possible improvement in outcome from a set of resource inputs; productive and allocative efficiency defined in health outcome terms.

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  • Farrell measures of efficiency

    Farrell MJ. The measurement of productive efficiency. Journal of the Royal Statistical Society, Series A (General). 1957;120(3):253-290. Technical efficiency measured against an efficient frontier estimated from observed units.

    View source →

Canonical Identity

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