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Effectiveness Measurement Using DEA & BSC Methods in Public Health Services


It is well-known that health-care systems all over the world try to improve efficiency and effectiveness due to high pressure to pursue rational performance. Many of the health-care reforms in different countries are conducted with the objectives to rationalise costs, to make health services more available, and to increase, or at least not to reduce, the quality of health services. Adequate efficient metrics used in assessing health-care services are critical for the quality of decision-making. The subject of this research is efficiency measurement in the institutes of public health in Croatia oriented to preventive activities, i.e. monitoring, analysis, and evaluation of the health of the population. Diversity of the programmes and temporal variability are the characteristics of public health services, and it is therefore harder to measure the effects in the long run. This research aims to analyse and propose a new approach to the measurement system using two methods: the Data Envelopment Analysis (DEA) and the Balanced Score Card (BSC), combined into the DEABSC integrative model, which can be an efficient method for the decision-making process. The starting point of this research is the analysis of the measurement system in public-health services in Croatia. The results confirm a weak and inadequate efficiency measurement system and very low effectiveness measurement. To enhance the efficiency measurement, we have developed the conceptual integrative DEABSC model which has been tested at the Teaching Institute of Public Health – the Department of Health Ecology. Using DEA for 2017, we have identified relatively efficient units that helped establish future goals set in the BSC strategic map. The combination of DEA and BSC allows identifying options for improving the effectiveness of public-health service programmes. The study confirms that it is possible to determine the relative efficiency of different DMUs within the Department of Health Ecology and use best practice for each perspective in the BSC Cause & Effect conceptual model. This paper also provides recommendations for an easier establishment of performance measurement in order to achieve the mission of public health institutions, but also indicates some limitations in the application of the methods.

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Political-administrative relations: The role of political advisers

Éireann. (2011). Ceisteanna - Questions: Ministerial staff. 29 March. Dáil Debates, 728 (6). De Visscher, C., & Houlberg Salomonsen, H. (2013). Explaining differences in ministerial ménages à trois: Multiple bargains in Belgium and Denmark. International Review of Administrative Sciences, 79 (1), 71-90. Di Mascio, F., & Natalini, A. (2013). Analysing the role of ministerial cabinets in Italy: Legacy and temporality in the study of administrative reforms. International Review of Administrative Sciences, 79 (2), 328

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Collaborative housing and blockchain

-first-government-to-secure-land-titles-on-thebitcoin-blockchain-expands-project/#39cb78074dcd [7 November 2017]. Simón, H., Lambea, N., & Garcia, R. M. (2017). Shared ownership and temporal ownership in Catalan law. International Journal of Law in the Built Environment, 9 (1). Snow, P., Deery, B., Lu, J., Johnston, D., Kirby, P., Sprague, A. Y., & Byington, D. (2014). Business processes secured by immutable audit trails on the blockchain. Retrieved from [12 March 2018]. Sparkes, P., Bulut, D., Habdas, M., Jordan, M., Moreno, H. S., Nasarre-Aznar, S., Ralli, T., & Strutz, M. (2017). What everyone

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Administrative History and the Theory of Fields: Towards a Social and Political History of Public Administration

reality taking place at a specific time and place. Second, they represent »a form of incorporated history«. And third, they produce an understanding of reality »that is open to conjuncture, contingency, and radical discontinuity«. Overall, the theory provides a framework that allows understanding social reality by linking structures, agents, and institutions in a temporal perspective. Capital is defined as a resource that agents – individuals and organizations – have, can accumulate over time, and use to interact among each other. There are four types of capital

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Litigious Paranoia: Sense of Justice, Bureaucracy, and Media

temporally and spatially dependent power derived from emotions to take action and the social contextualization of emotions. On the relevance of the historicity of emotions in historical studies, see Ute Frevert: Emotions in History – Lost and Found, Budapest 2011; Ute Frevert / Thomas Dixon: Emotions in History. Continuity and Change in the Vocabulary of Feeling 1700–2000, Oxford 2014. Second, those media are shifted from the periphery to the center of cognitive interest which are brought into play to transfer the fury, the hate, but also the desperation and the suffering

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»Monitor Yourself!« The Controlled Emotions of Spanish Office Holders in the Early Modern Period

Chancillería in Valladolid. Ultimately, in 1597, he published a book about the office of the corregidores, the so-called Política para corregidores, which encompassed almost 2000 pages. In it, the ideal conduct of a corregidor was described: He should, it said, have a distinct sobriety (sobriedad), a moderate demeanour and maintain this moderation when eating and drinking. Jerónimo Castillo de Bobadilla: Política para corregidores y señores de vasallos, en tiempo de paz, y de guerra, y para prelados en lo espiritual, y temporal entre legos, jueces de comision, regidores

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An den Grenzen der Vernunft: Beamte und ›Barbaren‹ in den Peripherien Lateinamerikas, 18.–19. Jahrhundert

Entgleisungen bewahren. Ganz ohne Wut, und hier folgte Castilla aristotelischen Gedanken, ließe sich aber auch nicht gut regieren. Ein von Vernunft geleiteter Zorn sei den Richtern nämlich tugendhaft. Jerónimo Castillo de Bobadilla: Política para Corregidores y Señores de vasallos, en tiempo de paz y de guerra y para prelados en lo espiritual y temporal entre legos, juezes de comisión, regidores, abogados y otros officiales públicos y de las jurisdiciones, preeminencias, residencias y salarios dellos y de lo tocante a las de órdenes y cavalleros dellas [Politik für

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Building a Local Administration Abroad
The French Consulate in Salonica in the 19th Century

superimposition of French legal space with Ottoman spaces, both imperial and local, whose legality and temporality differed from the former. Despite the multiple changes of regime in France and the repeated demands of the Ottoman government, especially during the Congress of Paris in 1856 and that of Berlin in 1878, Pélissié du Rausas: Régime, vol. 1, p. 117. the capitulations were never abrogated. On the contrary, they were further consolidated in the successive commercial treaties of 1838 and 1861. These were emblematic of the asymmetrical relations which the European

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The Vaccine and Its Simulacra: Agnotology, Ontology and Biopolitics in France, 1800–1865

Edward Jenner: An Inquiry into the Causes and Effects of the Variolae Vaccinae, London, 1798. The details deemed essential were described with an extraordinary precision. The images reproduced above deployed an armada of details. The colours were essential. Time was as well. Hence the importance of a temporal representation of the vaccine: it was insufficient to obtain a pimple which vaguely resembled the represented pustule, it was necessary that the pustule exhibit the same succession of phenomena in time. Note also that the cross-sectional representation

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The Dutch Decentralized Unitary State and Its Effects on Civil Service Systems in the Period of the Night Watch, Welfare and Enabling States 1814–2016

thus provides a long-term perspective that can reveal »the fundamental dynamics of state building«. Laurence E. Lynn Jr., Public Management: Old and New, New York 2006, p. 22. Naturally this applies to the study of civil service systems as well. A long-term perspective enables us to see more fundamental developments and offers possibilities to assess motives, intentions and context of changes in civil service systems over time until the present day. A temporal perspective is not only a merit and interesting on its own but is also of prime importance for

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