Measuring and Evaluating Efficiency of Hospitals Through Total Quality Management

ABSTRACT

The purpose of this study is to measure and evaluate the efficiency of 12 hospitals in Turkey using a multi-criteria Data Envelopment Analysis (DEA) methodology. Number of beds, number of physicians and the critical factors of total quality management in the health care sector were used as inputs of the model. The outputs used in this analysis incorporated financial and non-financial performance of hospitals, number of outpatients and number of patient days. Performance of the hospitals was measured using subjective measures based on executive's perception of how their organization performed relative to the competition. Results provide management with information regarding the relatively best practice hospitals in the observation sets and locate the relatively inefficient hospitals by comparison with the best practice ones. At last some suggestions are made for the least efficient hospital.     

Productive Efficiency of the Swine Industry in Hawaii: Stochastic Frontier vs. Data Envelopment Analysis

Improving productive efficiency is an increasingly important determinant of the future of the swine industry in Hawaii. This paper examines the productive efficiency of a sample of swine producers in Hawaii by estimating a stochastic frontier production function and the constant returns to scale (CRS) and variable returns to scale (VRS) output-oriented DEA models. The technical efficiency estimates obtained from the two frontier techniques are compared. The scale properties are also examined under the two approaches. The industry's potential for increasing production through improved efficiency is also discussed.     

Technical Efficiency of the Brazilian Municipalities: Correcting Nonparametric Frontier Measurements for Outliers

In this paper we estimate the DEA technical efficiency for 4796 Brazilian municipalities, by applying a recently proposed “Jackstrap” method, which combines Bootstrap and Jackknife resampling techniques, to reduce the effect of outliers and possible errors in the data set. We perform calculations to identify and eliminate high leverage municipalities, using different variants of Data Envelopment Analysis (DEA), as well as Free Disposal Hull (FDH). Corroborating previous results, efficiency results for the Brazilian municipalities show a clear relationship between the size of the municipality and its efficiency scores. Indeed, under both DEA variants, smaller cities tend to be less efficient than larger ones hence indicating that the quality of the frontier adjustment improves significantly as the size of the municipality increases. We present arguments that may explain to some extent these findings, such as economies of scale and the excess spending due to revenue from royalties. However, such effects require further, more careful examination.     

Nonparametric Efficiency Analysis under Price Uncertainty: A First-Order Stochastic Dominance Approach

This paper extends the nonparametric approach to efficiency analysis to deal with uncertainty of input-output prices. We generalize the notion of economic efficiency to derive necessary and sufficient first-order stochastic dominance (FSD) efficiency conditions. Interestingly, the FSD conditions include as limiting cases the traditional conditions for economic efficiency and technical efficiency. Furthermore, we propose empirical tests for these FSD conditions, which require minimal assumptions concerning the preferences of the decision-maker and the statistical distribution of the prices. From operational point of view, the FSD conditions can be tested empirically using standard mathematical programming techniques. An empirical application to the Dutch electricity distribution sector illustrates the approach.     

Testing Independence in Models of Productive Efficiency

Bootstrap methods for inference in nonparametric models of productive efficiency can be simplified, reducing computational burden, when the independence condition implicitly assumed in Simar and Wilson (1998) holds. This paper surveys nonparametric tests of independence that might be useful in this context.     

Specification of Distance Functions Using Semi- and Nonparametric Methods with an Application to the Dynamic Performance of Eastern and Western European Air Carriers

In this paper we examine the productive performance of a group of three East European carriers and compare it to thirteen of their West European competitors during the period 1977–1990. We first model the multiple output/multiple input technology with a stochastic distance frontier using recently developed semiparametric efficient methods. The endogeneity of multiple outputs is addressed in part by introducing multivariate kernel estimators for the joint distribution of the multiple outputs and potentially correlated firm random effects. We augment estimates from our semiparametric stochastic distance function with nonparametric distance function methods, using linear programming techniques, as well as with extended decomposition methods, based on the Malmquist index number. Both semi- and nonparametric methods indicate significant slack in resource utilization in the East European carriers relative to their Western counterparts, and limited convergence in efficiency or technical change between them. The implications are rather stark for the long run viability of the East European carriers in our sample.     

The Use of Data Envelopment Analysis with Probabilistic Assurance Regions for Measuring Hospital Efficiency

This paper uses Data Envelopment Analysis (DEA) for an estimation of the cost efficiency of 70 Danish hospitals. The analysis relates to a cost function based on 483 outputs in combination with a set of probabilistic assurance regions defined by the cost distributions for each output. It is demonstrated that the probabilistic assurance region approach allows for (i) a frontier estimation in the full output space, i.e., no fixed aggregation is required, and (ii) a controlling of the variation in heterogeneity of the output clusters, in casu Diagnosis Related Groups. The likelihood of the estimated efficiency score for a given hospital can be measured based on the sensitivity of the score w.r.t. the probability levels used in the specification of confidence intervals for the probabilistic assurance regions.     

上市企业效率评估：聚焦水运业

水运是我国融入经济全球化的战略通道。在当前的国际金融危机之下,我国的水上运输和港口企业已受到较为严重的影响,文章利用数据包络分析、因子分析等研究方法．借助在沪、深两市上市的水运业21家公司2007年度数据,算得各企业的总体技术效率、纯技术效率、规模效率和规模收益状态,从而评价其经营的相对效率,给出对应的管理建议,以期为这些水上运输业企业提供有益参考,     

基于MEA和Luenberger生产率指数的中国商业银行效率及生产率模式评估

引入多方向效率分析模型(MEA)模型对我国16家上市商业银行2011—2018年各指标的效率进行了评估,结果显示国有银行效率低下的主要原因是净利息利润、存款和劳动力的效率较低。为进一步研究中国商业银行生产率的构成情况,引入基于方向性距离函数的Luenberger生产率指数及其分解结果,来评价中国商业银行各指标的生产率,得到中国商业银行生产率的变化主要归功于净利息利润和净非利息利润生产率的变化。     

粤东西北与珠三角物流产业技术效率比较

运用DEA效率测度方法,通过对2013-2017年粤东西北与珠三角区域物流产业技术效率的对比研究,探索推动广东省区域物流协调发展的路径。结果显示:对比珠三角区域,粤东西北区域物流产业技术效率与珠三角区域存在较大差距,尤其是粤东与粤西地区,粤东区域物流产业技术效率值仅为0.4,粤西区域物流产业技术效率值为0.81,均远低于珠三角区域物流产业技术效率值0.94。纯技术效率低下是制约粤东西北地区物流产业技术效率提升的主要因素,应加强物流产业信息技术应用,推进物流技术装备现代化,提高技术创新能力水平。     

基于DEA的电子商务上市公司技术效率评价

文章收集了国内外16家电子商务上市公司年报数据并进行整理,运用DEA的CCR和BCC模型来计算这些企业的技术效率,并且运用差额变量分析给相对无效率的公司提供改进的意见。数据结果显示:整体情况均为相对有效,且经营状况都比较稳定,说明电子商务企业正经历着一个稳步发展的阶段。     

Efficiency Rankings of MBA Programs in Indian Top Public Colleges

This study examines the relative efficiency of the top 20 Indian public colleges that offer MBAs. These colleges were chosen from a list provided by Careers 360, a magazine in India known for its university rankings. The purpose of this study was to evaluate the colleges on an efficiency basis rather than on a total score ranking scale as is the common practice of most publications that rank universities or programs. The ranking method used in this study is based on data envelopment analysis （DEA）, a nonparametric procedure for evaluating entities based upon examining inputs in relation to outputs achieved. The rankings using DEA were somewhat different than those given by Careers 360. The results of the DEA analysis of this study rank the universities that are the most efficient at getting students the best salaries and return on investment （ROI） based on the inputs of diversity, work experience, and residency. The authors conclude, as previous studies have shown, that DEA analysis is a useful and non-biased method of comparing university programs.     

Analysis of Intertemporal Efficiency Trends Using Rank Statistics With an Application Evaluating the Macro Economic Performance of OECD Nations

This paper presents two applications of rank statistics to evaluate efficiency performance trends using productive efficiency measures derived through various Data Envelopment Analysis (DEA) models. The paper starts with a discussion of the difficulties in obtaining consistent ranks from DEA efficiency ratings. Next, a procedure is proposed to identify intertemporal performance trends using any one of several possible efficiency measures. Another procedure is then developed to test the stability over time of the rank positions of the analyzed units. For each statistical procedure, a small numerical example involving DEA efficiency measures is provided to illustrate the proposed technique. Finally, the new procedures are applied to data reflecting the macro-economic performance of 17 OECD nations in 1979–1988. The outcomes of the application are discussed and contrasted with previous research in this area.     

高等教育的全面质量管理与经营效率的评估

高等教育的目标是培育精英,故其质量管理极其重要。在教育面临激烈竞争及资源有限的情况 下,各高校纷纷重视经营效率的提高。在高校推行全面质量管理能够有效增进高校的教育质量及绩效提升 竞争力,其实施成果可以数据包络分析法评估。     

A Mathematical Programming Approach for Measuring Technical Efficiency in a Fuzzy Environment

A three stage approach is proposed to measure technical efficiency in a fuzzy environment. This approach uses the traditional data envelopment analysis framework and then merges concepts developed in fuzzy parametric programming (Carlsson and Korhonen, 1986). In the first stage, vague input and output variables are expressed in terms of their risk-free and impossible bounds and a membership function. This membership function represents the degree to which a production scenario is plausible. In the second stage, conventional efficiency measurement models (Banker, Charnes and Cooper, 1984; Deprins, Simar and Tulkens, 1984) are re-formulated in terms of the risk-free and impossible bounds and the membership function for each of the fuzzy input and output variables. In the third stage, technical efficiency scores are computed for different values of the membership function so as to identify uniquely sensitive decision making units. The approach is illustrated in the context of a preprint and packaging manufacturing line which inserts commercial pamphlets into newspapers.     

基于超效率SBM模型的中国区域全要素能源效率评价

建立了基于DEA模型的全要素能源效率评价指标体系,运用考虑非期望产出的超效率SBM模型,对我国30个省(直辖市、自治区)2007—2016年的能源效率进行了测度,将测度结果按照东部、中部、西部三个区域进行了时空差异分析,并对各区域的全要素能源效率变化趋势进行收敛性检验。结果显示:2007—2016年我国全要素能源效率整体呈现下降趋势,从三个区域的对比研究可以看出,我国区域能源效率存在明显差异,具体表现为东部能源效率最高、中部次之、西部最差,与我国区域经济发展水平的梯度相一致。通过收敛性检验可以看出2007—2016年,我国全要素能源效率呈发散趋势,即地区之间的差距在逐渐增大。     

Measurement of Dynamic Efficiency in Production: An Application of Data Envelopment Analysis to Japanese Electric Utilities

The purpose of this paper is to measure productive efficiencies when a firm employs quasi-fixed inputs that cannot be instantaneously adjusted to their optimal levels. To this end, data envelopment analysis (DEA) is extended to a dynamic framework so that investment behavior can be modelled with the efficient production frontier. Based on the work of Nemoto and Goto (1999), we show how the efficiencies of quasi-fixed inputs and their adjustment processes are evaluated. An application to Japanese electric utilities over the 1981–1995 period delivers empirically plausible results and proves the usefulness of the procedure.     

Evaluating the Adequacy of Parametric Functional Forms in Estimating Monotone and Concave Production Functions

We consider situations where the a priori guidance provided by theoretical considerations indicates only that the function linking the endogenous and exogenous variables is monotone and concave (or convex). We present methods to evaluate the adequacy of a parametric functional form to represent the relationship given the minimal maintained assumption of monotonicity and concavity (or convexity). We evaluate the adequacy of an assumed parametric form by comparing the deviations of the fitted parametric form from the observed data with the corresponding deviations estimated under DEA. We illustrate the application of our proposed methods using data collected from school districts in Texas. Specifically, we examine whether the Cobb–Douglas and translog specifications commonly employed in studies of education production are appropriate characterizations. Our tests reject the hypotheses that either the Cobb–Douglas or the translog specification is an adequate approximation to the general monotone and concave production function for the Texas school districts.     

Measuring Cost Efficiency in European Banking: A Comparison of Frontier Techniques

This paper investigates the consistency of efficiency frontier methods on European banking samples. We measure the cost efficiency of banks from five European countries (France, Germany, Italy, Spain, Switzerland) with three approaches: stochastic frontier approach, distribution-free approach, and data envelopment analysis. We compare means, correlation coefficients, two public policy issues, and the correlation with standard measures of performance. In general, we conclude in favor of the lack of robustness between approaches, even if there are some similarities in particular between parametric approaches. We do, however, observe some correlation between all frontier approaches and standard measures of performance.     

基于GDP水平的区域技术创新效率测度

区域技术创新效率是区域发展的动力,是衡量区域技术创新运营机制有效程度的重要标准,反应一个地区的研发水平和投入资源的利用率。通过建立区域技术创新效率指标体系,根据2009年我国30个省、市、自治区人均GDP构造系数矩阵,确定区域间的竞合关系;应用带有系数矩阵的交叉效率模型对2009年我国30个省、市、自治区的技术创新效率进行测度得出交叉效率矩阵,最后应用熵值法确定权重并得出最终效率。实证结果表明全部30个地区的技术创新效率均具有提升空间,该方法可以对所有区域进行充分排序且与传统仁慈型和进取型交叉效率方法相比更符合实际情况。