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Quality‐efficiency trade‐off when the state is the sole provider of hospital services: Evidence from New Zealand

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  • Antony Andrews
  • Biresh K. Sahoo
  • Omphile Temoso
  • Sean Kimpton

Abstract

The purpose of this study is to explore the trade‐off between technical efficiency and the quality of hospital services when the state is the sole provider. Data from 20 New Zealand District Health Boards from 2011 to 2017 is used to estimate technical efficiency using the data envelopment analysis technique, which employs an additive inverse formulation for undesirable outcomes. The estimated average quality‐adjusted technical efficiency score is 0.69. In comparison, when the quality variable was removed, the efficiency declined to 0.66. More importantly, the ranking of district health boards stays consistent across both models, indicating that there is very little trade‐off between quality and efficiency. A sensitivity analysis also confirms the lack of a trade‐off between quality and efficiency.

Suggested Citation

  • Antony Andrews & Biresh K. Sahoo & Omphile Temoso & Sean Kimpton, 2023. "Quality‐efficiency trade‐off when the state is the sole provider of hospital services: Evidence from New Zealand," Australian Economic Papers, Wiley Blackwell, vol. 62(2), pages 335-348, June.
    • Handle: RePEc:bla:ausecp:v:62:y:2023:i:2:p:335-348
    DOI: 10.1111/1467-8454.12288
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    References listed on IDEAS

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    1. Léopold Simar & Paul Wilson, 2000. "Statistical Inference in Nonparametric Frontier Models: The State of the Art," Journal of Productivity Analysis, Springer, vol. 13(1), pages 49-78, January.
    2. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128, October.
    3. Mahlberg, Bernhard & Luptacik, Mikulas & Sahoo, Biresh K., 2011. "Examining the drivers of total factor productivity change with an illustrative example of 14 EU countries," Ecological Economics, Elsevier, vol. 72(C), pages 60-69.
    4. Sahoo, Nihar R. & Mohapatra, Pratap K.J. & Sahoo, Biresh K. & Mahanty, Biswajit, 2017. "Rationality of energy efficiency improvement targets under the PAT scheme in India – A case of thermal power plants," Energy Economics, Elsevier, vol. 66(C), pages 279-289.
    5. Sahoo, Biresh K. & Acharya, Debashis, 2010. "An alternative approach to monetary aggregation in DEA," European Journal of Operational Research, Elsevier, vol. 204(3), pages 672-682, August.
    6. Sahoo, Biresh K. & Luptacik, Mikulas & Mahlberg, Bernhard, 2011. "Alternative measures of environmental technology structure in DEA: An application," European Journal of Operational Research, Elsevier, vol. 215(3), pages 750-762, December.
    7. repec:rre:publsh:v:38:y:2008:i:3:p:381-93 is not listed on IDEAS
    8. Jan Clement & Vivian Valdmanis & Gloria Bazzoli & Mei Zhao & Askar Chukmaitov, 2008. "Is more better? An analysis of hospital outcomes and efficiency with a DEA model of output congestion," Health Care Management Science, Springer, vol. 11(1), pages 67-77, March.
    9. Sahoo, Biresh K. & Singh, Ramadhar & Mishra, Bineet & Sankaran, Krithiga, 2017. "Research productivity in management schools of India during 1968-2015: A directional benefit-of-doubt model analysis," Omega, Elsevier, vol. 66(PA), pages 118-139.
    10. Niccie L. McKay & Mary E. Deily, 2008. "Cost inefficiency and hospital health outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 17(7), pages 833-848, July.
    11. Fare, Rolf, et al, 1989. "Multilateral Productivity Comparisons When Some Outputs Are Undesirable: A Nonparametric Approach," The Review of Economics and Statistics, MIT Press, vol. 71(1), pages 90-98, February.
    12. Seiford, Lawrence M. & Zhu, Joe, 2002. "Modeling undesirable factors in efficiency evaluation," European Journal of Operational Research, Elsevier, vol. 142(1), pages 16-20, October.
    13. Mary E. Deily & Niccie L. McKay, 2006. "Cost inefficiency and mortality rates in Florida hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 419-431, April.
    14. William W. Cooper & Lawrence M. Seiford & Kaoru Tone, 2007. "Data Envelopment Analysis," Springer Books, Springer, edition 0, number 978-0-387-45283-8, December.
    15. Hervé Leleu & Mona Al-Amin & Michael Rosko & Vivian Valdmanis, 2017. "A robust analysis of hospital efficiency and factors affecting variability," Post-Print halshs-01720471, HAL.
    16. Scheel, Holger, 2001. "Undesirable outputs in efficiency valuations," European Journal of Operational Research, Elsevier, vol. 132(2), pages 400-410, July.
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