Regional Differences in the Efficiency of Health Production: an Artefact of Spatial Dependence?
AbstractThe inefficiency of health care provision presents a major health policy concern in Germany. In order to address the issue of efficiency comprehensively – i.e. at the level of the entire system of health care provision rather than individual service providers – empirical analyses are often based on data at the regional level.However, regional efficiencies might be subject to spatial dependence, rendering any analysis biased that aims at identifying the determinants of efficiency differentials. We address this issue by specifying a spatial autoregressive model to explain efficiency scores for German districts which we derive through data envelopment analysis. Regression results suggest that spatial dependence is not a dominant feature in the data. Hence, ignoring spatial interdependence is unlikely to severely bias results of efficiency analyses based on regional data.This holds, in particular, for the role of the states in the efficiency of health production. Significant heterogeneity among states is found in the data regardless of whether or not spatial dependence is accounted for.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
Bibliographic InfoPaper provided by Rheinisch-Westfälisches Institut für Wirtschaftsforschung, Ruhr-Universität Bochum, Universität Dortmund, Universität Duisburg-Essen in its series Ruhr Economic Papers with number 0112.
Length: 18 pages
Date of creation: Jun 2009
Date of revision:
Find related papers by JEL classification:
- I12 - Health, Education, and Welfare - - Health - - - Health Production
- R10 - Urban, Rural, Regional, Real Estate, and Transportation Economics - - General Regional Economics - - - General
This paper has been announced in the following NEP Reports:
- NEP-ALL-2009-07-03 (All new papers)
- NEP-EFF-2009-07-03 (Efficiency & Productivity)
- NEP-GEO-2009-07-03 (Economic Geography)
- NEP-HEA-2009-07-03 (Health Economics)
- NEP-URE-2009-07-03 (Urban & Real Estate Economics)
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.:
- G�ran Therborn & K.C. Ho, 2009. "Introduction," City, Taylor & Francis Journals, vol. 13(1), pages 53-62, March.
- Boris Augurzky & Sebastian Krolop & Rosemarie Gülker & Christoph M. Schmidt & Hendrik Schmitz & Christoph Schwierz & Stefan Terkatz, 2009. "Krankenhaus Rating Report 2009 – Im Auge des Orkans," RWI Materialien, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, pages 160, December.
- Anselin, Luc, 2002. "Under the hood : Issues in the specification and interpretation of spatial regression models," Agricultural Economics, Blackwell, vol. 27(3), pages 247-267, November.
- Annika Herr, 2008. "Cost and technical efficiency of German hospitals: does ownership matter?," Health Economics, John Wiley & Sons, Ltd., vol. 17(9), pages 1057-1071.
- Boris Augurzky & Harald Tauchmann & Andreas Werblow & Stefan Felder, 2008. "Effizienzreserven im Gesundheitswesen," RWI Materialien, Rheinisch-Westfälisches Institut für Wirtschaftsforschung, pages 54, December.
- Seiford, Lawrence M. & Thrall, Robert M., 1990. "Recent developments in DEA : The mathematical programming approach to frontier analysis," Journal of Econometrics, Elsevier, vol. 46(1-2), pages 7-38.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Sabine Weiler).
If references are entirely missing, you can add them using this form.