Dynamic Network DEA Approach for Evaluating Hospital Performance in the Healthcare Sector

This study simultaneously evaluates the performance of Training and Research Hospitals in Turkey for 2018 and 2019 at both the overall and sub-unit levels. Traditional Data Envelopment Analysis (DEA) models treat decision-making units as a single process, often neglecting internal structures. To overcome this limitation, the study employs the Dynamic Network Data Envelopment Analysis (DN-DEA) approach, which incorporates two interrelated sub-units: administrative services and medical care services. This enables independent evaluation of sub-units, without disregarding their mutual connections. The results show that hospitals efficient in both sub-units are classified as fully efficient. However, some hospitals not on the overall efficiency frontier demonstrated full efficiency in specific sub-units. For instance, H12 and H33 were efficient in administrative services, while hospitals such as H14, H17, H21, and H23 attained efficiency only in medical services. In 2018, the budget account balance was identified as the most critical input requiring reduction (72.7%) for inefficient hospitals, followed by the number of resident physicians (50.7%). In 2019, the budget balance remained the top priority for reduction (62.1%), while the insufficient reduction in resident physicians caused the required adjustment to rise to 52.3%. In light of these findings, it is recommended that hospital performance management consider not only overall efficiency scores but also sub-unit-level analyses. Furthermore, the study emphasizes that improvements in budget management and human resource planning may play a critical role in enhancing hospital efficiency.