A new examination of hospital performance after healthcare reform in Turkey: sensitivity and quality comparisons

The implementation of Health Transformation Program in Turkey brought opportunities to obtain new variables such as performance scores and service quality standards. The objectives of this study are: 1) perform sensitivity analysis to compare new variables to previous studies, 2) explore the effect of newly obtained quality scores on efficiency level. The study utilised data from 245 Ministry of Health general hospitals in 2008. Two models with old and new output variables were compared in sensitivity analysis. Then, a model which included quality scores was evaluated to test any evidence about efficiency and quality trade-offs. The sensitivity analysis showed that there was no significant difference between the two models. Quality variable added model have had no significant effect on existing models. The efficient hospitals in both models stayed efficient, however, quality scores had no effect on efficient hospitals, but some of the inefficient hospitals have increased their scores and became efficient.