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- Exploring the potential of Data Envelopment Analysis for enhancing pay-for-performance programme design in primary health carePublication . Kalinichenko, Olena; Amado, Carla; Santos, SérgioIn recent years, implementation of pay-for-performance (P4P) programmes in health care has become a worldwide initiative. However, most P4P programmes incorporate systems of Performance Indicators (PI) without accounting for trade-offs between indicators. This article has two objectives: (1) to develop a Data Envelopment Analysis (DEA) methodology for performance assessment of primary care providers; and (2) to propose an innovative methodology for P4P contracting based on the DEA assessment results. To achieve the first objective, we modify the standard DEA model to account for the necessary relations between the weights attributed to each PI and domain of performance and to account for the effect of the relevant environmental variables. To achieve the second objective, we combine relative and absolute performance assessments in the elaboration of several bases for reward, and then we link these assessments to a system of graduated rewards. A benchmarking programme is also proposed to contribute to the dissemination of best practices. This article contributes to the literature by proposing an enhanced methodology for performance assessment of primary care providers which can form the basis for P4P rewards planning. The applicability and advantages of the proposed methodology are illustrated with data from Portugal, but it can easily be adapted to different sets of PIs or domains, making it relevant for performance assessment and for P4P reward setting in other contexts and countries.
- Comparing the quality of life of cities that gained and lost population: An assessment with DEA and the Malmquist indexPublication . Amado, Carla; Barreira, Ana; Santos, Sérgio; Guimaraes, Maria HelenaThis study compares the quality of life (QoL) of cities that lost population with that of cities that gained population. A unique dataset composed of observations for 11 dimensions of QoL for all mainland Portuguese cities is used. By employing a non-parametric approach (data envelopment analysis), and by using a Malmquist-type index, this study identifies differences in QoL between the group of cities that lost population and the group of cities that gained population, as well as differences within each group. Despite the heterogeneity in cities that shrunk, this group presents, on average, higher QoL than cities that have grown.