Hospital Efficiency: An Empirical Analysis of District and Grant-in-Aid Hospitals in Gujarat

This study focuses on analysing the hospital efficiency of district level government hospitals and grant-in-aid hospitals in Gujarat. The study makes an attempt to provide an overview of the general status of the health care services provided by hospitals in the state of Gujarat in terms of their technical and allocative efficiency. One of the two thrusts behind addressing the issue of efficiency was to take stock of the state of healthcare services (in terms of efficiency) provided by grant-in-aid hospitals and district hospitals in Gujarat. The motivation behind addressing the efficiency issue is to provide empirical analysis of governments policy to provide grants to not-for-profit making institutions which in turn provide hospital care in the state. The study addresses the issue whether grant-in-aid hospitals are relatively more efficient than public hospitals. This comparison between grant-in-aid hospitals and district hospitals in terms of their efficiency has been of interest to many researchers in countries other than India, and no consensus has been reached so far as to which category is more efficient. The relative efficiency of government and not-for-profit sector has been reviewed in this paper. It is expected that the findings of the study would be useful to evaluate this policy and help policy makers to develop benchmarks in providing the grants to such institutions.

Gaming in a benchmarking environment. A non-parametric analysis of benchmarking in the water sector

This paper discusses the use of benchmarking in general and its application to the drinking water sector. It systematizes the various classifications on performance measurement, discusses some of the pitfalls of benchmark studies and provides some examples of benchmarking in the water sector. After presenting in detail the institutional framework of the water sector of the Belgian region of Flanders (without benchmarking experiences), Wallonia (recently started a public benchmark) and the Netherlands (introduced already in 1997 a public benchmark), we non-parametrically measure the productivity gains by the use of a dynamic Malmquist index. The three regions, each at a different stage of the benchmarking circle, exhibit different performance trends. The ‘carrot’ and the ‘stick’ of benchmarking seem to offer an effective incentive to trigger performance. In addition, the Malmquist decompositions provide some evidence on the ‘gaming’ of the stakeholders by the water utilities.Benchmarking; gaming; Malmquist decomposition; regulation; water sector

Far out or alone in the crowd: Classification of selfevaluators in DEA

The units found strongly efficient in DEA studies on efficiency can be divided into self-evaluators and active peers, depending on whether the peers are referencing any inefficient units or not. The contribution of the paper starts with subdividing the selfevaluators into interior and exterior ones. The exterior self-evaluators are efficient “by default”; there is no firm evidence from observations for the classification. These units should therefore not been regarded as efficient, and be removed from the observations on efficiency scores when performing a two-stage analysis of explaining the distribution of the scores. A method for classifying self-evaluators based on the additive DEA model is developed. The application to municipal nursing- and home care services of Norway shows significant effects of removing exterior self-evaluators from the data when doing a two-stage analysis.Self-evaluator; interior and exterior self-evaluator; DEA; efficiency; referencing zone; nursing homes

Who leads research productivity change? Guidelines for R&D policy-makers

We rely on efficiency and productivity analysis based on Malmquist indices to evaluate to what extent policy-makers have been able to promote the creation and consolidation of comprehensive research groups that contribute to the implementation of a successful innovation system. We suggest that this dynamic evaluation offers relevant information to current ex-post policy evaluation methods, helping decision makers to readapt and reorient policies and their associated means, most notably resource allocation (financial schemes), to better respond to the actual needs of promising research groups in their search for excellence (micro-level perspective), and to adapt future policy design to the achievement of medium-long term policy objectives (meso and macro level perspectives). We apply this methodology to the case of the Spanish R&D Food Technology Program finding that a large size and a comprehensive multi-dimensional research output are the key features of the leading groups exhibiting high efficiency and productivity levels. Identifying these groups as benchmark, we conclude that the financial grants allocated by the program, typically aimed at small-sized and partially oriented research group, have no succeeded in reorienting them in time so as to overcome their limitations.Innovation Policy; Management; Malmquist Index.

Decentralization and Local Governments’ Performance: How Does Fiscal Autonomy Affect Spending Efficiency?

In Italy, as in other countries around the world, recent reforms share the goal of increasing the fiscal autonomy of lower tiers of governments, from Regions to Municipalities, in order to align spending with funding responsibilities and increase the efficiency in the provision of essential public services. The purpose of this paper is to assess spending efficiency of local governments and to investigate the effects of tax decentralization, focusing on the role played by incumbent politicians’ accountability. The analysis relies on a sample of Italian municipalities and exploits both parametric (SFA) and nonparametric (DEA) techniques to study spending inefficiency and its main determinants. Consistently with modern fiscal federalism theories, our results show that more fiscally autonomous municipalities exhibit less inefficient behaviours. We also find that the shorter is the distance from new elections, the higher is excess spending, thus giving further support to the traditional “electoral budget cycle” agument. Other political features of governing coalition, such as age and gender of the mayor, do not seem to exert any significant impact on inefficiency levels.Local governments, Fiscal autonomy, Political accountability, Spending efficiency, Parametric and nonparametric frontiers

Consolidating the Water Industry: an Analysis of the Potential Gains from Horizontal Integration in a Conditional Efficiency Framework

The German potable water supply industry is regarded highly fragmented, thus preventing efficiency improvements that could happen through consolidation. Focusing on a hypothetical restructuring of the industry, we use a cross-section sample of 364 German water utilities in 2006, applying Data Envelopment Analysis, to analyze the potential efficiency gains from hypothetical mergers between water utilities at the county level. A conditional efficiency framework is applied to account for the water utilities' operating environments. A conditional order-m approach is applied for the detection of potential outlying observations. Merger gains are decomposed into a technical efficiency effect, a harmony effect and a scale effect. The greatest efficiency improvement potentials turn out to result from reducing individual inefficiencies while pure merger gains are found to be low. The results suggest improving incentives for efficient operations in water supply and a consolidation of the smallest water utilities.The final publication is available at Springer via http://dx.doi.org/10.1007/s11123-014-0407-x // This publication was produced as part of the GRASP project, funded by the European Commission through the 7th Framework Programme under contract no. 244725

Nonparametric Estimates Of The Components Of Productivity And Profitability Change In U.S. Agriculture.

Profitability change can be decomposed into the product of a total factor productivity (TFP) index and an index of relative price change. O’Donnell (2008) shows that the TFP index can be further decomposed into an index of technical change and various indexes of efficiency change – these indexes measure changes in productivity resulting from movements in the production frontier, movements by firms towards the frontier, and movements by firms around the frontier to capture economies of scale and scope. The O’Donnell decomposition methodology can be applied in any multiple-input multiple-output setting, it makes no assumptions concerning the optimising behaviour of firms or the degree of competition in product markets, and it only involves components that can be unambiguously interpreted as measures of either technical change or efficiency change. This paper uses the methodology to decompose spatially - and temporally-transitive Lowe indexes of TFP change in U.S. agriculture for the period 1960-2004. To implement the methodology, data envelopment analysis (DEA) is used to estimate separate production frontiers for each of the ten farm production regions identified by the USDA Economic Research Service (ERS). California and Florida are found to be the most profitable and productive states. In most states, the main drivers of TFP change over the 45-year study period appear to have been technical change and scale and mix efficiency change. For example, Texas is found to have experienced a 40% increase in productivity due to technical change and a 32% increase in productivity due to economies of scale and scope, resulting in an overall productivity increase of 1.40 ! 1.32 – 1 = 85%; in Tennessee, the combined effects of technical progress (122%), technical efficiency improvement (1%) and diseconomies of scale and scope (-24%) resulted in an net productivity increase of 2.22 ! 1.01 ! 0.76 – 1 = 70%.

Using Total Factor Productivity and Data Envelopment Analysis for Performance Comparisons Among Government Enterprises: Concepts and Issues

The purpose of this paper is to review and comment on a number of popular methods of performance measurement, in particular total factor productivity and data envelopment analysis; and to draw attention to potential pitfalls or misinterpretations which can arise in using these techniques. Potential users may not be aware that there are a number of different formulations and interpretations of these concepts, and that numerical measures of performance can vary considerably even when a consistent performance measure is being used