Care of the Elderly
Measuring the productive efficiency and clinical quality of institutional long-term care for the elderly
Juha Laine,
Miika Linna,
Unto Häkkinen,
Anja Noro,
Corresponding Author
Juha Laine
Centre for Health Economics at Stakes—CHESS, Finland
STAKES, Lintulahdenkuja 4, P.O. Box 220, FIN-00531 Helsinki, Finland===Search for more papers by this authorMiika Linna
Centre for Health Economics at Stakes—CHESS, Finland
Search for more papers by this authorUnto Häkkinen
Centre for Health Economics at Stakes—CHESS, Finland
Search for more papers by this authorJuha Laine,
Miika Linna,
Unto Häkkinen,
Anja Noro,
Corresponding Author
Juha Laine
Centre for Health Economics at Stakes—CHESS, Finland
STAKES, Lintulahdenkuja 4, P.O. Box 220, FIN-00531 Helsinki, Finland===Search for more papers by this authorMiika Linna
Centre for Health Economics at Stakes—CHESS, Finland
Search for more papers by this authorUnto Häkkinen
Centre for Health Economics at Stakes—CHESS, Finland
Search for more papers by this authorAbstract
The authors consider the association between productive efficiency and clinical quality in institutional long-term care for the elderly. Cross-sectional data were collected from 122 wards in health-centre hospitals and residential homes in Finland in 2001. Productive efficiency was measured in terms of technical efficiency, which was defined as the unit's distance from the (best practice) production frontier. The analysis employed stochastic production frontier estimation, where technical inefficiency in the production function was specified to be a function of ward characteristics and clinical quality of care. Several quality indicators based on the Resident Assessment Instrument, such as prevalence of pressure ulcers and depression with no treatment, were used in the analysis. The results did not reveal systematic association between technical efficiency and clinical quality of care. However, the prevalence of pressure ulcers, indicating poor quality of care was associated with technical efficiency, a fact which highlights the importance of including quality measures in the assessment of efficiency in long-term care. Copyright © 2004 John Wiley & Sons, Ltd.
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