IDEAS home Printed from https://ideas.repec.org/p/iza/izadps/dp2689.html
   My bibliography  Save this paper

An Analysis of Hospital Efficiency and Productivity Growth Using the Luenberger Productivity Indicator

Author

Listed:
  • Barros, Carlos Pestana

    (Universidade Técnica de Lisboa)

  • Menezes, Antonio

    (University of the Azores)

  • Vieira, José António Cabral

    (University of the Azores)

  • Peypoch, Nicolas

    (Université de Perpignan)

  • Solonandrasana, Bernardin

    (Université de Perpignan)

Abstract

We analyze the efficiency and productivity growth of a representative sample of Portuguese hospitals from 1997 to 2004, using an innovative approach by employing the directional distance function and the Luenberger productivity indicator. The primary advantage of our approach is that both input contractions and output expansions are considered. Our model generates a productivity indicator that is decomposed into the usual constituents of productivity growth: technological change and efficiency change. The results show that, on average, Portuguese hospitals did not experience productivity growth during the period analyzed. In addition, the incidence of positive productivity growth across Portuguese hospitals was remarkably low.

Suggested Citation

  • Barros, Carlos Pestana & Menezes, Antonio & Vieira, José António Cabral & Peypoch, Nicolas & Solonandrasana, Bernardin, 2007. "An Analysis of Hospital Efficiency and Productivity Growth Using the Luenberger Productivity Indicator," IZA Discussion Papers 2689, Institute of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp2689
    as

    Download full text from publisher

    File URL: https://docs.iza.org/dp2689.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Morey, RC & Fine, DJ & Loree, SW, 1990. "Comparing the allocative efficiencies of hospitals," Omega, Elsevier, vol. 18(1), pages 71-83.
    2. Chambers, Robert G., 1996. "A New Look at Exact Input, Output, Productivity, and Technical Change Measurement," Working Papers 197840, University of Maryland, Department of Agricultural and Resource Economics.
    3. Walter Briec & Robert Chambers & Rolf Färe & Nicolas Peypoch, 2006. "Parallel Neutrality," Journal of Economics, Springer, vol. 88(3), pages 285-305, September.
    4. Jean‐Philippe Boussemart & Walter Briec & Kristiaan Kerstens & Jean‐Christophe Poutineau, 2003. "Luenberger and Malmquist Productivity Indices: Theoretical Comparisons and Empirical Illustration," Bulletin of Economic Research, Wiley Blackwell, vol. 55(4), pages 391-405, October.
    5. Zuckerman, Stephen & Hadley, Jack & Iezzoni, Lisa, 1994. "Measuring hospital efficiency with frontier cost functions," Journal of Health Economics, Elsevier, vol. 13(3), pages 255-280, October.
    6. Eulália Dalmau-Atarrodona & Jaume Puig-Junoy, 1998. "Market Structure and Hospital Efficiency: Evaluating Potential Effects of Deregulation in a National Health Service," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 13(4), pages 447-466, August.
    7. Valdmanis, Vivian, 1992. "Sensitivity analysis for DEA models : An empirical example using public vs. NFP hospitals," Journal of Public Economics, Elsevier, vol. 48(2), pages 185-205, July.
    8. Michael D. Rosko, 2001. "Cost efficiency of US hospitals: a stochastic frontier approach," Health Economics, John Wiley & Sons, Ltd., vol. 10(6), pages 539-551, September.
    9. Luenberger, David G., 1992. "Benefit functions and duality," Journal of Mathematical Economics, Elsevier, vol. 21(5), pages 461-481.
    10. Gary Ferrier & Michael Rosko & Vivian Valdmanis, 2006. "Analysis of uncompensated hospital care using a DEA model of output congestion," Health Care Management Science, Springer, vol. 9(2), pages 181-188, May.
    11. Anatoly I. Pilyavsky & William E. Aaronson & Patrick M. Bernet & Michael D. Rosko & Vivian G. Valdmanis & Mikhail V. Golubchikov, 2006. "East–west: does it make a difference to hospital efficiencies in Ukraine?," Health Economics, John Wiley & Sons, Ltd., vol. 15(11), pages 1173-1186, November.
    12. Banker, Rajiv D & Maindiratta, Ajay, 1988. "Nonparametric Analysis of Technical and Allocative Efficiencies in Production," Econometrica, Econometric Society, vol. 56(6), pages 1315-1332, November.
    13. Ana Rodríguez‐Álvarez & C. A. Knox Lovell, 2004. "Excess capacity and expense preference behaviour in National Health Systems: an application to the Spanish public hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 13(2), pages 157-169, February.
    14. Unto Häkkinen, 2005. "The impact of changes in Finland's health care system," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 101-118, September.
    15. Bruce Hollingsworth & Andrew Street, 2006. "The market for efficiency analysis of health care organisations," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1055-1059, October.
    16. Varian, Hal R, 1984. "The Nonparametric Approach to Production Analysis," Econometrica, Econometric Society, vol. 52(3), pages 579-597, May.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Galvis-Aponte Luis Armando & Hahn-De-Castro Lucas Wilfried, 2016. "Crecimiento municipal en Colombia: el papel de las externalidades espaciales, el capital humano y el capital físico," Revista Sociedad y Economía, Universidad del Valle, CIDSE, issue 31, pages 11-286, May.
    2. Antonio José Orozco-Gallo, 2017. "Una aproximación regional a la eficiencia y productividad de los hospitales públicos colombianos," Chapters, in: Jaime Bonet & Karelys Guzmán-Finol & Lucas Wilfried Hahn-De-Castro (ed.), La salud en Colombia: una perspectiva regional, chapter 6, pages 173-209, Banco de la Republica de Colombia.
    3. Jui-Hsiang Wang, & Chun-Chu Liu, 2017. "Nursing manpower and productivity in medical service industry," Journal of Economic and Financial Studies (JEFS), LAR Center Press, vol. 5(2), pages 7-13, April.
    4. Esso-hanam Atake, 2015. "Technical efficiency of public hospitals in Togo: A directional distance function approach," Economics Bulletin, AccessEcon, vol. 35(3), pages 1752-1764.
    5. Karelys Guzmán Finol, 2015. "¿Qué hay detrás de un cambio en la productividad hospitalaria?," Documentos de trabajo sobre Economía Regional y Urbana 215, Banco de la Republica de Colombia.
    6. Chia-Hsuan Wu & Ching-Cheng Chang & Po-Chi Chen & Ken-Nan Kuo, 2013. "Efficiency and productivity change in Taiwan’s hospitals: a non-radial quality-adjusted measurement," Central European Journal of Operations Research, Springer;Slovak Society for Operations Research;Hungarian Operational Research Society;Czech Society for Operations Research;Österr. Gesellschaft für Operations Research (ÖGOR);Slovenian Society Informatika - Section for Operational Research;Croatian Operational Research Society, vol. 21(2), pages 431-453, March.
    7. Karelys Guzmán-Finol, 2017. "¿Qué hay detrás de un cambio en la productividad hospitalaria?," Chapters, in: Jaime Bonet & Karelys Guzmán-Finol & Lucas Wilfried Hahn-De-Castro (ed.), La salud en Colombia: una perspectiva regional, chapter 7, pages 211-247, Banco de la Republica de Colombia.
    8. Epure, Mircea & Kerstens, Kristiaan & Prior, Diego, 2008. "Benchmarking and Total Factor Productivity: A Luenberger Decomposition within the Banking Sector," Efficiency Series Papers 2008/03, University of Oviedo, Department of Economics, Oviedo Efficiency Group (OEG).
    9. Sharon Hadad & Yossi Hadad & Tzahit Simon-Tuval, 2013. "Determinants of healthcare system’s efficiency in OECD countries," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(2), pages 253-265, April.
    10. Diogo Ferreira & Rui Marques, 2015. "Did the corporatization of Portuguese hospitals significantly change their productivity?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(3), pages 289-303, April.
    11. Kejia Chu & Ning Zhang & Zhongfei Chen, 2015. "The Efficiency and Its Determinants for China’s Medical Care System: Some Policy Implications for Northeast Asia," Sustainability, MDPI, vol. 7(10), pages 1-20, October.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Carlos Barros & António Gomes de Menezes & Nicolas Peypoch & Bernardin Solonandrasana & José Vieira, 2008. "An analysis of hospital efficiency and productivity growth using the Luenberger indicator," Health Care Management Science, Springer, vol. 11(4), pages 373-381, December.
    2. Pestana Barros, Carlos & Peypoch, Nicolas, 2010. "Productivity changes in Portuguese bus companies," Transport Policy, Elsevier, vol. 17(5), pages 295-302, September.
    3. O'Neill, Liam & Rauner, Marion & Heidenberger, Kurt & Kraus, Markus, 2008. "A cross-national comparison and taxonomy of DEA-based hospital efficiency studies," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 158-189, September.
    4. Carlos Barros & Hercules Haralambides & Mohamed Hussain & Nicolas Perpoch, 2011. "Seaport Efficiency and Productivity Growth," Chapters, in: Kevin Cullinane (ed.), International Handbook of Maritime Economics, chapter 17, Edward Elgar Publishing.
    5. Puig-Junoy, Jaume, 2000. "Partitioning input cost efficiency into its allocative and technical components: an empirical DEA application to hospitals," Socio-Economic Planning Sciences, Elsevier, vol. 34(3), pages 199-218, September.
    6. Goncalves, Olga, 2013. "Efficiency and productivity of French ski resorts," Tourism Management, Elsevier, vol. 36(C), pages 650-657.
    7. Guilhermina Rego & Rui Nunes & José Costa, 2010. "The challenge of corporatisation: the experience of Portuguese public hospitals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(4), pages 367-381, August.
    8. Bonasia, Mariangela & Kounetas, Konstantinos & Oreste, Napolitano, 2020. "Assessment of regional productive performance of European health systems under a metatechnology framework," Economic Modelling, Elsevier, vol. 84(C), pages 234-248.
    9. W. Briec & K. Kerstens, 2009. "Infeasibility and Directional Distance Functions with Application to the Determinateness of the Luenberger Productivity Indicator," Journal of Optimization Theory and Applications, Springer, vol. 141(1), pages 55-73, April.
    10. Layer, Kevin & Johnson, Andrew L. & Sickles, Robin C. & Ferrier, Gary D., 2020. "Direction selection in stochastic directional distance functions," European Journal of Operational Research, Elsevier, vol. 280(1), pages 351-364.
    11. Roberto Colombi & Gianmaria Martini & Giorgio Vittadini, 2017. "Determinants of transient and persistent hospital efficiency: The case of Italy," Health Economics, John Wiley & Sons, Ltd., vol. 26(S2), pages 5-22, September.
    12. Cristian Nedelea, I. & Matthew Fannin, J., 2013. "Analyzing cost efficiency of Critical Access Hospitals," Journal of Policy Modeling, Elsevier, vol. 35(1), pages 183-195.
    13. Jean-Pascal Guironnet & Nicolas Peypoch, 2005. "Human Capital Allocation and Overeducation: A Measure of French Productivity," Working Papers 05-10, LAMETA, Universtiy of Montpellier, revised Oct 2005.
    14. Timo Kuosmanen & Mika Kortelainen & Timo Sipiläinen & Laurens Cherchye, 2005. "Firm and Industry Level Profit Efficiency Analysis Under Incomplete Price Data: A Nonparametric Approach based on Absolute and Uniform Shadow Prices," Microeconomics 0509011, University Library of Munich, Germany.
    15. Subhash C. Ray, 2018. "Data Envelopment Analysis with Alternative Returns to Scale," Working papers 2018-20, University of Connecticut, Department of Economics.
    16. Camilla Mastromarco & Lenka Stastna & Jana Votapkova, 2019. "Efficiency of hospitals in the Czech Republic: Conditional efficiency approach," Journal of Productivity Analysis, Springer, vol. 51(1), pages 73-89, February.
    17. Kuosmanen, Timo & Kortelainen, Mika & Sipiläinen, Timo & Cherchye, Laurens, 2010. "Firm and industry level profit efficiency analysis using absolute and uniform shadow prices," European Journal of Operational Research, Elsevier, vol. 202(2), pages 584-594, April.
    18. Guironnet, J.-P. & Peypoch, N., 2007. "Human capital allocation and overeducation: A measure of French productivity (1987, 1999)," Economic Modelling, Elsevier, vol. 24(3), pages 398-410, May.
    19. Briec, Walter & Kerstens, Kristiaan, 2009. "The Luenberger productivity indicator: An economic specification leading to infeasibilities," Economic Modelling, Elsevier, vol. 26(3), pages 597-600, May.
    20. Carlos Pestana Barros & Guglielmo Maria Caporale & Luis A. Gil-Alana, 2007. "Identification of Segments of European Banks with a Latent Class Frontier Model," CESifo Working Paper Series 2110, CESifo.

    More about this item

    Keywords

    efficiency; productivity; Luenberger productivity indicator; hospitals; technological change;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L5 - Industrial Organization - - Regulation and Industrial Policy

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:iza:izadps:dp2689. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Holger Hinte (email available below). General contact details of provider: https://edirc.repec.org/data/izaaade.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.