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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 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: https://aquila.iseg.utl.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. Leopold Simar & Paul 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.
  2. António Afonso & Ludger Schuknecht & Vito Tanzi, 2005. "Public sector efficiency: An international comparison," Public Choice, Springer, vol. 123(3), pages 321-347, June.
  3. 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.
  4. 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.
  5. 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.
  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. 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.
  8. 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.
  9. 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.
  10. 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.
  11. 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.
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Citations

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Cited by:
  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.
  2. 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.
  3. 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).
  4. António Afonso & Ludger Schuknecht & Vito Tanzi, 2008. "Income distribution determinants and public spending efficiency," Working Paper Series 861, European Central Bank.
  5. 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.

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