Cost-utility of denosumab for the treatment of postmenopausal osteoporosis in Spain

The objective of this study was to estimate the cost-effectiveness of denosumab for fracture prevention compared with no treatment, generic bisphosphonates, and strontium ranelate in a cohort of osteoporotic postmenopausal women in Spain

On the consistency of the DEA-based average efficiency bootstrap

It is shown that the bootstrap method should be applied with care for the Data Envelopment Analysis (DEA) estimator of average technical efficiency if the production frontier is stochastic. A stochastic production frontier leads to an inconsistency of the DEA estimator, which in turn leads to inconsistent and potentially highly misleading bootstrap confidence intervals. A Monte Carlo simulation study reveals that the empirical coverage accuracy of the bootstrap confidence intervals approaches zero as the sample size increases, even for small contributions of frontier variance to total frontier and efficiency variance.

Bootstrapping the Malmquist productivity index - a simulation study

This paper presents a Monte Carlo simulation study of the bootstrap algorithm proposed by Lothgren and Tambour for calculation of bootstrap confidence intervals for the firm-specific Data Envelopment Analysis (DEA) Malmquist productivity index. The simulation results indicate that the coverage accuracy of bootstrap confidence intervals are near the nominal confidence level for small to moderate sized samples. For larger sample sizes, a clear convergence of empirical to nominal level is found.

Specification and estimation of stochastic multiple-output production and technical inefficiency

This paper presents a primal-based approach for specification and estimation of multiple-output production frontiers that allows simultaneous identification and estimation of determinants of technical inefficiency. The proposed model extends the technical efficiency effects model by Battese and Coelli (1995) to general multiple-output technologies. An empirical application using Swedish health care panel data from the years 1989–1994 is included. The key issue is to test for the effects on technical efficiency of an organizational reform implemented with the primary purpose to increase efficiency. The results reveal no significant effect on technical efficiency of the reform, but evidence of overall decreased technical efficiency and technical progress in the provision of health care over the studied time period are found.

Testing scale efficiency in DEA models: a bootstrapping approach

This paper presents a method for estimation and test of firm-specific scale efficiency using data envelopment analysis (DEA). The use of a simple bootstrap algorithm is proposed to perform firm-specific inference for scale efficiency. An empirical application using Swedish hospital data is provided. It is found that about 40% of the departments were scale efficient according to the original results. However, for about one-third of those departments the hypothesis of scale efficiency could be rejected.

Bootstrapping the data envelopment analysis Malmquist productivity index

This paper presents a bootstrap approach to calculate confidence intervals for firm-specific Malmquist productivity indices obtained from data envelopment analysis (DEA) models. The bootstrap is easily implemented and allows identification of production units that have significant productivity changes. An application using data from Swedish eye-care departments is included. We find that 40% of departments have significant progress in productivity whereas only 10% of the departments have a significant regress in productivity. This differs from the original results where about half the sample have estimates of progress and the other half have estimates of regress in productivity.

Health system effects on cost efficiency in the OECD countries

This paper investigates the effects of different health systems on cost efficiency in inpatient health care among the OECD countries. The results indicate that public contract systems are more efficient and that public integrated systems are less efficient than public reimbursement systems.