The Learning Curve for Coronary Surgery: An Stochastic Frontier Model Approach

Posted: 21 Jun 2007

See all articles by Miguel Angel Negrin

Miguel Angel Negrin

University of Las Palmas de Gran Canaria - Department of Quantitative Methods in Economics

Jaime Pinilla

University of Las Palmas de Gran Canaria

Francisco J. Vázquez-Polo

University of Las Palmas de Gran Canaria - Department of Quantitative Methods in Economics

Carles Murillo

Universitat Pompeu Fabra

Abstract

Objective: To study the learning curve associated with independent practice in coronary artery surgery.

Participants: 123 patients undergoing coronary artery surgery for the first time between January 2001 and April 2002, who were operated on by 6 surgeons.

Methods: Stochastic frontier cost funtion and an inefficiency model. The analysis of the data was carried out as an individual approach in order to estimate the influence of individual effects. Considering each patient as if it was the result of a small production line enables us to evaluate variations between different inputs. We assume that each patient enters in the hospital and faces a cost function that not only does it depend on resources used, but also on patient-specific characteristic and circumstances that might arise during surgery. The principal added value of this paper consists in the stochastic frontier model approach. The stochastic frontier approach enables us to measure the efficiency derived from the learning process.

Results: The results obtained also suggest the following factors have an important impact on technical efficiency: the presence of surgery complications, be a diabetic patients and occurrences of retrospective myocardial infarction.

Conclusions: Costs in patients operated on by newly appointed consultant sugeons is similar to costs in patients operated on by established surgeons. Assuming the availability of appropriate sources of data, stochastic frontier approach might prove fruitful in other areas of health care evaluative research.

Keywords: Learning curve, stochastic bayesian frontiers, coronary surgery

Suggested Citation

Negrin, Miguel Angel and Pinilla, Jaime and Vázquez-Polo, Francisco J. and Murillo, Carles, The Learning Curve for Coronary Surgery: An Stochastic Frontier Model Approach. iHEA 2007 6th World Congress: Explorations in Health Economics Paper, Available at SSRN: https://ssrn.com/abstract=994248

Miguel Angel Negrin (Contact Author)

University of Las Palmas de Gran Canaria - Department of Quantitative Methods in Economics ( email )

Campus de Tafira
35017 Las Palmas
Spain

Jaime Pinilla

University of Las Palmas de Gran Canaria ( email )

C/Juan de Quesada, No. 30
Las Palmas de Gran Canaria, Las Palmas 35017
Spain

Francisco J. Vázquez-Polo

University of Las Palmas de Gran Canaria - Department of Quantitative Methods in Economics ( email )

Campus de Tafira
35017 Las Palmas
Spain

Carles Murillo

Universitat Pompeu Fabra ( email )

Ramon Trias Fargas, 25-27
Barcelona, E-08005
Spain

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