IDEAS home Printed from https://ideas.repec.org/a/bla/ausecp/v62y2023i2p335-348.html
   My bibliography  Save this article

Quality‐efficiency trade‐off when the state is the sole provider of hospital services: Evidence from New Zealand

Author

Listed:
  • Antony Andrews
  • Biresh K. Sahoo
  • Omphile Temoso
  • Sean Kimpton

Abstract

The purpose of this study is to explore the trade‐off between technical efficiency and the quality of hospital services when the state is the sole provider. Data from 20 New Zealand District Health Boards from 2011 to 2017 is used to estimate technical efficiency using the data envelopment analysis technique, which employs an additive inverse formulation for undesirable outcomes. The estimated average quality‐adjusted technical efficiency score is 0.69. In comparison, when the quality variable was removed, the efficiency declined to 0.66. More importantly, the ranking of district health boards stays consistent across both models, indicating that there is very little trade‐off between quality and efficiency. A sensitivity analysis also confirms the lack of a trade‐off between quality and efficiency.

Suggested Citation

  • Antony Andrews & Biresh K. Sahoo & Omphile Temoso & Sean Kimpton, 2023. "Quality‐efficiency trade‐off when the state is the sole provider of hospital services: Evidence from New Zealand," Australian Economic Papers, Wiley Blackwell, vol. 62(2), pages 335-348, June.
    • Handle: RePEc:bla:ausecp:v:62:y:2023:i:2:p:335-348
    DOI: 10.1111/1467-8454.12288
    as

    Download full text from publisher

    File URL: https://doi.org/10.1111/1467-8454.12288
    Download Restriction: no
    File URL: https://libkey.io/10.1111/1467-8454.12288?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Léopold Simar & Paul Wilson, 2000. "Statistical Inference in Nonparametric Frontier Models: The State of the Art," Journal of Productivity Analysis, Springer, vol. 13(1), pages 49-78, January.
    2. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128, October.
    3. Mahlberg, Bernhard & Luptacik, Mikulas & Sahoo, Biresh K., 2011. "Examining the drivers of total factor productivity change with an illustrative example of 14 EU countries," Ecological Economics, Elsevier, vol. 72(C), pages 60-69.
    4. Sahoo, Nihar R. & Mohapatra, Pratap K.J. & Sahoo, Biresh K. & Mahanty, Biswajit, 2017. "Rationality of energy efficiency improvement targets under the PAT scheme in India – A case of thermal power plants," Energy Economics, Elsevier, vol. 66(C), pages 279-289.
    5. Sahoo, Biresh K. & Acharya, Debashis, 2010. "An alternative approach to monetary aggregation in DEA," European Journal of Operational Research, Elsevier, vol. 204(3), pages 672-682, August.
    6. Niccie L. McKay & Mary E. Deily, 2008. "Cost inefficiency and hospital health outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 17(7), pages 833-848, July.
    7. Sahoo, Biresh K. & Luptacik, Mikulas & Mahlberg, Bernhard, 2011. "Alternative measures of environmental technology structure in DEA: An application," European Journal of Operational Research, Elsevier, vol. 215(3), pages 750-762, December.
    8. Fare, Rolf, 1989. "Multilateral Productivity Comparisons When Some Outputs Are Undesirable: A Nonparametric Approach," The Review of Economics and Statistics, MIT Press, vol. 71(1), pages 90-98, February.
    9. Seiford, Lawrence M. & Zhu, Joe, 2002. "Modeling undesirable factors in efficiency evaluation," European Journal of Operational Research, Elsevier, vol. 142(1), pages 16-20, October.
    10. Mary E. Deily & Niccie L. McKay, 2006. "Cost inefficiency and mortality rates in Florida hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 15(4), pages 419-431, April.
    11. repec:rre:publsh:v:38:y:2008:i:3:p:381-93 is not listed on IDEAS
    12. Jan Clement & Vivian Valdmanis & Gloria Bazzoli & Mei Zhao & Askar Chukmaitov, 2008. "Is more better? An analysis of hospital outcomes and efficiency with a DEA model of output congestion," Health Care Management Science, Springer, vol. 11(1), pages 67-77, March.
    13. William W. Cooper & Lawrence M. Seiford & Kaoru Tone, 2007. "Data Envelopment Analysis," Springer Books, Springer, edition 0, number 978-0-387-45283-8, March.
    14. Sahoo, Biresh K. & Singh, Ramadhar & Mishra, Bineet & Sankaran, Krithiga, 2017. "Research productivity in management schools of India during 1968-2015: A directional benefit-of-doubt model analysis," Omega, Elsevier, vol. 66(PA), pages 118-139.
    15. Hervé Leleu & Mona Al-Amin & Michael Rosko & Vivian Valdmanis, 2017. "A robust analysis of hospital efficiency and factors affecting variability," Post-Print halshs-01720471, HAL.
    16. William W. Cooper & Lawrence M. Seiford & Kaoru Tone, 2007. "The Basic CCR Model," Springer Books, in: Data Envelopment Analysis, edition 0, chapter 2, pages 21-39, Springer.
    17. Scheel, Holger, 2001. "Undesirable outputs in efficiency valuations," European Journal of Operational Research, Elsevier, vol. 132(2), pages 400-410, July.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Jeanneaux, Philippe & Latruffe, Laure, 2016. "Modelling pollution-generating technologies in performance benchmarking: Recent developments, limits and future prospects in the nonparametric frameworkAuthor-Name: Dakpo, K. Hervé," European Journal of Operational Research, Elsevier, vol. 250(2), pages 347-359.
    2. Gómez-Calvet, Roberto & Conesa, David & Gómez-Calvet, Ana Rosa & Tortosa-Ausina, Emili, 2014. "Energy efficiency in the European Union: What can be learned from the joint application of directional distance functions and slacks-based measures?," Applied Energy, Elsevier, vol. 132(C), pages 137-154.
    3. Cherchye, Laurens & Rock, Bram De & Walheer, Barnabé, 2015. "Multi-output efficiency with good and bad outputs," European Journal of Operational Research, Elsevier, vol. 240(3), pages 872-881.
    4. Abad, Arnaud & Briec, Walter, 2019. "On the axiomatic of pollution-generating technologies: Non-parametric production analysis," European Journal of Operational Research, Elsevier, vol. 277(1), pages 377-390.
    5. Cordero Ferrera, Jose Manuel & Alonso Morán, Edurne & Nuño Solís, Roberto & Orueta, Juan F. & Souto Arce, Regina, 2013. "Efficiency assessment of primary care providers: A conditional nonparametric approach," MPRA Paper 51926, University Library of Munich, Germany.
    6. Leleu, Hervé, 2013. "Shadow pricing of undesirable outputs in nonparametric analysis," European Journal of Operational Research, Elsevier, vol. 231(2), pages 474-480.
    7. Cordero, José Manuel & Alonso-Morán, Edurne & Nuño-Solinis, Roberto & Orueta, Juan F. & Arce, Regina Sauto, 2015. "Efficiency assessment of primary care providers: A conditional nonparametric approach," European Journal of Operational Research, Elsevier, vol. 240(1), pages 235-244.
    8. Atkinson, Scott E. & Tsionas, Mike G., 2021. "Generalized estimation of productivity with multiple bad outputs: The importance of materials balance constraints," European Journal of Operational Research, Elsevier, vol. 292(3), pages 1165-1186.
    9. Pham, Manh D. & Zelenyuk, Valentin, 2019. "Weak disposability in nonparametric production analysis: A new taxonomy of reference technology sets," European Journal of Operational Research, Elsevier, vol. 274(1), pages 186-198.
    10. Apergis, Nicholas & Aye, Goodness C. & Barros, Carlos Pestana & Gupta, Rangan & Wanke, Peter, 2015. "Energy efficiency of selected OECD countries: A slacks based model with undesirable outputs," Energy Economics, Elsevier, vol. 51(C), pages 45-53.
    11. Toloo, Mehdi & Hančlová, Jana, 2020. "Multi-valued measures in DEA in the presence of undesirable outputs," Omega, Elsevier, vol. 94(C).
    12. Li, Sung Ko & He, Xinju, 2019. "The impacts of marketization and subsidies on the treatment quality performance of the Chinese hospitals sector," China Economic Review, Elsevier, vol. 54(C), pages 41-50.
    13. Jie Wu & Qingyuan Zhu & Pengzhen Yin & Malin Song, 2017. "Measuring energy and environmental performance for regions in China by using DEA-based Malmquist indices," Operational Research, Springer, vol. 17(3), pages 715-735, October.
    14. Chiu, Yung-Ho & Lee, Jen-Hui & Lu, Ching-Cheng & Shyu, Ming-Kuang & Luo, Zhengying, 2012. "The technology gap and efficiency measure in WEC countries: Application of the hybrid meta frontier model," Energy Policy, Elsevier, vol. 51(C), pages 349-357.
    15. Meleddu, Marta & Vecco, Marilena & Mazzanti, Massimiliano, 2024. "The Role of Voluntary Environmental Policies Towards Achieving Circularity," Ecological Economics, Elsevier, vol. 219(C).
    16. Xiang Ji & Jiasen Sun & Qunwei Wang & Qianqian Yuan, 2019. "Revealing Energy Over-Consumption and Pollutant Over-Emission Behind GDP: A New Multi-criteria Sustainable Measure," Computational Economics, Springer;Society for Computational Economics, vol. 54(4), pages 1391-1421, December.
    17. Wang, Ke & Wei, Yi-Ming & Huang, Zhimin, 2018. "Environmental efficiency and abatement efficiency measurements of China's thermal power industry: A data envelopment analysis based materials balance approach," European Journal of Operational Research, Elsevier, vol. 269(1), pages 35-50.
    18. Shih-Heng Yu, 2019. "Benchmarking and Performance Evaluation Towards the Sustainable Development of Regions in Taiwan: A Minimum Distance-Based Measure with Undesirable Outputs in Additive DEA," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 144(3), pages 1323-1348, August.
    19. Nils Gutacker & Chris Bojke & Silvio Daidone & Nancy J. Devlin & David Parkin & Andrew Street, 2013. "Truly Inefficient Or Providing Better Quality Of Care? Analysing The Relationship Between Risk‐Adjusted Hospital Costs And Patients' Health Outcomes," Health Economics, John Wiley & Sons, Ltd., vol. 22(8), pages 931-947, August.
    20. Davutyan, Nurhan & Bilsel, Murat & Tarcan, Menderes, 2015. "Migration, Risk-Adjusted Mortality, Varieties of Congestion and Patient Satisfaction in Turkish Provincial General Hospitals," Data Envelopment Analysis Journal, now publishers, vol. 1(2), pages 135-169, July.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bla:ausecp:v:62:y:2023:i:2:p:335-348. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www.blackwellpublishing.com/journal.asp?ref=0004-900X .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.