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

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Author Info
António Afonso
Miguel St. Aubyn

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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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Publisher Info
Paper provided by Department of Economics at the School of Economics and Management (ISEG), Technical University of Lisbon. in its series Working Papers 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, School of Economics and Management (ISEG), Technical University of Lisbon, Rua do Quelhas 6, 1200-781 LISBON, PORTUGAL
Web page: http://www.iseg.utl.pt/departamentos/economia/

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

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Find related papers by JEL classification:
C14 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods: General - - - Semiparametric and Nonparametric Methods
C61 - Mathematical and Quantitative Methods - - Mathematical Methods and Programming - - - Optimization Techniques; Programming Models; Dynamic Analysis
H52 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Education
I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Léopold Simar, Paul W. Wilson, 2000. "A general methodology for bootstrapping in non-parametric frontier models," Journal of Applied Statistics, Taylor and Francis Journals, vol. 27(6), pages 779-802, August. [Downloadable!] (restricted)
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  2. António Afonso & Ludger Schuknecht & Vito Tanzi, 2005. "Public sector efficiency: An international comparison," Public Choice, Springer, vol. 123(3), pages 321-347, June. [Downloadable!] (restricted)
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  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. [Downloadable!] (restricted)
  4. 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. [Downloadable!] (restricted)
  5. Afonso, Antonio & St. Aubyn, Miguel, 2006. "Cross-country efficiency of secondary education provision: A semi-parametric analysis with non-discretionary inputs," Economic Modelling, Elsevier, vol. 23(3), pages 476-491, May. [Downloadable!] (restricted)
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  6. 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. [Downloadable!] (restricted)
  7. 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. [Downloadable!] (restricted)
  8. 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. [Downloadable!]
  9. Jean Spinks & Bruce Hollingsworth, 2005. "Health production and the socioeconomic determinants of health in OECD countries: the use of efficiency models," Centre for Health Economics Working Papers 151/05, Monash University, Centre for Health Economics. [Downloadable!]
  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. [Downloadable!] (restricted)
  11. 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. [Downloadable!] (restricted)
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Cited by:
(explanations, Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.)

  1. Daniel Becker, 2008. "Public-Sector Efficiency and Interjurisdictional Competition - an Empirical Investigation," Thuenen-Series of Applied Economic Theory 101, University of Rostock, Institute of Economics, Germany. [Downloadable!]
  2. António Afonso & Ludger Schuknecht & Vito Tanzi, 2008. "Income distribution determinants and public spending efficiency," Working Paper Series 861, European Central Bank. [Downloadable!]
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