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Efficiency and Technological Change in Health Care Services in Ontario

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This paper presents productivity measurement results for hospital services using panel data for Ontario hospitals between 2003 and 2006. The study uses the Malmquist Productivity index (MPI) obtained through the application of Data Envelopment Analysis (DEA) which is decomposed into efficiency change (ECH), i.e., movement towards the best practice frontier and technological change (TCH), i.e., movement of the frontier itself (Färe et al. [12]). The study also uses kernel density estimation techniques for analysis of efficiency distributions of the productivity scores and their components across different types of hospitals (e.g. small /large and rural /urban) and over time. Our results suggest that in addition to average productivity it is important to examine distributions of productivity and of its components which we find differs by hospital type and over time. We find that productivity growth occurred mostly through improvement in technology and in spite of declining efficiency. The results provide useful insight into the underlying mechanisms of observed changes in overall productivity, in technological change and in technical efficiency change in this vital sector of the health care market.

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  • H. Chowdhury & V. Zelenyuk & W. Wodchis & A. Laporte, 2010. "Efficiency and Technological Change in Health Care Services in Ontario," CEPA Working Papers Series WP082010, School of Economics, University of Queensland, Australia.
    • Handle: RePEc:qld:uqcepa:54
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    File URL: https://economics.uq.edu.au/files/5235/WP082010.pdf
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    1. 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.
    2. Biorn, Erik & Hagen, Terje P. & Iversen, Tor & Magnussen, Jon, 2002. "The Effect of Activity-Based Financing on Hospital Efficiency: A Panel Data Analysis of DEA Efficiency Scores 1992-2000," MPRA Paper 8099, University Library of Munich, Germany.
    3. Beatriz Gonzalez Lopez-Valcarcel & Patricia Barber Perez, 1996. "Changes in the efficiency of spanish public hospitals after the introduction of program-contracts," Investigaciones Economicas, Fundación SEPI, vol. 20(3), pages 377-402, September.
    4. Timothy J. Coelli & D.S. Prasada Rao & Christopher J. O’Donnell & George E. Battese, 2005. "An Introduction to Efficiency and Productivity Analysis," Springer Books, Springer, edition 0, number 978-0-387-25895-9, June.
    5. Subodh Kumar & R. Robert Russell, 2002. "Technological Change, Technological Catch-up, and Capital Deepening: Relative Contributions to Growth and Convergence," American Economic Review, American Economic Association, vol. 92(3), pages 527-548, June.
    6. Gattoufi, Said & Oral, Muhittin & Kumar, Ashok & Reisman, Arnold, 2004. "Epistemology of data envelopment analysis and comparison with other fields of OR/MS for relevance to applications," Socio-Economic Planning Sciences, Elsevier, vol. 38(2-3), pages 123-140.
    7. Nishimizu, Mieko & Page, John M, Jr, 1982. "Total Factor Productivity Growth, Technological Progress and Technical Efficiency Change: Dimensions of Productivity Change in Yugoslavia, 1965-78," Economic Journal, Royal Economic Society, vol. 92(368), pages 920-936, December.
    8. Lawrence Seiford, 1997. "A bibliography for Data Envelopment Analysis (1978-1996)," Annals of Operations Research, Springer, vol. 73(0), pages 393-438, October.
    9. Emrouznejad, Ali & Parker, Barnett R. & Tavares, Gabriel, 2008. "Evaluation of research in efficiency and productivity: A survey and analysis of the first 30 years of scholarly literature in DEA," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 151-157, September.
    10. Gattoufi, Said & Oral, Muhittin & Reisman, Arnold, 2004. "A taxonomy for data envelopment analysis," Socio-Economic Planning Sciences, Elsevier, vol. 38(2-3), pages 141-158.
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    1. Marthinus C. Breitenbach & Victor Ngobeni & Goodness C. Aye, 2021. "Efficiency of Healthcare Systems in the First Wave of COVID-19 – A Technical Efficiency Analysis," Economic Studies journal, Bulgarian Academy of Sciences - Economic Research Institute, issue 6, pages 3-21.
    2. Breitenbach, Marthinus C & Ngobeni, Victor & Ayte, Goodness, 2020. "The first 100 days of COVID-19 coronavirus – How efficient did country health systems perform to flatten the curve in the first wave?," MPRA Paper 8872, University Library of Munich, Germany.
    3. Simar, Léopold & W. Wilson, Paul, 2019. "Central limit theorems and inference for sources of productivity change measured by nonparametric Malmquist indices," European Journal of Operational Research, Elsevier, vol. 277(2), pages 756-769.
    4. Victor Ngobeni & Marthinus C. Breitenbach & Goodness C. Aye, 2020. "Technical Efficiency of Provincial Public Healthcare in South Africa," Working Papers 202013, University of Pretoria, Department of Economics.
    5. Mohsen Afsharian & Heinz Ahn, 2015. "The overall Malmquist index: a new approach for measuring productivity changes over time," Annals of Operations Research, Springer, vol. 226(1), pages 1-27, March.
    6. Alexakis, Christos & Izzeldin, Marwan & Johnes, Jill & Pappas, Vasileios, 2019. "Performance and productivity in Islamic and conventional banks: Evidence from the global financial crisis," Economic Modelling, Elsevier, vol. 79(C), pages 1-14.
    7. Dickens S Omondi Aduda & Collins Ouma & Rosebella Onyango & Mathews Onyango & Jane Bertrand, 2015. "Voluntary Medical Male Circumcision Scale-Up in Nyanza, Kenya: Evaluating Technical Efficiency and Productivity of Service Delivery," PLOS ONE, Public Library of Science, vol. 10(2), pages 1-17, February.
    8. Zhensheng Chen & Xueli Chen & Tomas Baležentis & Xiaoqing Gan & Vivian Valdmanis, 2020. "Productivity change and its driving forces in Chinese healthcare sector," PLOS ONE, Public Library of Science, vol. 15(12), pages 1-16, December.
    9. Han Khanh Nguyen, 2021. "Application of Mathematical Models to Assess the Impact of the COVID-19 Pandemic on Logistics Businesses and Recovery Solutions for Sustainable Development," Mathematics, MDPI, vol. 9(16), pages 1-21, August.
    10. Seijas Díaz , Amparo & Iglesias Gómez , Guillermo, 2013. "Evolution of productivity and relation with satisfaction in hospital care and specialized care of Autonomous Communities Health Systems," INVESTIGACIONES REGIONALES - Journal of REGIONAL RESEARCH, Asociación Española de Ciencia Regional, issue 27, pages 7-32.
    11. Breitenbach, Marthinus C & Ngobeni, Victor & Aye, Goodness C, 2020. "Global Healthcare Resource Efficiency in the Management of COVID-19 Death and Infection Prevalence Rates," MPRA Paper 104814, University Library of Munich, Germany.

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