What is the difference between effectiveness and efficiency in healthcare management

Efficiency and effectiveness are not the same thing. Efficiency is defined as the ability to accomplish something with the least amount of wasted time, money, and effort or competency in performance. Effectiveness is defined as the degree to which something is successful in producing a desired result; success. Managers need to appreciate the way each affects an organization. One measure of maintenance efficiency is total maintenance costs compared to replacement asset value RAV.

Some refer to this as equipment replacement value ERV. It is defined as the monetary value that would be required to replace the current assets in the organization. It includes production and process equipment, as well as utilities, support, and all related costs.

For example, in the past 12 months, I have had some maintenance expenses. Based on these expenses, the ratio of total maintenance costs to RAV is 3. Managers are responsible for determining the most appropriate mix of physical asset policies, work management, and reliability improvement processes to reduce the costs of non-value added or recurring expenses. In my example, some expenses might be considered capital expense or improvements.

Perhaps I purchase a higher quality shingle, for example. Another measure of maintenance efficiency is corrective maintenance CM versus preventive maintenance PM. Evaluating total maintenance costs to RAV does not naturally give enough detail to identify where costs are applied.

Therefore, observational studies and randomized controlled trials are the main types of studies used to evaluate treatments. In the last ones, patients are assigned to active or control group by through randomization. Nowadays is assimilated efficacy with randomized controlled trials and effectiveness with observational studies [ 6 ].

Guidelines are mostly based on evidence gathered from randomized controlled trials [ 6 - 8 ]. Currently, effectiveness can be defined as the extent to which a drug achieves its intended effect in the usual clinical setting. It can be evaluated through observational studies of real practice.

In real practice studies "how the drug works in a real-world situation" there are interactions with other medications and interactions with health conditions of the patient. A treatment is effective if it works in real life in non-ideal circumstances [ 7 , 8 ]. Effectiveness cannot be measured in controlled trials, because the act of inclusion into a study is a distortion of usual practice [ 9 , 10 ].

On the contrary, observational studies usually called pragmatic trials, real-world trials, naturalistic trials do not require randomization. Nevertheless, nowadays we cannot obviate the concept evidence-based medicine.

It was initially developed by Guyatt, et al. Evidence-based medicine is the conscientious, explicit and reasonable use of best evidence and making decisions about the case of individual patients.

Evidence-based medicine integrates clinical experience with the best available research information [ 12 ]. It categorizes different types of clinical evidence and ranks them according to the strength of their freedom from the various biases that beset medical research. One of the scales most used is the Scottish Intercollegiate Guidelines Network SIGN which use a code together the study type for decide the level of evidence [ 13 ].

High level of strength of recommendation is assigned to randomized control trials with a very low risk of bias and low levels of recommendation correspond to observational studies. Hence, the called "pragmatic studies" or "real-life studies" might be qualified as low evidence. This would suppose a contradiction, the most effectiveness studies would be the lowest level of evidence. Efficiency is the ratio of the output to the inputs of any system. An efficient system or person is one who achieves higher levels of performance outcome, output relative to the inputs resources, time, money consumed [ 14 ].

Historically, efficiency measurements come from engineering science where performance had to be measured. The result has been typically displayed as physical units per resource used. Achieving efficiency, which is defined as maximizing the outputs achieved per unit of input invested [ 14 ] is naturally of great interest to national governments, international donors and other stakeholders in the health sector.

As what type of product is being evaluated, we distinguish between two types of outputs: Health services visits, drugs, admissions and health outcomes by way of example: Preventable deaths, functional status, clinical outcomes such as blood pressure or blood sugar control. Effectiveness studies can be valuable to test whether and how much the results of efficacy trials are applicable to practical life.

Characteristic differences of efficacy studies and effectiveness studies:. Effectiveness trials are used to study or capture the multi-factorial nature of interventions and inform the result of intervention in practical setting. Effectiveness trials have limited exclusion criteria and it involves more heterogeneous population.

Effectiveness studies are usually conducted in more practical situations which are applicable to diverse population. These studies allow the real-world factors to take place and try harder to duplicate the situations that will be encountered in real-world. The study does not strictly limit to the protocols, rather is gives space for practical contexts.