Measuring performance change in Scottish hospitals: a Malmquist and times-series approach

We applied a Malmquist approach to assess levels and change of efficiency and technology in Scottish hospitals. The biased corrected Malmquist index, the efficiency change index, and the technology change index appear to vacillate improving and regressing over the four time intervals with the overall indices (2003–2007). We did not detect steady movement in these measures in one way or another, but we have advanced the literature by employing a time-series trend analysis to gauge changes without the obfuscation by white noise. By using regression, we found a definite and statistically significant trend of improvement, from the first period as it affects the final period of the performance measures. This lends some encouragement to Scottish hospital management that they are doing more with less—which is particularly relevant in times of more austerity in government spending but without a decrease in demand. A longer time period would be necessary in order to ascertain if improvements would be achieved, overall, even with increases and decreases in performance during intervening time periods.