Using data envelopment analysis for formative evaluation of radiotherapy services: an exploratory study

Radiotherapy is an important element in cancer treatment, both for cure and for palliation. Whilst performance measurement and performance improvement are major concerns of most radiotherapy departments, measuring and managing the performance of these departments is particularly challenging. This article critically explores the use of Data Envelopment Analysis (DEA) for formative evaluation of radiotherapy services. Following a review of the literature, a conceptual framework for performance assessment of radiotherapy departments is developed and its use illustrated. Our empirical analysis uses mostly data from 2007 and compares the fairness of access to services, technical efficiency, and clinical effectiveness across the English strategic health authorities. The analysis shows that whilst the application of DEA in this context meets some difficulties, it also has great potential by providing valuable information to improve services, especially if used in a formative mode