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Efficiency of New Zealand’s District Health Boards at Providing Hospital Services: A stochastic frontier analysis

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  • Nan Jiang

    (Auckland University of Technology)

  • Antony Andrews

    (Auckland University of Technology)

Abstract

The majority of secondary and tertiary healthcare services in New Zealand are provided through public hospitals managed by 20 local District Health Boards. Due to data issues and ill-judged generic public perceptions, efficiency studies are insufficient in spite of the extensive empirical literatures available. This inevitably leads to criticisms about the perverse incentives which might be created by the National Health Targets designed to improve the performance of public health services. Utilizing a multifaceted administrative hospital dataset, this is the first case study to measure both the technical and cost efficiency of New Zealand public hospitals during the period of 2011–2017. More specifically, it deals with the question of how hospital efficiency varies with respect to activities accounted for by the National Health Targets. The empirical results show no evidence that these targets are achieved at the expenses of lowering the overall efficiency of hospital operations. The national technical efficiency is averaged at 86 percent over the period and cost efficiency is 85 percent. The results are derived by stochastic input distance function and cost frontier in order to accommodate multiple outputs and limited number of census observations. Efficiency ranking is sensitive to specifications of the inefficiency error term, but reasonably robust to the choice of functional form and different proxies for capital input.

Suggested Citation

  • Nan Jiang & Antony Andrews, 2020. "Efficiency of New Zealand’s District Health Boards at Providing Hospital Services: A stochastic frontier analysis," Journal of Productivity Analysis, Springer, vol. 53(1), pages 53-68, February.
    • Handle: RePEc:kap:jproda:v:53:y:2020:i:1:d:10.1007_s11123-019-00550-z
    DOI: 10.1007/s11123-019-00550-z
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    Cited by:

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    2. Zhichao Wang & Valentin Zelenyuk, 2021. "Performance Analysis of Hospitals in Australia and its Peers: A Systematic Review," CEPA Working Papers Series WP012021, School of Economics, University of Queensland, Australia.
    3. Cristian Barra & Raffaele Lagravinese & Roberto Zotti, 2022. "Exploring hospital efficiency within and between Italian regions: new empirical evidence," Journal of Productivity Analysis, Springer, vol. 57(3), pages 269-284, June.
    4. Zhichao Wang & Bao Hoang Nguyen & Valentin Zelenyuk, 2024. "Performance analysis of hospitals in Australia and its peers: a systematic and critical review," Journal of Productivity Analysis, Springer, vol. 62(2), pages 139-173, October.
    5. Antony Andrews & Grigorios Emvalomatis, 2024. "Do adjustment costs constrain public healthcare providers’ technical efficiency? Evidence from the New Zealand Public Healthcare System," Health Care Management Science, Springer, vol. 27(2), pages 268-283, June.
    6. Ligia Alba Melo-Becerra & Diego Vásquez-Escobar & María Isabel Alarcón-Obando & Giselle Tatiana Silva-Samudio, 2024. "Empresas Promotoras de Salud en Colombia: Gestión del riesgo en salud, eficiencia técnica y solidez financiera," Borradores de Economia 1272, Banco de la Republica de Colombia.
    7. Dino Rizzi & Michele Zanette, 2021. "Potential efficiency gains and expenditure savings in the Italian Regional Healthcare Systems," Politica economica, Società editrice il Mulino, issue 2, pages 187-214.

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    More about this item

    Keywords

    NZ hospitals; Stochastic frontier analysis; Technical efficiency; Cost efficiency;
    All these keywords.

    JEL classification:

    • D24 - Microeconomics - - Production and Organizations - - - Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

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