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- Performance evaluation in Portuguese electricity distribution utilitiesPublication . Santos, Sérgio Pereira dos; Amado, Carla; Rosado, Joaquim; Rodrigues, Paulo M. M.; Santos, Sérgio Pereira dos; Ferreira, F. A. F.The Portuguese electricity system has undergone a major transformation in recent years due to its integration in the liberalised Iberian market. The group responsible for the electricity generation and distribution in Portugal (EDP) has been consistently focusing in service quality and efficiency. In the last 3 years, a stringent cost cutting and efficiency improvement program was implemented. This paper conducted a Data Envelopment Analysis (DEA) study to measure the relative efficiency of the 14 electricity distribution units belonging to EDP. A dynamic analysis using Malmquist Indices was also conducted in order to evaluate the changes in productivity from 2002 to 2005. Our results show that, on average, we can find evidence of 2% productivity gains in the Portuguese electricity distribution sector. Furthermore, we found evidence of significant discrimination among regional areas, suggesting that a benchmarking exercise based on the DEA results could be valuable for performance improvement in some regions.
- Assessing the efficiency of mother-to-child HIV prevention in low- and middle-income countries using data envelopment analysisPublication . Santos, Sérgio Pereira dos; Amado, Carla; Santos, MauroAIDS is one of the most significant health care problems worldwide. Due to the difficulty and costs involved in treating HIV, preventing infection is of paramount importance in controlling the AIDS epidemic. The main purpose of this paper is to explore the potential of using Data Envelopment Analysis (DEA) to establish international comparisons on the efficiency of implementation of HIV prevention programmes. To do this we use data from 52 low- and middle-income countries regarding the prevention of mother-to-child transmission of HIV. Our results indicate that there is a remarkable variation in the efficiency of prevention services across nations, suggesting that a better use of resources could lead to more and improved services, and ultimately, prevent the infection of thousands of children. These results also demonstrate the potential strategic role of DEA for the efficient and effective planning of scarce resources to fight the epidemic.
- Performance assessment of primary health care services using data envelopment analysis and the quality-adjusted malmquist indexPublication . De Mattos Capeletti, Nuno; Amado, Carla; Santos, SérgioPrimary Health Care (PHC) is intended to provide a comprehensive response to the patients' health needs. Considering the increasing demand to optimise the use of the available resources while keeping a high-quality standard, it is essential to investigate the health services' performance. We propose a methodology based on the Data Envelopment Analysis (DEA) technique, examining the volume of activities performed and considering the impact of these activities by using a quality indicator directly related to care outcomes. To perform a longitudinal analysis and observe the changes in quality separately, a Quality-Adjusted Malmquist Productivity Index is implemented. The methodology is illustrated by analysing the performance and the evolution in productivity and quality of the primary care services delivered by the municipalities of the Brazilian state of Santa Catarina from 2008 to 2014. Our findings reinforce the view that adequate planning and structuring of PHC services must consider not only the volume of activity but also the impact of the services delivered.
- Formative evaluation of electricity distribution utilities using data envelopment analysisPublication . Santos, Sérgio Pereira dos; Amado, Carla; Rosado, JoaquimThe use of Data Envelopment Analysis (DEA) in the electricity distribution sector has been prolific in the number of papers published in research journals. However, while numerous studies have been documented, they have mostly been summative. Their aim has been predominantly descriptive and classificatory. This paper argues that evaluations of a formative nature are more effective than summative studies in promoting a better understanding of the structures and processes of electricity distribution utilities and, consequently, are more appropriate to contribute to performance improvement. To illustrate the use of DEA for formative evaluation, and highlight some of the difficulties of using DEA in practice, this paper compares the cost-efficiency of the Portuguese electricity distribution companies from 2002 to 2006. A dynamic analysis using Malmquist Indices is also conducted in order to evaluate the changes in productivity over this period. Our analysis shows that the application of DEA for formative purposes meets some difficulties. In particular it shows that while the modelling of productivity/efficiency scores using DEA is relatively straightforward, it is comparatively more difficult to develop models that are economically valid and that produce results with face validity. On the basis of the insights derived from this analysis, the paper provides some recommendations regarding the successful application of DEA for performance improvement.
- Using data envelopment analysis for formative evaluation of radiotherapy services: an exploratory studyPublication . Santos, Sérgio Pereira dos; Amado, Carla; Tànfani, E.; Testi, A.Radiotherapy is an important element in cancer treatment, both for cure and for palliation. Whilst performance measurement and performance improvement are major concerns of most radiotherapy departments, measuring and managing the performance of these departments is particularly challenging. This article critically explores the use of Data Envelopment Analysis (DEA) for formative evaluation of radiotherapy services. Following a review of the literature, a conceptual framework for performance assessment of radiotherapy departments is developed and its use illustrated. Our empirical analysis uses mostly data from 2007 and compares the fairness of access to services, technical efficiency, and clinical effectiveness across the English strategic health authorities. The analysis shows that whilst the application of DEA in this context meets some difficulties, it also has great potential by providing valuable information to improve services, especially if used in a formative mode.
- Measuring active ageing: a Data Envelopment Analysis approachPublication . Amado, Carla; São José, José; Santos, Sérgio Pereira dosThe 'Active Ageing Index' was created with the purpose of helping policy makers implement and monitor active ageing policies both at European and national levels. However, this index has not fully achieved this purpose. In this article we propose a methodological approach based on Data Envelopment Analysis to enhance the measurement of active ageing in the European Union countries. We use a model with 22 indicators grouped into four domains. By introducing different types of virtual weight restrictions, we combine normative judgements with an optimisation procedure, showing each country in the best possible light. Furthermore, we undertake a sensitivity analysis regarding the effect of varying the limits of the relative contribution of each domain.The results show that the proposed approach has great potential in this context, allowing the comparison of countries and the identification of relevant targets and benchmarks, even when there is uncertainty regarding the relative importance of the indicators and domains considered. For most countries, the results are robust regarding different levels of flexibility for the relative contribution of each domain. We identify six countries that represent relevant benchmarks for the underperforming countries. The underperforming countries have some potential for improvement in terms of active ageing, whilst respecting their preferences and specificities for the processes that can be used to actively age. Based on a flexible evaluation of the countries, we contribute to develop a better tool to guide the European Union countries towards the formulation and monitoring of more effective policy measures to promote active ageing. (C) 2016 Elsevier B.V. All rights reserved.
- Integrating the data envelopment analysis and the balanced scorecard approaches for enhanced performance assessmentPublication . Amado, Carla; Santos, Sérgio Pereira dos; Marques, P.This article presents the development of a conceptual framework which aims to assess Decision Making Units (DMUs)from multiple perspectives. The proposed conceptual framework combines the Balanced Scorecard(BSC)method with the non-parametric technique known as Data Envelopment Analysis (DEA) by using various interconnected models which try to encapsulate four perspectives of performance (financial, customers, internal processes,learning and growth). The practical relevance of the conceptual model has been tested by using it to assess the performance of DMUs in a multinational company which operates in two business areas.Various models were developed with the collaboration of the directors of the company in order to conceive an appropriate and consensual framework, which may provide useful information for the company.The application of the conceptual framework provides structured information regarding the performance of each DMU(from multiple perspectives)and ways to improve it.By integrating the BSC and the DEA approaches this research helps to identify where there is room for improving organisational performance and points out opportunities for reciprocal learning between DMUs.In doing so,this article provides a set of recommendations relating to the successful application of DEA and its integration with the BSC,in order to promote a continuous learning process and to bring about improvements in performance.
- On the need for reform of the portuguese judicial system - does data envelopment analysis assessment support it?Publication . Santos, Sérgio Pereira dos; Amado, CarlaThe Portuguese judicial system has attracted considerable criticism in recent years and demands for reforms have gained prominence. By using the Data Envelopment Analysis technique and focusing on the performance of 223 Portuguese first instance courts during the period of 2007 to 2011, this research has found evidence that supports some of this criticism and justifies the calls for reforms, better performance and accountability of the judicial system. In particular, our results found a sector with considerable scope for improvement with less than 16 percent of the 223 courts analysed making an efficient use of their resources in each year and with only one third of the courts being considered efficient in at least one of the five years assessed. Whilst the results suggest that improvement can be achieved with better case management, scale factors also seem to play an important role in explaining inefficiency, with most of the inefficient courts being smaller than optimal and with smaller courts being, on average, less efficient than larger ones. The existence of a statistically significant relationship between courts’ efficiency and size was confirmed by the Mann-Whitney test. These results indicate considerable scope for improvement and that some of the planned reforms are timely and seem well targeted. However, the results also suggest that efficiency increases matching peers’ best practices are not enough to sustainably reduce the prevailing judicial backlog and length of court proceedings in a considerable number of courts. Major changes in the capacity and/or functioning of the Portuguese judicial system might also be required.
- Exploring the use of DEA for formative evaluation in primary care: an application to EnglandPublication . Amado, CarlaEste artigo discute a avaliação do desempenho formativa no contexto da prestação de cuidados primários. Na primeira parte do artigo, discutimos o contexto do trabalho: a prestação de cuidados primários em Inglaterra. Nesta introdução discutimos também os objectivos deste estudo. Na segunda parte do artigo fazemos uma discussão da metodologia proposta para medir a eficiência e a efectividade organizacional. A técnica não paramétrica de análise de dados conhecida por Data Envelopment Analysis (DEA) é introduzida. Na terceira parte do artigo fazemos uma revisão da literatura nesta área. Os estudos publicados que usam o DEA para comparar centros de saúde são revistos de uma forma critica. Esta revisão da literatura permite identificar as deficiências dos estudos até agora levados a cabo nesta área, no sentido de elaborar um novo framework para comparação de centros de saúde.
- Um estudo exploratório sobre o potencial do Data Envelopment Analysis para avaliar a equidade de acesso em cuidados de saúde primáriosPublication . Ribeiro, A. R. F.; Amado, Carla; Santos, Sérgio Pereira dosThis article focuses on the assessment of equity of access to primary health care in Portugal and has three specific objectives: (1) to present a conceptual model for performance evaluation in primary health care, (2) to evaluate the equity of access in a sample of Portuguese health centers groupings (ACES), (3) to analyze the relationship between the level of equity of access and other variables theoretically related to equity of access in primary care. We use the technique Data Envelopment Analysis to compare equity of access. The level of equity of access across the ACES compared varies between 56% and 100% with an average of 82%. Seven ACES (17% of the total) have a relative level of 100% of equity of access. These results suggest that the geographical distribution of human resources in the ACES compared could be improved in order to meet the satisfaction of the local health needs in each ACES. Based on correlation analysis, it was concluded that the relative level of equity of access is positively correlated with the rate of use of hospital emergency rooms, suggesting effects of transferring demand from health centers to hospitals.
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