Quantifying the effects of modelling choices on hospital efficiency measures: A meta-regression analysis
It has often been argued that the results of efficiency analyses in health care are influenced by the modelling choices made by the researchers involved. In this paper we use meta-regression analysis in an attempt to quantify the degree to which modelling factors influence efficiency estimates. The data set is derived from 253 estimated models reported in 95 empirical analyses of hospital efficiency in the 22-year period from 1987 to 2008. A meta-regression model is used to investigate the degree to which differences in mean efficiency estimates can be explained by factors such as: sample size; dimension (number of variables); parametric versus non-parametric method; returns to scale (RTS) assumptions; functional form; error distributional form; input versus output orientation; cost versus technical efficiency measure; and cross-sectional versus panel data. Sample size, dimension and RTS are found to have statistically significant effects at the 1% level. Sample size has a negative (and diminishing) effect on efficiency; dimension has a positive (and diminishing) effect; while the imposition of constant returns to scale has a negative effect. These results can be used in improving the policy relevance of the empirical results produced by hospital efficiency studies.
|Date of creation:||2009|
|Contact details of provider:|| Postal: St. Lucia, Qld. 4072|
Phone: +61 7 3365 6570
Fax: +61 7 3365 7299
Web page: http://www.uq.edu.au/economics/
More information through EDIRC
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.:
- Espey, Molly, 1998. "Gasoline demand revisited: an international meta-analysis of elasticities," Energy Economics, Elsevier, vol. 20(3), pages 273-295, June.
- Nijkamp, Peter & Poot, Jacques, 2004. "Meta-analysis of the effect of fiscal policies on long-run growth," European Journal of Political Economy, Elsevier, vol. 20(1), pages 91-124, March.
- Peter C. Smith & Andrew Street, 2005. "Measuring the efficiency of public services: the limits of analysis," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 168(2), pages 401-417.
- U. -G. Gerdtham & C. Rehnberg & M. Tambour, 1999.
"The impact of internal markets on health care efficiency: evidence from health care reforms in Sweden,"
Taylor & Francis Journals, vol. 31(8), pages 935-945.
- Gerdtham, Ulf-G. & Rehnberg, Clas & Tambour, Magnus, 1997. "The Impact of Internal Markets on Health Care Efficiency: Evidence from Health Care Reforms in Sweden," SSE/EFI Working Paper Series in Economics and Finance 170, Stockholm School of Economics.
- MacKinnon, James G. & White, Halbert & Davidson, Russell, 1983. "Tests for model specification in the presence of alternative hypotheses : Some further results," Journal of Econometrics, Elsevier, vol. 21(1), pages 53-70, January.
- Russell Davidson & James G. MacKinnon, 1981. "Tests for Model Specification in the Presence of Alternative Hypotheses: Some Further Results," Working Papers 430, Queen's University, Department of Economics.
- Maria Abreu Henri L. F. de Groot & Raymond J. G. M. Florax, 2005. "A Meta-Analysis of β-Convergence: the Legendary 2%," Journal of Economic Surveys, Wiley Blackwell, vol. 19(3), pages 389-420, 07.
- Hristos Doucouliagos & Martin Paldam, 2006. "Aid Effectiveness on Accumulation: A Meta Study," Kyklos, Wiley Blackwell, vol. 59(2), pages 227-254, 05.
- Hristos Doucouliagos & Martin Paldam, 2005. "Aid Effectiveness on Accumulation. A Meta Study," Economics Working Papers 2005-12, Department of Economics and Business Economics, Aarhus University.
- Frech, H E, III & Mobley, Lee Rivers, 2000. "Efficiency, Growth, and Concentration: An Empirical Analysis of Hospital Markets," Economic Inquiry, Western Economic Association International, vol. 38(3), pages 369-384, July.
- Frech, Ted E, 1998. "Efficiency, Growth and Concentration: An Empirical Analysis of Hospital Markets," University of California at Santa Barbara, Economics Working Paper Series qt7cd1329w, Department of Economics, UC Santa Barbara.
- Molly Espey, 2000. "The Impact of Airport Noise and Proximity on Residential Property Values," Growth and Change, Wiley Blackwell, vol. 31(3), pages 408-419.
- Chris Doucouliagos, 1995. "Worker Participation and Productivity in Labor-Managed and Participatory Capitalist Firms: A Meta-Analysis," ILR Review, Cornell University, ILR School, vol. 49(1), pages 58-77, October.
- Doucouliagos, Chris, 1997. "The Aggregate Demand for Labour in Australia: A Meta-analysis," Australian Economic Papers, Wiley Blackwell, vol. 36(69), pages 224-242, December.
- Loren Tauer, 2001. "Input aggregation and computed technical efficiency," Applied Economics Letters, Taylor & Francis Journals, vol. 8(5), pages 295-297.
- Rachel Croson & Melanie Marks, 2000. "Step Returns in Threshold Public Goods: A Meta- and Experimental Analysis," Experimental Economics, Springer;Economic Science Association, vol. 2(3), pages 239-259, March.
- U.-G. Gerdtham & M. Löthgren & M. Tambour & C. Rehnberg, 1999. "Internal markets and health care efficiency: a multiple-output stochastic frontier analysis," Health Economics, John Wiley & Sons, Ltd., vol. 8(2), pages 151-164.
- Gerdtham, Ulf-G. & Löthgren, Mickael & Tambour, Magnus & Rehnberg, Clas, 1998. "Internal Markets and Health Care Efficiency: A Multiple-Output Stochastic Frontier Analysis," SSE/EFI Working Paper Series in Economics and Finance 222, Stockholm School of Economics.
- Boris Bravo-Ureta & Daniel Solís & Víctor Moreira López & José Maripani & Abdourahmane Thiam & Teodoro Rivas, 2007. "Technical efficiency in farming: a meta-regression analysis," Journal of Productivity Analysis, Springer, vol. 27(1), pages 57-72, February.
- Bravo-Ureta, Boris & Solís, Daniel & Moreira, Victor & Maripani, José & Thiam, Abdourahmane & Rivas, Teodoro, 2005. "Technical Efficiency in Farming: A Meta-regression analysis," Efficiency Series Papers 2005/01, University of Oviedo, Department of Economics, Oviedo Efficiency Group (OEG).
- Andrew Street, 2003. "How much confidence should we place in efficiency estimates?," Health Economics, John Wiley & Sons, Ltd., vol. 12(11), pages 895-907.
- Loomis, John B. & White, Douglas S., 1996. "Economic benefits of rare and endangered species: summary and meta-analysis," Ecological Economics, Elsevier, vol. 18(3), pages 197-206, September.
- Martijn Brons & Peter Nijkamp & Eric Pels & Piet Rietveld, 2005. "Efficiency of urban public transit: A meta analysis," Transportation, Springer, vol. 32(1), pages 1-21, January.
- Valdmanis, Vivian, 1992. "Sensitivity analysis for DEA models : An empirical example using public vs. NFP hospitals," Journal of Public Economics, Elsevier, vol. 48(2), pages 185-205, July.
- Donald F. Vitaliano & Mark Toren, 1996. "Hospital Cost and Efficiency in a Regime of Stringent Regulation," Eastern Economic Journal, Eastern Economic Association, vol. 22(2), pages 161-175, Spring.
- Mike Smet, 2007. "Measuring performance in the presence of stochastic demand for hospital services: an analysis of Belgian general care hospitals," Journal of Productivity Analysis, Springer, vol. 27(1), pages 13-29, February.
- 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.
- Andrew Street & Rowena Jacobs, 2002. "Relative performance evaluation of the English acute hospital sector," Applied Economics, Taylor & Francis Journals, vol. 34(9), pages 1109-1119.
- Gannon, Brenda, 2004. "Technical Efficiency of Hospitals in Ireland," Papers HRBWP18, Economic and Social Research Institute (ESRI).
- Cremieux, Pierre-Yves & Ouellette, Pierre, 2001. "Omitted variable bias and hospital costs," Journal of Health Economics, Elsevier, vol. 20(2), pages 271-282, March.
- Bruce Hollingsworth & Andrew Street, 2006. "The market for efficiency analysis of health care organisations," Health Economics, John Wiley & Sons, Ltd., vol. 15(10), pages 1055-1059.
- Newhouse, Joseph P., 1994. "Frontier estimation: How useful a tool for health economics?," Journal of Health Economics, Elsevier, vol. 13(3), pages 317-322, October.
- Diego Prior & Magda Solà, 2000. "Technical efficiency and economies of diversification in health care," Health Care Management Science, Springer, vol. 3(4), pages 299-307, September.
- Diego Prior, 2006. "Efficiency and total quality management in health care organizations: A dynamic frontier approach," Annals of Operations Research, Springer, vol. 145(1), pages 281-299, July.
- Grosskopf, S. & Valdmanis, V., 1987. "Measuring hospital performance : A non-parametric approach," Journal of Health Economics, Elsevier, vol. 6(2), pages 89-107, June.
- Espey, Molly & Thilmany, Dawn D., 2000. "Farm Labor Demand: A Meta-Regression Analysis Of Wage Elasticities," Journal of Agricultural and Resource Economics, Western Agricultural Economics Association, vol. 25(01), July. Full references (including those not matched with items on IDEAS)