Pay for performance in health care: a new best practice tariff-based tool using a log-linear piecewise frontier function and a dual–primal approach for unique solutions

Health care systems worldwide have faced a problem of resources scarcity that, in turn, should be allocated to the health care providers according to the corresponding population needs. Such an allocation should be as much as effective and efficient as possible to guarantee the sustainability of those systems. One alternative to reach that goal is through (prospective) payments due to the providers for their clinical procedures. The way that such payments are computed is frequently unknown and arguably far from being optimal. For instance, in Portugal, public hospitals are clustered based on criteria related to size, consumed resources, and volume of medical acts, and payments associated with the inpatient services are equal to the smallest unitary cost within each cluster. First, there is no reason to impose a single benchmark for each inefficient hospital. Second, this approach disregards dimen sions like quality (and access) and the environment, which are paramount for fair comparisons and benchmarking exercises. This paper proposes an innovative tool to achieve best-practices tariff. This tool merges both quality and financial sustain ability concepts, attributing a hospital-specific tariff that can be different from hospital to hospital. That payment results from the combination of costs related to a set of potential benchmarks, keeping quality as high as possible and higher than a user-predefined threshold, and being able to generate considerable cost savings. To obtain those coefficients we propose and detail a log-linear piecewise frontier function as well as a dual–primal approach for unique solutions.info:eu-repo/semantics/publishedVersio

The components of output growth: A cross-country analysis

Economic Growth;Output;Productivity

A Stochastic Frontier Analysis of Output Level and Growth in Poland and Western Economies

This paper uses Bayesian stochastic frontier methods to measure the productivity gap between Poland and Western countries that existed before the beginning of the main Polish economic reform. Using data for 20 Western economies, Poland and Yugoslavia (1980-1990) we estimate a translog stochastic frontier and make inference about individual efficiencies. Following the methodology proposed in our earlier work, we also decompose output growth into technical, efficiency and input changes and examine patterns of growth in the period under consideration.Bayesian inference;efficiency;Gibbs sampling;productivity analysis;technical change

A Stochastic Frontier Analysis of Output Level and Growth in Poland and Western Economies

This paper uses Bayesian stochastic frontier methods to measure the productivity gap between Poland and Western countries that existed before the beginning of the main Polish economic reform. Using data for 20 Western economies, Poland and Yugoslavia (1980-1990) we estimate a translog stochastic frontier and make inference about individual efficiencies. Following the methodology proposed in our earlier work, we also decompose output growth into technical, efficiency and input changes and examine patterns of growth in the period under consideration.

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.

Evaluating the efficiency of the research sector in Russian regions: a dynamic data envelopment analysis

The nonparametric method of dynamic data envelopment analysis (DDEA) has become increasingly popular for conducting comparative efficiency evaluations. In recent years, dynamic data envelopment analysis (DDEA), a variant of this method, has gained significant attention. This article applies dynamic analysis to evaluate the efficiency of the research sector in Russian regions. Traditional input variables such as the number of research staff and R&D expenditure are considered, while publication and patent metrics serve as output indicators. The analysis covers a substantial time period, spanning from 2009 to 2020. Notably, the proposed evaluation method incorporates publication quality measures as a carry-over variable, in addition to accumulated R&D expenditure. The study employs dynamic data envelopment analysis to compare the obtained results with previous evaluations of the research and technology sector in Russian regions. The findings demonstrate that the proposed method serves as a valuable ranking technique, enhancing existing evaluations of regions' research and technology potential in terms of efficiency. The article concludes by discussing the prospects and limitations of the method in evaluating and forecasting research and technology profiles of regions