计量经济分析 = Econometric analysis

The measurement of efficiency and productivity of health service delivery has become a small industry. This is a review of 317 published papers on frontier efficiency measurement. The techniques used are mainly based on non-parametric data envelopment analysis, but there is increasing use of parametric techniques, such as stochastic frontier analysis. Applications to hospitals and other health care organizations and areas are reviewed and summarised, and some meta-type analysis undertaken. Cautious conclusions are that public provision may be potentially more efficient than private, in certain settings. The paper also considers conceptualizations of efficiency, and points to dangers and opportunities in generating such information. Finally, some criteria for assessing the use and usefulness of efficiency studies are established, with a view to helping both researchers and those assessing whether or not to act upon published results.

The measurement of efficiency and productivity of health care delivery

The study described in this article investigates the relationship between high school size and student learning. We used three waves of data from NELS:88 and hierarchical linear modeling (HLM) methods to examine how students’ achievement growth in two subjects (reading and mathematics) over the high school years is influenced by the size of the high school they attend. Three research questions guided the study: (a) Which size high school is most effective for students’ learning?, (b) In which size high school is learning most equitably distributed?, and (c) Are size effects consistent across high schools defined by their social compositions? Results suggest that the ideal high school, defined in terms of effectiveness (i.e., learning), enrolls between 600 and 900 students. In schools smaller than this, students learn less; those in large high schools (especially over 2,100) learn considerably less. Learning is more equitable in very small schools, with equity defined by the relationship between learning and student socioeconomic status (SES). An important finding from the study is that the influence of school size on learning is different in schools that enroll students of varying SES and in schools with differing proportions of minorities. Enrollment size has a stronger effect on learning in schools with lower-SES students and also in schools with high concentrations of minority students. Implications for educational policy are discussed.

/pdf/high-school-size-which-works-best-and-for-whom-draft-2gcy5yss1w.pdf

High School Size: Which Works Best, and for Whom? Draft.

New Public Governance

This paper provides an extensive overview of the literature on efficiency in education. It summarizes the earlier applied inputs, outputs and contextual variables, as well as the used data sources of papers in the field of efficiency in education. Moreover, it reviews the papers on education that applied methodologies as data envelopment analysis, Malmquist index, Bootstrapping, robust frontiers, metafrontier or stochastic frontier analysis. Based on the insights of the literature review, a second part of the paper provides some ways forward. It attempts to establish a link between the parametric ‘economics of education’ literature and the (semi-parametric) ‘efficiency in education literature’. We point to the similarities between matching and conditional efficiency; difference-in-differences and metafrontiers; and quantile regressions and partial frontiers. The paper concludes with some practical directions for prospective researchers in the field.

/pdf/efficiency-in-education-a-review-of-literature-and-a-way-jq65h8tz6o.pdf

Efficiency in education: a review of literature and a way forward

This paper describes the efficiency of Dutch hospitals using the method of Data Envelopment Analysis (DEA). In particular the analysis focuses on explaining cost inefficiency measures due to each hospital’s operating environment. In previous works, the resulting DEA score is regressed on environmental factors via a Tobit approach. Previously, these approaches have been used (Simar and Wilson, J Prod Anal 7(1):63–80, 2000) but later these authors (Simar and Wilson 2007) demonstrated that bias is incurred since the efficiency score is a point estimate without a probability distribution around it that is required by the Tobit methodology. In this paper we use the Simar and Wilson bootstrapping techniques in order to obtain more efficient estimates of the environmental effects. It is shown that differences in estimated effects exist between the non-bootstrapped and bootstrapped models.

https://repository.tudelft.nl/islandora/object/uuid%3A327d99d5-f0de-4bdf-9d9e-b13f77459a85/datastream/OBJ/download

Environmental factors and productivity on Dutch hospitals: a semi-parametric approach

Preface. Acknowledgments. Abstract of the Book. Part One: Introductory and Methodological Issues. Performance assessment in the public sector (J.L.T. Blank, C.A. Knox Lovell). Measuring efficiency in the public sector (C.A. Knox Lovell). Part Two: Health Services. Comparing techniques for measuring the efficiency of Australian private hospitals (R. Webster, S.Kennedy and L. Johnson). Between bed and budget. The efficiency of Dutch hospitals (J.L.T. Blank, E. Eggink and A.H.Q.M. Merkies). Remedying excess capacities in French surgery units by industry reallocations: the scope for short and long term improvements in plant capacity utilization (B. Dervaux, K. Kerstens and H. Leleu). Efficiency of Dutch nursing homes: the sensitivity of DEA-scores to different sets of resource prices (E. Eggink, J.L.T. Blank). Part Three: Educational Services. Input regulations and allocative efficiency in US public schools (S. Grosskopf et al.). Economics of scale and school consolidation in Dutch primary school industry (A.H.Q.M. Merkies). Part Four: Law Enforcement. Cost efficiency in Florida prisons (K. Gyimah-Brempong). The revenue approach to Dutch police departments (E.P. van Tulder). Efficiency of local police districts: a New South Wales experience (A. Hughes, S. Yaisawamg). Part Five: Regional Services. What is known about municipal efficiency? The Belgian case and beyond (B. De Borger, K. Kerstens). Efficiencies in Unites States metropolitan areas (H.O. Fried, J.D. Klein). Part Six: Concluding Remarks. Efficiency research in the public sector: some final considerations (J.L.T. Blank). Name index. Subject index. Biographies. Correspondence.

Public provision and performance : contributions from efficiency and productivity measurement

Inter-municipal cooperation is increasingly popular in European countries. Saving cost is a key motivation. This paper analyses the relation between inter-municipal cooperation and cost efficiency among Dutch municipal tax departments between 2005 and 2012. Motivated by the notion that cost savings are ascribed to scale economies, the relation between cooperation and cost is modelled explicitly through scale. The size of the cooperation is incorporated as a determinant of cost efficiency. The results indicate that inter-municipal cooperation can contribute to reducing cost and that the relation can be explained by scale. Municipalities or cooperations sized around 10,000 inhabitants are estimated up to 30% inefficient. At 60,000 inhabitants, the benefits of scaling are largely exhausted. Other than through scale, municipalities that cooperate are not estimated to operate significantly more or less efficient.

/pdf/inter-municipal-cooperation-economies-of-scale-and-cost-5052zmtxde.pdf

Inter-municipal cooperation, economies of scale and cost efficiency: an application of stochastic frontier analysis to Dutch municipal tax departments

On the Allocation of Resources for Secondary Schools.

Hospitals worldwide command the majority of any countries health care budget. Reasons for these higher costs include the aging of the population requiring more intensive health care treatments provided in hospitals, the relatively high costs of labor in this labor intensive industry and payment systems that may encourage inefficient behavior on the part of hospital managers and physicians. Governments are seeking to instruments to mitigate this cost rise. Liberalizing hospital markets, deregulation, changing budget systems and changing ownership are only a few examples of attempts to make hospitals more efficient. Hospital industry responds in various ways to changing market conditions and legislation. In most western hospital markets we observe hospital consolidation, acquisitions, mergers and the founding of several types of network and hospital associations. The question is whether this trend also contributes to more efficiency.In this volume a number of outstanding internationally known scholars in the field of productivity measurement and health economics provide the reader with an excellent insight in the complexity of the issue. They explain that there is no straightforward panacea or recipe for the issues addressed. It is shown that the composition of the demand for care, the economic context, environmental and geographical conditions affect the outcomes. Policymakers should therefore take these nuances into account. A policy of increasing productivity starts with knowledge and insights in the complexity of the issue. The book therefore advocates the development of a strategy of collecting relevant data and conducting academic research that meet the standard of the state of the art.The book provides two illustrative examples of such a strategy in Finland and Australia. The authors have avoided as much as possible the technical jargon and complex mathematics and statistics involved in this research area. Therefore the book is par excellence suitable for policymakers and hospital managers, as well as for graduate students of health economics and health administration. It avoids, as much as possible, technical jargon and complex mathematics and statistics. It has international in scope.

Jos L. T. Blank

Papers

Environmental factors and productivity on Dutch hospitals: a semi-parametric approach

Public provision and performance : contributions from efficiency and productivity measurement

Inter-municipal cooperation, economies of scale and cost efficiency: an application of stochastic frontier analysis to Dutch municipal tax departments

On the Allocation of Resources for Secondary Schools.

Evaluating hospital policy and performance : contributions from hospital policy and productivity research