IDEAS home Printed from https://ideas.repec.org/a/eee/jomega/v98y2021ics0305048319300702.html
   My bibliography  Save this article

Factor-analysis-based directional distance function: The case of New Zealand hospitals

Author

Listed:
  • Deng, Zhongqi
  • Jiang, Nan
  • Pang, Ruizhi

Abstract

This paper develops a new factor-analysis-based (FAB) approach for choosing the optimal direction in a directional distance function (DDF) analysis. It has the combined merits of factor analysis and slacks-based measure (SBM) and incorporates the relative ease with which various input-output could be adjusted. This development relieves the reliance on price information that is difficult to obtain in the provision of public goods. This new FAB-DDF model has been applied on a dataset containing all public hospitals in New Zealand (NZ) observed during 2011–2017. The empirical results indicate that the average reduction across different labor is in the range of 3–10 percent, and the corresponding figure for capital input is 25.7 percent. The case-adjusted inpatient-discharge and price-adjusted outpatient-visit are used as measures of desirable output, the average efficiencies are 92.7 percent and 99 percent respectively. Hospital readmission within 28 days of discharge is used as a measure for undesirable output, and the average efficiency score is 90 percent. These results support the suspicion that perverse incentives might exist under the National Health Targets, which was a set of six indicators used in the last decade to evaluate the performance of local District Health Boards. The newly elected labor government in 2018 abolished the targets, and the replacement scheme is still under development.

Suggested Citation

  • Deng, Zhongqi & Jiang, Nan & Pang, Ruizhi, 2021. "Factor-analysis-based directional distance function: The case of New Zealand hospitals," Omega, Elsevier, vol. 98(C).
    • Handle: RePEc:eee:jomega:v:98:y:2021:i:c:s0305048319300702
    DOI: 10.1016/j.omega.2019.102111
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0305048319300702
    Download Restriction: Full text for ScienceDirect subscribers only
    File URL: https://libkey.io/10.1016/j.omega.2019.102111?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to look for a different version below or search for a different version of it.

    Other versions of this item:

    References listed on IDEAS

    as
    1. Gale Boyd & George Tolley & Joseph Pang, 2002. "Plant Level Productivity, Efficiency, and Environmental Performance of the Container Glass Industry," Environmental & Resource Economics, Springer;European Association of Environmental and Resource Economists, vol. 23(1), pages 29-43, September.
    2. Andrew T. Foerster & Pierre-Daniel G. Sarte & Mark W. Watson, 2011. "Sectoral versus Aggregate Shocks: A Structural Factor Analysis of Industrial Production," Journal of Political Economy, University of Chicago Press, vol. 119(1), pages 1-38.
    3. David Parkin & Bruce Hollingsworth, 1997. "Measuring production efficiency of acute hospitals in Scotland, 1991-94: validity issues in data envelopment analysis," Applied Economics, Taylor & Francis Journals, vol. 29(11), pages 1425-1433.
    4. McFadden, Daniel, 1978. "Cost, Revenue, and Profit Functions," Histoy of Economic Thought Chapters, in: Fuss, Melvyn & McFadden, Daniel (ed.),Production Economics: A Dual Approach to Theory and Applications, volume 1, chapter 1, McMaster University Archive for the History of Economic Thought.
    5. Jose Zofio & Jesus Pastor & Juan Aparicio, 2013. "The directional profit efficiency measure: on why profit inefficiency is either technical or allocative," Journal of Productivity Analysis, Springer, vol. 40(3), pages 257-266, December.
    6. Luenberger, David G., 1992. "Benefit functions and duality," Journal of Mathematical Economics, Elsevier, vol. 21(5), pages 461-481.
    7. Kumar, Surender, 2006. "Environmentally sensitive productivity growth: A global analysis using Malmquist-Luenberger index," Ecological Economics, Elsevier, vol. 56(2), pages 280-293, February.
    8. Schmitt, Matt, 2017. "Do hospital mergers reduce costs?," Journal of Health Economics, Elsevier, vol. 52(C), pages 74-94.
    9. Feng, Guohua & Serletis, Apostolos, 2014. "Undesirable outputs and a primal Divisia productivity index based on the directional output distance function," Journal of Econometrics, Elsevier, vol. 183(1), pages 135-146.
    10. Rolf Färe & Shawna Grosskopf & Carl A. Pasurka & William L. Weber, 2012. "Substitutability among undesirable outputs," Applied Economics, Taylor & Francis Journals, vol. 44(1), pages 39-47, January.
    11. Annika Herr & Hendrik Schmitz & Boris Augurzky, 2011. "Profit efficiency and ownership of German hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 20(6), pages 660-674, June.
    12. Fare, Rolf & Grosskopf, Shawna & Noh, Dong-Woon & Weber, William, 2005. "Characteristics of a polluting technology: theory and practice," Journal of Econometrics, Elsevier, vol. 126(2), pages 469-492, June.
    13. Chambers, Robert & Färe, Rolf & Grosskopf, Shawna & Vardanyan, Michael, 2013. "Generalized quadratic revenue functions," Journal of Econometrics, Elsevier, vol. 173(1), pages 11-21.
    14. Atkinson, Scott E. & Tsionas, Mike G., 2016. "Directional distance functions: Optimal endogenous directions," Journal of Econometrics, Elsevier, vol. 190(2), pages 301-314.
    15. Aletras, Vassilios & Kontodimopoulos, Nick & Zagouldoudis, Athanasios & Niakas, Dimitris, 2007. "The short-term effect on technical and scale efficiency of establishing regional health systems and general management in Greek NHS hospitals," Health Policy, Elsevier, vol. 83(2-3), pages 236-245, October.
    16. Fuss, Melvyn & McFadden, Daniel, 1978. "Production Economics: A Dual Approach to Theory and Applications (II): Applications of the Theory of Production," History of Economic Thought Books, McMaster University Archive for the History of Economic Thought, volume 2, number fuss1978a.
    17. Fare, Rolf & Grosskopf, Shawna & Weber, William L., 2006. "Shadow prices and pollution costs in U.S. agriculture," Ecological Economics, Elsevier, vol. 56(1), pages 89-103, January.
    18. Jens J. Krüger, 2017. "Revisiting the world technology frontier: a directional distance function approach," Journal of Economic Growth, Springer, vol. 22(1), pages 67-95, March.
    19. Boivin, Jean & Ng, Serena, 2006. "Are more data always better for factor analysis?," Journal of Econometrics, Elsevier, vol. 132(1), pages 169-194, May.
    20. Chang, Hsihui & Cheng, Mei-Ai & Das, Somnath, 2004. "Hospital ownership and operating efficiency: Evidence from Taiwan," European Journal of Operational Research, Elsevier, vol. 159(2), pages 513-527, December.
    21. Oxholm, Anne Sophie & Kristensen, Søren Rud & Sutton, Matt, 2018. "Uncertainty about the effort–performance relationship in threshold-based payment schemes," Journal of Health Economics, Elsevier, vol. 62(C), pages 69-83.
    22. Fuss, Melvyn & McFadden, Daniel (ed.), 1978. "Production Economics: A Dual Approach to Theory and Applications," Elsevier Monographs, Elsevier, edition 1, number 9780444850133.
    23. H. Shelton Brown, 2003. "Managed care and technical efficiency," Health Economics, John Wiley & Sons, Ltd., vol. 12(2), pages 149-158, February.
    24. R. Färe & S. Grosskopf & G. Whittaker, 2013. "Directional output distance functions: endogenous directions based on exogenous normalization constraints," Journal of Productivity Analysis, Springer, vol. 40(3), pages 267-269, December.
    25. Fukuyama, Hirofumi & Weber, William L., 2009. "A directional slacks-based measure of technical inefficiency," Socio-Economic Planning Sciences, Elsevier, vol. 43(4), pages 274-287, December.
    26. Eggleston, Karen, 2005. "Multitasking and mixed systems for provider payment," Journal of Health Economics, Elsevier, vol. 24(1), pages 211-223, January.
    27. Pang, Rui-Zhi & Deng, Zhong-Qi & Hu, Jin-li, 2015. "Clean energy use and total-factor efficiencies: An international comparison," Renewable and Sustainable Energy Reviews, Elsevier, vol. 52(C), pages 1158-1171.
    28. Mark Agee & Scott Atkinson & Thomas Crocker, 2012. "Child maturation, time-invariant, and time-varying inputs: their interaction in the production of child human capital," Journal of Productivity Analysis, Springer, vol. 38(1), pages 29-44, August.
    29. 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, September.
    30. Badau, Flavius & Färe, Rolf & Gopinath, Munisamy, 2016. "Global resilience to climate change: Examining global economic and environmental performance resulting from a global carbon dioxide market," Resource and Energy Economics, Elsevier, vol. 45(C), pages 46-64.
    31. 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.
    32. Fuss, Melvyn & McFadden, Daniel, 1978. "Production Economics: A Dual Approach to Theory and Applications (I): The Theory of Production," History of Economic Thought Books, McMaster University Archive for the History of Economic Thought, volume 1, number fuss1978.
    33. Friesner, Daniel & Mittelhammer, Ron & Rosenman, Robert, 2013. "Inferring the incidence of industry inefficiency from DEA estimates," European Journal of Operational Research, Elsevier, vol. 224(2), pages 414-424.
    34. Rolf Färe & Shawna Grosskopf, 2000. "Theory and Application of Directional Distance Functions," Journal of Productivity Analysis, Springer, vol. 13(2), pages 93-103, March.
    35. Chambers, Robert G. & Chung, Yangho & Fare, Rolf, 1996. "Benefit and Distance Functions," Journal of Economic Theory, Elsevier, vol. 70(2), pages 407-419, August.
    36. Tone, Kaoru, 2001. "A slacks-based measure of efficiency in data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 130(3), pages 498-509, May.
    37. Ancarani, A. & Di Mauro, C. & Giammanco, M.D., 2009. "The impact of managerial and organizational aspects on hospital wards' efficiency: Evidence from a case study," European Journal of Operational Research, Elsevier, vol. 194(1), pages 280-293, April.
    38. Lee, Chia-Yen, 2014. "Meta-data envelopment analysis: Finding a direction towards marginal profit maximization," European Journal of Operational Research, Elsevier, vol. 237(1), pages 207-216.
    39. Luenberger, David G., 1995. "Externalities and benefits," Journal of Mathematical Economics, Elsevier, vol. 24(2), pages 159-177.
    40. R. G. Chambers & Y. Chung & R. Färe, 1998. "Profit, Directional Distance Functions, and Nerlovian Efficiency," Journal of Optimization Theory and Applications, Springer, vol. 98(2), pages 351-364, August.
    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. Xian‐Hui He & Yung‐ho Chiu & Tzu‐Han Chang & Liang‐Chun Lu & Shih‐Yung Chiu, 2021. "Analyzing hospital medical efficiency of administration and medical treatment in China," Managerial and Decision Economics, John Wiley & Sons, Ltd., vol. 42(6), pages 1564-1578, September.
    2. Gao, Qiuming & Wang, Derek, 2021. "Hospital efficiency and equity in health care delivery: A study based in China," Socio-Economic Planning Sciences, Elsevier, vol. 76(C).
    3. Vardanyan, Michael & Valdmanis, Vivian G. & Leleu, Hervé & Ferrier, Gary D., 2022. "Estimating technology characteristics of the U.S. hospital industry using directional distance functions with optimal directions," Omega, Elsevier, vol. 113(C).
    4. Tavana, Madjid & Izadikhah, Mohammad & Toloo, Mehdi & Roostaee, Razieh, 2021. "A new non-radial directional distance model for data envelopment analysis problems with negative and flexible measures," Omega, Elsevier, vol. 102(C).
    5. Zhichao Wang & Bao Hoang Nguyen & Valentin Zelenyuk, 2024. "Performance analysis of hospitals in Australia and its peers: a systematic and critical review," Journal of Productivity Analysis, Springer, vol. 62(2), pages 139-173, October.
    6. Zhongqi Deng & Yu Zhang & Ao Yu, 2020. "The New Economy in China: An Intercity Comparison," SAGE Open, , vol. 10(4), pages 21582440209, December.
    7. Zhichao Wang & Valentin Zelenyuk, 2021. "Performance Analysis of Hospitals in Australia and its Peers: A Systematic Review," CEPA Working Papers Series WP012021, School of Economics, University of Queensland, Australia.
    8. Deng, Zhongqi & Song, Shunfeng & Jiang, Nan & Pang, Ruizhi, 2023. "Sustainable development in China? A nonparametric decomposition of economic growth," China Economic Review, Elsevier, vol. 81(C).
    9. Zhongqi Deng & Qianyu Zhao & Helen X. H. Bao, 2020. "The Impact of Urbanization on Farmland Productivity: Implications for China’s Requisition–Compensation Balance of Farmland Policy," Land, MDPI, vol. 9(9), pages 1-24, September.

    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. Deng, Zhongqi & Song, Shunfeng & Jiang, Nan & Pang, Ruizhi, 2023. "Sustainable development in China? A nonparametric decomposition of economic growth," China Economic Review, Elsevier, vol. 81(C).
    2. Ke Wang & Yujiao Xian & Chia-Yen Lee & Yi-Ming Wei & Zhimin Huang, 2019. "On selecting directions for directional distance functions in a non-parametric framework: a review," Annals of Operations Research, Springer, vol. 278(1), pages 43-76, July.
    3. Briec, Walter & Dumas, Audrey & Kerstens, Kristiaan & Stenger, Agathe, 2022. "Generalised commensurability properties of efficiency measures: Implications for productivity indicators," European Journal of Operational Research, Elsevier, vol. 303(3), pages 1481-1492.
    4. Song, Malin & Wang, Jianlin, 2018. "Environmental efficiency evaluation of thermal power generation in China based on a slack-based endogenous directional distance function model," Energy, Elsevier, vol. 161(C), pages 325-336.
    5. Briec, Walter & Comes, Christine & Kerstens, Kristiaan, 2006. "Temporal technical and profit efficiency measurement: Definitions, duality and aggregation results," International Journal of Production Economics, Elsevier, vol. 103(1), pages 48-63, September.
    6. Vardanyan, Michael & Valdmanis, Vivian G. & Leleu, Hervé & Ferrier, Gary D., 2022. "Estimating technology characteristics of the U.S. hospital industry using directional distance functions with optimal directions," Omega, Elsevier, vol. 113(C).
    7. Arabmaldar, Aliasghar & Sahoo, Biresh K. & Ghiyasi, Mojtaba, 2023. "A generalized robust data envelopment analysis model based on directional distance function," European Journal of Operational Research, Elsevier, vol. 311(2), pages 617-632.
    8. Fangqing Wei & Junfei Chu & Jiayun Song & Feng Yang, 2019. "A cross-bargaining game approach for direction selection in the directional distance function," OR Spectrum: Quantitative Approaches in Management, Springer;Gesellschaft für Operations Research e.V., vol. 41(3), pages 787-807, September.
    9. Nan Jiang & Antony Andrews, 2020. "Efficiency of New Zealand’s District Health Boards at Providing Hospital Services: A stochastic frontier analysis," Journal of Productivity Analysis, Springer, vol. 53(1), pages 53-68, February.
    10. Kuosmanen, Timo & Johnson, Andrew, 2017. "Modeling joint production of multiple outputs in StoNED: Directional distance function approach," European Journal of Operational Research, Elsevier, vol. 262(2), pages 792-801.
    11. Färe, Rolf & Pasurka, Carl & Vardanyan, Michael, 2017. "On endogenizing direction vectors in parametric directional distance function-based models," European Journal of Operational Research, Elsevier, vol. 262(1), pages 361-369.
    12. Pham, Manh D. & Zelenyuk, Valentin, 2019. "Weak disposability in nonparametric production analysis: A new taxonomy of reference technology sets," European Journal of Operational Research, Elsevier, vol. 274(1), pages 186-198.
    13. 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.
    14. Malin Song & Jianlin Wang & Jiajia Zhao & Tomas Baležentis & Zhiyang Shen, 2020. "Production and safety efficiency evaluation in Chinese coal mines: accident deaths as undesirable output," Annals of Operations Research, Springer, vol. 291(1), pages 827-845, August.
    15. Manh D. Pham & Valentin Zelenyuk, 2017. "Convexity, Disposability and Returns to Scale in Production Analysis," CEPA Working Papers Series WP042017, School of Economics, University of Queensland, Australia.
    16. Martin Bod’a & Martin Dlouhý & Emília Zimková, 2018. "Unobservable or omitted production variables in data envelopment analysis through unit-specific production trade-offs," 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. 26(4), pages 813-846, December.
    17. A. Abad & P. Ravelojaona, 2017. "Exponential environmental productivity index and indicators," Journal of Productivity Analysis, Springer, vol. 48(2), pages 147-166, December.
    18. Yaryna Kolomiytseva, 2018. "Revisiting Transformation and Directional Technology Distance Functions," Papers 1812.10108, arXiv.org.
    19. Shuguang Lin & Paul Rouse & Ying-Ming Wang & Lin Lin & Zhen-Quan Zheng, 2023. "Performance measurement of nonhomogeneous Hong Kong hospitals using directional distance functions," Health Care Management Science, Springer, vol. 26(2), pages 330-343, June.
    20. Mauricio Benegas & Emerson Marinho, 2008. "Duality, Net Supply, and The Directional Distance Function," Anais do XXXVI Encontro Nacional de Economia [Proceedings of the 36th Brazilian Economics Meeting] 200807211656140, ANPEC - Associação Nacional dos Centros de Pós-Graduação em Economia [Brazilian Association of Graduate Programs in Economics].

    More about this item

    Keywords

    Factor-analysis-based measure; Directional distance function; NZ hospital efficiency; Hospital readmission;
    All these keywords.

    JEL classification:

    • C61 - Mathematical and Quantitative Methods - - Mathematical Methods; Programming Models; Mathematical and Simulation Modeling - - - Optimization Techniques; Programming Models; Dynamic Analysis
    • D24 - Microeconomics - - Production and Organizations - - - Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    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:eee:jomega:v:98:y:2021:i:c:s0305048319300702. 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: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/375/description#description .

    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.