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Efficiency in university hospitals: A genetic optimized semi-parametric production function

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  • Wanke, Peter
  • Araujo, Claudia
  • Tan, Yong
  • Antunes, Jorge
  • Pimenta, Roberto

Abstract

This paper investigates the social-welfare efficiency drivers of public university hospitals in Brazil by focusing on how the surrounding social welfare conditions may affect their performance. A novel Genetic Envelopment Analysis (GEA) approach is developed here to this end. Subsequently, LASSO regression is applied to filter the impact of social-welfare related variables –on efficiency scores. Results indicate that beds, number of employees and number of doctors are the influential factors in determining the efficiency level, while the operating scales are not relevant to the productivity level. We further find that there is a degree of difference related to the efficiency level among the hospitals in the sample. Finally, our results show that GEA estimates present higher discrimination and dispersion compared to DEA, SFA and TOPSIS, also GEA provides the most reliable and accurate results. In the second stage analysis, we find that female population ratio and high school ratio significantly affect the efficiency level in a negative manner, while the urban population ratio has a significant and positive impact. Based on these results, we provide important policy implications.

Suggested Citation

  • Wanke, Peter & Araujo, Claudia & Tan, Yong & Antunes, Jorge & Pimenta, Roberto, 2023. "Efficiency in university hospitals: A genetic optimized semi-parametric production function," Operations Research Perspectives, Elsevier, vol. 10(C).
    • Handle: RePEc:eee:oprepe:v:10:y:2023:i:c:s2214716023000143
    DOI: 10.1016/j.orp.2023.100279
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    1. Grosskopf, Shawna & Margaritis, Dimitri & Valdmanis, Vivian, 2004. "Competitive effects on teaching hospitals," European Journal of Operational Research, Elsevier, vol. 154(2), pages 515-525, April.
    2. Sevaux, M. & Mineur, Y., 2007. "A curve-fitting genetic algorithm for a styling application," European Journal of Operational Research, Elsevier, vol. 179(3), pages 895-905, June.
    3. Marina Martins Siqueira & Claudia Affonso Silva Araujo, 2018. "Efficiency of Brazilian public services of kidney transplantation: Benchmarking Brazilian states via data envelopment analysis," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(4), pages 1067-1087, October.
    4. Abdollah Hadi-Vencheh & Peter Wanke & Ali Jamshidi, 2020. "What Does Cost Structure Have to Say about Thermal Plant Energy Efficiency? The Case from Angola," Energies, MDPI, vol. 13(9), pages 1-25, May.
    5. Mitropoulos, Panagiotis & Talias, Μichael A. & Mitropoulos, Ioannis, 2015. "Combining stochastic DEA with Bayesian analysis to obtain statistical properties of the efficiency scores: An application to Greek public hospitals," European Journal of Operational Research, Elsevier, vol. 243(1), pages 302-311.
    6. 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.
    7. Wanke, Peter & Azad, M.D. Abul Kalam & Barros, C.P., 2016. "Predicting efficiency in Malaysian Islamic banks: A two-stage TOPSIS and neural networks approach," Research in International Business and Finance, Elsevier, vol. 36(C), pages 485-498.
    8. Lindlbauer, Ivonne & Schreyögg, Jonas & Winter, Vera, 2016. "Changes in technical efficiency after quality management certification: A DEA approach using difference-in-difference estimation with genetic matching in the hospital industry," European Journal of Operational Research, Elsevier, vol. 250(3), pages 1026-1036.
    9. Emma Medin & Kjartan Anthun & Unto Häkkinen & Sverre Kittelsen & Miika Linna & Jon Magnussen & Kim Olsen & Clas Rehnberg, 2011. "Cost efficiency of university hospitals in the Nordic countries: a cross-country analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(6), pages 509-519, December.
    10. Udhayakumar, A. & Charles, V. & Kumar, Mukesh, 2011. "Stochastic simulation based genetic algorithm for chance constrained data envelopment analysis problems," Omega, Elsevier, vol. 39(4), pages 387-397, August.
    11. Scrucca, Luca, 2013. "GA: A Package for Genetic Algorithms in R," Journal of Statistical Software, Foundation for Open Access Statistics, vol. 53(i04).
    12. Yasar Ozcan & Marcos Lins & Maria Lobo & Angela da Silva & Roberto Fiszman & Basilio Pereira, 2010. "Evaluating the performance of Brazilian university hospitals," Annals of Operations Research, Springer, vol. 178(1), pages 247-261, July.
    13. Ferrara, Giancarlo & Vidoli, Francesco, 2017. "Semiparametric stochastic frontier models: A generalized additive model approach," European Journal of Operational Research, Elsevier, vol. 258(2), pages 761-777.
    14. Banker, Rajiv D. & Chang, Hsihui, 2006. "The super-efficiency procedure for outlier identification, not for ranking efficient units," European Journal of Operational Research, Elsevier, vol. 175(2), pages 1311-1320, December.
    15. Athanassopoulos, Antreas & Gounaris, Chrysostomos, 2001. "Assessing the technical and allocative efficiency of hospital operations in Greece and its resource allocation implications," European Journal of Operational Research, Elsevier, vol. 133(2), pages 416-431, January.
    16. J Harris & H Ozgen & Y Ozcan, 2000. "Do mergers enhance the performance of hospital efficiency?," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 51(7), pages 801-811, July.
    17. Chilingerian, Jon A., 1995. "Evaluating physician efficiency in hospitals: A multivariate analysis of best practices," European Journal of Operational Research, Elsevier, vol. 80(3), pages 548-574, February.
    18. Claudia Affonso Silva Araujo & Peter Wanke & Marina Martins Siqueira, 2018. "A performance analysis of Brazilian public health: TOPSIS and neural networks application," International Journal of Productivity and Performance Management, Emerald Group Publishing Limited, vol. 67(9), pages 1526-1549, November.
    19. Pereira, Miguel Alves & Camanho, Ana Santos & Figueira, José Rui & Marques, Rui Cunha, 2021. "Incorporating preference information in a range directional composite indicator: The case of Portuguese public hospitals," European Journal of Operational Research, Elsevier, vol. 294(2), pages 633-650.
    20. Himadri Ghosh & M. A. Iquebal & Prajneshu, 2011. "Bootstrap study of parameter estimates for nonlinear Richards growth model through genetic algorithm," Journal of Applied Statistics, Taylor & Francis Journals, vol. 38(3), pages 491-500, November.
    21. Mohammad Reza Mozaffari & Sahar Ostovan & Peter Fernandes Wanke, 2020. "A Hybrid Genetic Algorithm-Ratio DEA Approach for Assessing Sustainable Efficiency in Two-Echelon Supply Chains," Sustainability, MDPI, vol. 12(19), pages 1-17, September.
    22. Lin, Rung-Chuan & Sir, Mustafa Y. & Pasupathy, Kalyan S., 2013. "Multi-objective simulation optimization using data envelopment analysis and genetic algorithm: Specific application to determining optimal resource levels in surgical services," Omega, Elsevier, vol. 41(5), pages 881-892.
    23. D K Despotis, 2002. "Improving the discriminating power of DEA: focus on globally efficient units," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 53(3), pages 314-323, March.
    24. Behnam Zebardast & Isa Maleki, 2013. "A New Radial Basis Function Artificial Neural Network based Recognition for Kurdish Manuscript," International Journal of Applied Evolutionary Computation (IJAEC), IGI Global, vol. 4(4), pages 72-87, October.
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