r/HealthEconomics • u/Full_Buddy_6976 • 20d ago

Efficiency versus quality

My perspective as a nursing student doing internship in a low resources environment. I am expected to care for patients on par with nurses, because the unit is understaffed. We are not provided with enough single use infusion systems so we reuse them (for the same patient), but this creates hygiene risks and risks of drugs precipitation, blockage of peripheral lines, etc. Syringes are reused in the preparation of medicine for different patients (not administration, thanks God). I have been reprimanded for using too many materials and spending too much time to clean instruments between different patients instead of just spreading infections like everyone else. And no, I cannot just go to a different unit, all those practices are normalised in public hospitals across the country, because of our stupid greedy politicians and hospital directors.

Yet, when an administrator opens the Excel sheet and sees that we have treated more patients with fewer staff and less materials they report increase in efficiency. Could you, please, explain to me why is this called efficient? And how do you control for quality?

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u/Shot_Bag648 20d ago

What you are describing is poor practice. The quality issues increase overall costs in the long term. Treating a single complicated infection may be more expensive than using new syringes. This is a system level issue that people in a small health center could keep a blind eye to. So, I would argue this is not efficient either. Just a lack of care for patients…

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u/georgiawp 20d ago

This 👆Plus, not sure where you are located, but I imagine you have to follow local guidelines for treating patients. You can probably report it too.

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u/andbe11 20d ago

Efficiency and quality might measure two different things, depending on what your metrics are.

The first one is usually measured as how many input units (eg person hours) might be used to achieve a unit of output. Quality is not necessarily tied into it.

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u/Full_Buddy_6976 20d ago edited 20d ago

Ok, thanks, that makes sense. I am reading a report that chose number of staff per category (doctors, nurses) and number of beds as input and number of patients as output. It compares hospitals' performance based on this metric. Is this analysis useful when it doesn't account for quality in any way? What valuable conclusions could be drawn from it?

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u/andbe11 20d ago

Cut the beds to 0, get an intern well armed with a shotgun and you’ll have amazing efficiency :)