How efficient are New Zealand's District Health Boards at producing life expectancy gains for Māori and Europeans?

As an open access journal, all articles in ANZJPH will be freely available to read, download and share immediately on publication[EN] Objective: Use data envelopment analysis (DEA) to measure the efficiency of New Zealand’s District Health Boards (DHBs) at achieving gains in Māori and European life expectancy (LE). Methods: Using life tables for 2006 and 2013, a two-output DEA model established the production possibility frontier for Māori and European LE gain. Confidence limits were generated from a 10,000 replicate Monte Carlo simulation. Results: Results support the use of LE change as an indicator of DHB efficiency. DHB mean income and education were related to initial LE but not to its rate of change. LE gains were unrelated to either the initial level of life expectancy or to the proportion of Māori in the population. DHB efficiency ranged from 79% to 100%. Efficiency was significantly correlated with DHB financial performance. Conclusion: Changes in LE did not depend on the social characteristics of the DHB. The statistically significant association between efficiency and financial performance supports its use as an indicator of managerial effectiveness. Implications for Public Health: Efficient health systems achieve better population health outcomes. DEA can be used to measure the relative efficiency of sub-national health authorities at achieving health gain and equity outcomes.Sandiford, P.; Vivas Consuelo, DJJ.; Rouse, P. (2017). How efficient are New Zealand's District Health Boards at producing life expectancy gains for Māori and Europeans?. Australian and New Zealand Journal of Public Health. 41(2):125-129. doi:10.1111/1753-6405.12618S12512941

Ownership, Control, Agency and Residual Claims in Healthcare:Insights on Co-operatives and Non-profit Organisations

Many issues surrounding healthcare entities’ performance can be traced to their governance and ownership. Increasingly, public services are being provided by non-profit organizations and/or cooperatives, particularly in the healthcare sector. This is not unproblematic. We draw on the conceptual separation of ownership and control, and the notion of firm ownership to derive a taxonomy of dimensions along which a contractual- and property rights theory of the firm can be structured, in order to determine the nature of firms’ differences. We utilize the taxonomy to illustrate important distinctions between non-profit and cooperative firms in the primary healthcare sector and propose testable hypotheses. Funders and regulators must recognise the differences between these firms, if public funding of healthcare is to achieve the expected outcomes