Technical efficiency,specialization and ownership form: evidences from a pooling of Italian hospitals

We evaluate how the productive structure and level of specialization of a hospital affect technical efficiency by analyzing a six-year panel database (2000/2005) drawn from hospital discharge records and Ministry of Health data. We adopt a distance function approach, while measuring the technical efficiency level with stochastic frontier techniques. After controlling for environmental variables and hospital case-mix, inefficiency is negatively associated with specialization and positively associated with capitalization. Capitalization is typical of private structures which, on average, use resources less efficiently with respect to public and not-for-profit hospitals. Finally, by looking at scale elasticities, we find some evidence of unexploited economies of scale, leaving room for centralization.     

Macroeconomic policy and the pricing behavior of imperfectly competitive firms

This paper develops theoretical models of the effect of expansionary macroeconomic policy on the pricing behavior of pure monopolist and oligopolist firms. A number of factors are identified which affect the magnitude of the price change chosen by an imperfectly competitive firm in response to macro policy action. The behavior of oligopolistic firms in response to macro policy changes is found to be influenced by the fact that expansionary macro policy initially impacts on industry demand rather than firm demand, and that the oligopolist's consequent pricing behavior will affect the share of the industry demand increase which it is able to appropriate.     

Oligopolistic and competitive behavior of spatially separated markets

We examine the connection between Cournot oligopoly and perfect competition by showing that a fairly general oligopoly model with spatially separated markets generates a general spatial price equilibrium model as an extreme, limiting case. Our analysis depends crucially on the fact that the governing equilibrium conditions of both the oligopoly and the spatial price equilibrium problem can be formulated as variational inequalities.     

Technical efficiency of Swedish employment offices

This paper studies technical efficiency for Swedish employment offices between 2004 and 2010. Efficiency is computed using a semi-dynamic DEA-framework. On the input side we include a measure of input quality and we also control for services that are carried out by private contractors. On the output side we are using both intermediate and final outputs. The motivation for using an intermediate output is to take into account the fact that employment offices might have strengthen the possibility for unemployed individuals that remain unemployed to get a job in the forthcoming year. The study identifies an average yearly inefficiency between 7 and 10 percent. It is also observed that the inefficiency is unevenly distributed. To make employment offices more efficient this uneven distribution needs to be considered, otherwise efforts to improve efficiency might instead result in increased inefficiency.     

Technical efficiency of for-profit and non-profit nursing homes

This paper employs data envelopment analysis to generate efficiency indices for individual nursing homes relative to a best-practice frontier. Further analysis then shows that these ‘unadjusted’ indices represent factors other than efficiency. Regression analysis purges the indices of these confounding influences. The resulting ‘adjusted’ efficiency indices demonstrate that for-profit homes have higher mean levels of efficiency and a more efficient production frontier than non-profit homes. These results support the property rights hypothesis that forprofit homes are inherently more efficient than non-profit ones.     

Efficiency of hospitals in the Czech Republic: Conditional efficiency approach

Journal of Productivity Analysis - This paper estimates the cost efficiency of 81 general hospitals in the Czech Republic during 2006–2010. We employ the conditional order-m approach to...     

Dynamic competitive retail pricing behavior with uncertainty and learning

When competing retailers lack full information about rivals' decision processes, how will dynamic pricing behavior vary from patterns observed in more traditional static or full-information models? We investigate this question in a dynamic alternating-moves duopoly model. Retailers update (linear) conjectures about rivals' future prices in a Bayesian fashion. We show that as observed and expected prices converge, a pricing equilibrium is always achieved, whether or not the conjectured and actual values of the slope of the rival's best response function are consistent. Assuming specific parameter values, we compare equilibrium prices and associated profits in our Bayesian learning model with those obtained under the assumptions of static Nash behavior, collusive behavior and dynamically optimal behavior with full information. We apply the notions of strategic substitutability and strategic complementarity to the analysis and find that when products are strategic complements, conjectures of higher rival price responsiveness lead to higher steady-state prices and profits. The reverse is true for strategic substitutes. We also find that learning about a rival's behavior proceeds more quickly, the less intensely related in demand are products. We find, in general, that equilibrium pricing patterns and profits can vary considerably from those in full-information environments, but that even with grossly wrong beliefs about rival behavior, competing retailers are still attracted to an equilibrium. The analysis suggests not only the value of investigating lessthan-full information situations but also the potential incremental value of signalling greater or less aggressiveness than truly characterizes one's behavior as a strategic option.     

Commitment, advertising and efficiency of two-sided investment in competitive search equilibrium

Competitive search entails both commitment to and advertising of pay-off relevant aspects of market participants. This paper considers incrementally the implications of each in a labor market where both workers and firms invest prior to market entry. A wide range of institutional arrangements are addressed within the same general framework. When the characteristics of jobs or workers are advertised the efficient outcome pertains. Commitment without advertising typically leads to market unravelling: the Diamond paradox. But, whenever wages and human capital are advertised, firms become residual claimants; the private and social returns to investment coincide. Absent wage commitment, the Hosios condition implies efficiency when investments are advertised.     

Technical efficiency of Norwegian banks: The non-parametric approach to efficiency measurement

The nonparametric frontier methodology is applied to a sample of banks, where output levels are measured either by the number of accounts and their average size, or by the total balances of the accounts. The efficiency rankings of individual banks are found to depend substantially on our choice of output metric, whereas the estimated size of potential productivity improvements in the banking sector are less affected. The results on economies of scale are also largely unchanged.The refereeing process of this paper was handled through S. Grosskopf.     

A strategic human resource perspective of firm competitive behavior

Embedded within firms are unique stores of intangible human assets that likely influence the way firms compete. We argue that the human and social capital of a firm, particularly at the upper echelon and board of director (BOD) levels, contribute to the firm's awareness of the competitive environment and its motivation and ability to undertake numerous, complex, and forceful competitive actions. We also suggest that the firm's executive compensation systems moderate the effects of these intangible human assets on firm competitive behavior. By examining how human capital, intra-firm social capital, and executive compensation influence firm competitive behavior, we advance a strategic HRM perspective of firm competitive behavior and outline several implications for future research.     

Capacity,competiton and efficiency in hospitals: A nonparametric approach

The purpose of this paper is to provide a new,multiple output measure of plant capacity which we use to analyze the performance of hospitals in different competitive environments. To evaluate each hospital's plant capacity, we employ a nonparametric (linear programming) framework. The resulting measure of capacity can be determined from observed inputs and outputs and is based on the best practice performance of all hospitals in the sample. This methodology is closely related to Farrell-type measures of efficiency and, as a by-product, yields information on efficiency of individual hospitals. This technique imposes no prespecified functional form and allows for multiple outpus (to account for differences in case-mix). We apply this methodological approach to a sample of hospitals in Michigan. Our results are used to compare capacity utilization and efficiency of hospitals across different competitive environments.The refereeing process of this paper was handled by R. Kopp.     

Evaluation of efficiency in Colombian hospitals: An analysis for the post-reform period

In this study we analyze the performance of 602 level 1 Colombian hospitals for the period 2009–2013. The analysis is carried out from both static and temporal perspectives in order to evaluate the evolution of total factor productivity (change in hospital performance) and its components throughout the period. The study also explores a question relevant not only to the Colombian health system, but to many others around the world, of whether primary care centers excessively refer patients to high-level hospitals, thereby negatively affecting the quality, efficiency, and effectiveness of all healthcare service provision. The results demonstrated that adjusted production (service provision) and levels of quality and referrals to higher-level hospitals could be improved, on average, by 44%. This increase in health service provision levels and their quality can be achieved by reducing personnel expenditure (by an average of 22%), expenditure on medicines (by 20%), and purchasing expenses (by 11%). The temporal analysis shows that total factor productivity (hospital performance change) worsened by 1% during the period, mainly due to the technological backlash experienced despite a slightly positive evolution in efficiency.     

Technical efficiency in farming: a meta-regression analysis

A meta-regression analysis including 167 farm level technical efficiency (TE) studies of developing and developed countries was undertaken. The econometric results suggest that stochastic frontier models generate lower mean TE (MTE) estimates than non-parametric deterministic models, while parametric deterministic frontier models yield lower estimates than the stochastic approach. The primal approach is the most common technological representation. In addition, frontier models based on cross-sectional data produce lower estimates than those based on panel data whereas the relationship between functional form and MTE is inconclusive. On average, studies for animal production show a higher MTE than crop farming. The results also suggest that the studies for countries in Western Europe and Oceania present, on average, the highest levels of MTE among all regions after accounting for various methodological features. In contrast, studies for Eastern European countries exhibit the lowest estimate followed by those from Asian, African, Latin American, and North American countries. Additional analysis reveals that MTEs are positively and significantly related to the average income of the countries in the data set but this pattern is broken by the upper middle income group which displays the lowest MTE.

Electronic medical record use and efficiency: A DEA and windows analysis of hospitals

We use data envelopment analysis (DEA) to examine the relationship between hospital electronic medical record (EMR) use and efficiency in a national sample of acute care hospitals. Data sources include the American Hospital Association (AHA), Health Information Management Systems Society (HIMSS), and Case Mix Index. Using two research approaches including a retrospective, cross-sectional design and a first differencing repeated measures design, we find limited evidence that EMRs can improve hospital efficiency. Small hospitals may benefit in the area of efficiency through EMR use, but medium and large hospitals generally do not demonstrate such a difference. Likewise, there does not appear to be a significant increase in efficiency over time associated with EMRs when compared to the efficiency of hospitals without such documentation.     

基于DEA-Tobit模型的上海医疗资源整合效率分析

本文以2007年至2010年上海市39家二级医院为样本,利用数据包络分析(DEA)和Tobit回归模型分析参与整合对医院效率变化的影响及其主导因素。结果发现在2010年整合组医院和非整合组医院的纯效率值产生显著差异。从投入要素的作用机制角度考虑,以2010年各医院效率值为因变量,高级职称医师比例、10万元以上设备比例以及是否整合为虚拟变量作为自变量,通过Tobit回归模型认定高级职称医生的比例提高是其效率提升的关键因素。     

Behavioral agency and corporate entrepreneurship: CEO equity incentives & competitive behavior

Scholars have long studied drivers of entrepreneurial behavior among established firms. Yet little is known about how individual factors shape a firm’s choice to pursue entrepreneurship. We draw on behavioral agency theory to explore the role of equity incentives in driving corporate entrepreneurship. Our findings suggest CEOs avoid corporate entrepreneurial behaviors as their option wealth increases. However industry dynamics also prove to be an important contingency when predicting the effects of both restricted stock and stock options on the likelihood that the CEO engages in corporate entrepreneurship. Our findings provide a theoretical platform for predicting dimensions of entrepreneurial behavior and highlight effects of CEO equity ownership.

     

Technical efficiency with state-contingent production frontiers using maximum entropy estimators

Although the theory of state-contingent production is well-established, the empirical implementation of this approach is still in an infancy stage. The possibility of finding a large number of states of nature, few observations per state and models affected by collinearity have led some researchers to claim the urgent need to develop robust estimation techniques. In this paper, we investigate the performance of some maximum entropy estimators to assess technical efficiency with state-contingent production frontiers. The methodological discussion and the simulation study provided in the paper reveal some of the potential of these estimators. Small mean squared error loss and small differences between the true and the estimated mean of technical efficiency show that the maximum entropy can be a powerful tool in the estimation of state-contingent production frontiers.     

Effect of armed conflicts on humanitarian operations: Total factor productivity and efficiency of rural hospitals

We study an important but widely neglected topic in humanitarian operations: armed conflicts. Specifically, this paper empirically analyzes the effect of armed conflicts on the operational performance of first-layer response organizations. Using as a case study the Colombian conflict we investigate the effect of conflict on public rural hospitals' (i) total factor productivity, (ii) efficiency and (iii) efficiency variability. The panel data set (2007–2011) used in this study includes information at the hospital level for 163 hospitals and qualitative data collected from interviews with medical staff from the Colombian Ministry of Health and hospitals in different conflict zones. Our results indicate that armed conflict has a positive effect on total factor productivity, while it has a negative impact on hospital efficiency, and interestingly that efficiency and total factor productivity both increase in post conflict. Finally, the results show that efficiency variability is higher in peace and post-conflict hospitals and lower in medium and severe-conflict hospitals. These results have operations management implications and opportunities for future research related to sourcing decisions, supply chain and workforce flexibility, behavioral impacts on the workforce, and humanitarian response to conflicts.     

Cooperative R&D ventures: Strategic behavior versus transactional efficiency

This paper examines a sample of 48 cooperative R&D ventures announced in the period 1983–1990 to determine their impact on the stock price of the announcing firms. It finds that the venturing firms earn statistically significant positive abnormal returns over periods surrounding the announcement date. These gains are greater than those that result from announcements of increases in expenditures on in-house R&D. The cross-sectional analysis reveals that abnormal returns to the venturing firms are independent of industry concentration, larger in international ventures than in domestic ventures, and equal in cooperative agreements and equity joint ventures. These results support the transactional efficiency perspective of cooperative R&D ventures and suggest that the relaxation of antitrust laws as they apply to cooperative R&D ventures in 1984 is a welfare-improving policy.