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A performance measurement framework combining DEA and balanced scorecard for the UK health sector

Published Online:pp 257-278https://doi.org/10.1504/IJOR.2011.042916

Balanced scorecard (BSC) and data envelopment analysis (DEA) are two popular performance measurement tools for measuring performance of organisational units. However, several shortcomings of the two tools have also been highlighted. A BSC readily provides complex business information to managers at a glance and facilitates improved decision-making. However, BSC in its original form does not include any objective methodology, and when many perspectives are considered in the BSC framework with several measures in each perspective, the ability of managers to comprehend the huge volume of information becomes limited. We propose in this paper that BSC can be advantageously integrated with DEA. Such integration can help overcome some of the shortcomings of the latter, such as the discriminating ability and the problem of a firm with extraordinary performance in terms of only one measure achieving high performance scores. The proposed integration of BSC with DEA, called the balanced efficiency assessment method in this paper, is applied to balanced performance evaluation of health authorities (HAs) in the UK. Six BSC perspectives are employed to evaluate the performance of HAs. Different sets of inputs and outputs are used in a DEA model for each perspective, and the DEA performance scores are aggregated across all the perspectives using arithmetic mean. It is found that there is no single HA that performs consistently well in terms of all the six perspectives and that a HA that performs well in terms of one perspective does not seem to be doing well in terms of others.

Keywords

BSCs, balanced scorecards, DEA, data envelopment analysis, healthcare hospitals, performance measurement

References

  • 1. A. Abran, L. Buglione, '‘A multidimensional performance model for consolidating balanced scorecards’' Advances in Engineering Software (2003) Google Scholar
  • 2. C.A.F. Amado, R.G. Dyson, '‘On comparing the performance of primary care providers’' European Journal of Operational Research (2008) Google Scholar
  • 3. J.M. Bates, D.B. Baines, D.K. Whynes, '‘Measuring the efficiency of prescribing by general practitioners’' Journal of the Operational Research Society (1996) Google Scholar
  • 4. S.M. Campbell, M.O. Roland, J.A. Quayle, S.A. Buetow, P.G. Shekelle, '‘Quality indicators for general practice: which ones can general practitioners and health authority managers agree are important and how useful are they?’' Journal of Public Health Medicine (1998) Google Scholar
  • 5. L-C. Chang, '‘The NHS performance assessment framework as a balanced scorecard approach: limitations and implications’' Int. J. Public Sector Management (2007) Google Scholar
  • 6. A. Charnes, W.W. Cooper, E. Rhodes, '‘Measuring efficiency of decision-making units’' European Journal of Operational Research (1978) Google Scholar
  • 7. T-Y. Chen, L-H. Chen, '‘DEA performance evaluation based on BSC indicators incorporated’' Int. J. Productivity and Performance Management (2007) Google Scholar
  • 8. T-Y. Chen, O.S. Yu, '‘Performance evaluation of selected US utility commercial lighting demand-side management programs’' Energy Engineering (1997) Google Scholar
  • 9. X-Y. Chen, K. Yamauchi, K. Kato, A. Nishimura, K. Ito, '‘Using the balanced scorecard to measure Chinese and Japanese hospital performance’' Int. J. Healthcare Quality Assurance (2006) Google Scholar
  • 10. T. Coelli, '‘A guide to DEAP version 2.1: a data envelopment analysis (computer) program’' (1996) Google Scholar
  • 11. W.W. Cooper, L.M. Seiford, K. Tone, Data Envelopment Analysis: A Comprehensive Text with Models, Applications, References and DEA-Solver Software (2007) Google Scholar
  • 12. J. Doyle, R. Green, '‘Data envelopment analysis and multiple criteria decision-making’' Omega (1993) Google Scholar
  • 13. R.G. Dyson, R. Allen, A.S. Camanho, V.V. Podinovski, C.S. Sarrico, E.A. Shale, '‘Pitfalls and protocols in DEA’' European Journal of Operational Research (2001) Google Scholar
  • 14. H. Eilat, B. Golany, A. Shtub, '‘Constructing and evaluating balanced portfolios of R&D projects with interactions: a DEA based methodology’' European Journal of Operational Research (2006) Google Scholar
  • 15. H. Eilat, B. Golany, A. Shtub, '‘R&D project evaluation: an integrated DEA and balanced scorecard approach’' Omega (2008) Google Scholar
  • 16. A. Giuffrida, H. Gravelle, '‘Measuring performance in primary care: econometric analysis and DEA’' Applied Economics (2001) Google Scholar
  • 17. G. Houghton, A. Rouse, '‘Are NHS primary care performance indicator scores acceptable as markers of general practitioner quality?’' British Journal of General Practice (2004) Google Scholar
  • 18. R.S. Kaplan, D.P. Norton, '‘The balanced scorecard – measure that drive performance’' Harvard Business Review (1992) Google Scholar
  • 19. R.S. Kaplan, D.P. Norton, '‘Putting the balanced scorecard to work’' Harvard Business Review (1993) Google Scholar
  • 20. M. Kennerley, A. Neeley, A. Neeley Ed., '‘Performance measurement frameworks: a review’' Business Performance Measurement: Theory and Practice (2006) Google Scholar
  • 21. A. Lakhani, J. Coles, D. Eayres, C. Spence, B. Rachet, '‘Creative use of existing clinical and health outcomes to assess NHS performance in England: Part 1 – performance indicators closely linked to clinical care’' British Medical Journal (2005) Google Scholar
  • 22. M.G. Lipe, S.E. Salterio, '‘The balanced scorecard: judgemental effects of common and unique performance measures’' The Accounting Review (2000) Google Scholar
  • 23. V. Nagar, M.V. Rajan, '‘Measuring customer relationships: the case of the retail banking industry’' Management Science (2005) Google Scholar
  • 24. A. Neely, M. Gregory, K. Platts, '‘Performance measurement system design – a literature review and research agenda’' Int. J. Operations and Production Management (1995) Google Scholar
  • 25. NHS Executive, Quality and Performance in the NHS Performance Indicators: July 2000 (2000) Google Scholar
  • 26. S. Purbey, K. Mukherjee, C. Bhar, '‘Performance measurement system for healthcare processes’' Int. J. Productivity and Performance Measurement (2007) Google Scholar
  • 27. R. Ramanathan, An Introduction to Data Envelopment Analysis: A Tool for Performance Measurement (2003) Google Scholar
  • 28. R. Ramanathan, '‘Operations assessment of hospitals in the Sultanate of Oman’' Int. J. Operations and Production Management (2005) Google Scholar
  • 29. S.C. Ray, '‘Resource-use efficiency in public schools: a study of Connecticut data’' Management Science (1991) Google Scholar
  • 30. V. Rich, '‘Interpreting the balanced scorecard: an investigation into performance analysis and bias’' Measuring Business Excellence (2007) Google Scholar
  • 31. R.C. Rickards, '‘Setting benchmarks and evaluating balanced scorecards with data envelopment analysis’' Benchmarking: An International Journal (2003) Google Scholar
  • 32. P. Rouse, M. Purrerill, D. Ryan, '‘Integrated performance measurement design: insights from an application in aircraft maintenance’' Management Accounting Research (2002) Google Scholar
  • 33. T.L. Saaty, The Analytic Hierarchy Process (1980) Google Scholar
  • 34. L.M. Seiford, J. Zhu, '‘Profitability and marketability of the top 55 US commercial banks’' Management Science (1999) Google Scholar
  • 35. A. Soteriou, S.A. Zenios, '‘Operations, quality, and profitability in the provision of banking services’' Management Science (1999) Google Scholar
  • 36. A.H.C. Tsang, A.K.S. Jardine, H. Kolodny, '‘Measuring maintenance performance: a holistic approach’' Int. J. Operations and Production Management (1999) Google Scholar
  • 37. M. Vasilloglou, D. Giokas, '‘Study of the relative efficiency of bank branches: an application of data envelopment analysis’' Journal of the Operational Research Society (1990) Google Scholar
  • 38. J-C. Wang, '‘Corporate performance efficiency investigated by data envelopment analysis and balanced scorecard’' The Journal of American Academy of Business (2006) Google Scholar