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Relative Efficiency of Health Provision: a DEA Approach with Non-discretionary Inputs

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  • António Afonso
  • Miguel St. Aubyn

Abstract

We estimate a semi-parametric model of health production process using a two-stage approach for OECD countries. By regressing data envelopment analysis output efficiency scores on non-discretionary variables, both using Tobit analysis and a single and double bootstrap procedure, we show that inefficiency is strongly related to GDP per head, the education level, and health behaviour such as obesity and smoking habits. The used bootstrapping procedure corrects likely biased DEA output scores taking into account that environmental variables are correlated to output and input variables.

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Bibliographic Info

Paper provided by ISEG - School of Economics and Management, Department of Economics, University of Lisbon in its series Working Papers Department of Economics with number 2006/33.

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Date of creation: 2006
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Handle: RePEc:ise:isegwp:wp332006

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Postal: Department of Economics, ISEG - School of Economics and Management, University of Lisbon, Rua do Quelhas 6, 1200-781 LISBON, PORTUGAL
Web page: https://aquila1.iseg.ulisboa.pt/aquila/departamentos/EC

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Keywords: technical efficiency; health; DEA; bootstrap; semi-parametric.;

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References

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  1. Simar, Leopold & Wilson, Paul W., 2007. "Estimation and inference in two-stage, semi-parametric models of production processes," Journal of Econometrics, Elsevier, vol. 136(1), pages 31-64, January.
  2. António Afonso & Miguel St. Aubyn, 2005. "Cross-country Efficiency of Secondary Education Provision: a Semi-parametric Analysis with Nondiscretionary Inputs," Working Papers Department of Economics 2005/05, ISEG - School of Economics and Management, Department of Economics, University of Lisbon.
  3. Ruggiero, John, 2004. "Performance evaluation when non-discretionary factors correlate with technical efficiency," European Journal of Operational Research, Elsevier, vol. 159(1), pages 250-257, November.
  4. António Afonso & Ludger Schuknecht & Vito Tanzi, 2005. "Public sector efficiency: An international comparison," Public Choice, Springer, vol. 123(3), pages 321-347, June.
  5. António Afonso & Miguel St. Aubyn, 2005. "Non-parametric approaches to education and health efficiency in OECD countries," Journal of Applied Economics, Universidad del CEMA, vol. 0, pages 227-246, November.
  6. Adler, Nicole & Golany, Boaz, 2001. "Evaluation of deregulated airline networks using data envelopment analysis combined with principal component analysis with an application to Western Europe," European Journal of Operational Research, Elsevier, vol. 132(2), pages 260-273, July.
  7. Leopold Simar & Paul Wilson, 2000. "A general methodology for bootstrapping in non-parametric frontier models," Journal of Applied Statistics, Taylor & Francis Journals, vol. 27(6), pages 779-802.
  8. Retzlaff-Roberts, Donna & Chang, Cyril F. & Rubin, Rose M., 2004. "Technical efficiency in the use of health care resources: a comparison of OECD countries," Health Policy, Elsevier, vol. 69(1), pages 55-72, July.
  9. Gupta, Sanjeev & Verhoeven, Marijn, 2001. "The efficiency of government expenditure: experiences from Africa," Journal of Policy Modeling, Elsevier, vol. 23(4), pages 433-467, May.
  10. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
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Citations

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Cited by:
  1. Afonso, António & Schuknecht, Ludger & Tanzi, Vito, 2008. "Income distribution determinants and public spending efficiency," Working Paper Series 0861, European Central Bank.
  2. Ana Poças & Elias Soukiazis, 2010. "Health Status Determinants in the OECD Countries. A Panel Data Approach with Endogenous Regressors," GEMF Working Papers 2010-04, GEMF - Faculdade de Economia, Universidade de Coimbra.
  3. Aleksander Aristovnik, 2013. "Relative Efficiency of Education Expenditures in Eastern Europe: A Non-parametric Approach," Journal of Knowledge Management, Economics and Information Technology, ScientificPapers.org, vol. 3(3), pages 4, June.
  4. Aristovnik, Aleksander, 2012. "The impact of ICT on educational performance and its efficiency in selected EU and OECD countries: a non-parametric analysis," MPRA Paper 39805, University Library of Munich, Germany.
  5. Péter Halmai & Viktória Vásáry, 2012. "Convergence crisis: economic crisis and convergence in the European Union," International Economics and Economic Policy, Springer, vol. 9(3), pages 297-322, September.
  6. Mihai Mutascu & Marius Milos, 2009. "Optimal Size Of Government Spending. The Case Of European Union Member States," Annales Universitatis Apulensis Series Oeconomica, Faculty of Sciences, "1 Decembrie 1918" University, Alba Iulia, vol. 1(11), pages 45.
  7. Francesco Porcelli, 2009. "Effects of fiscal decentralisation and electoral accountability efficiency evidence from the Italian health care sector," Working Papers 2009/29, Institut d'Economia de Barcelona (IEB).

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