Technical efficiency:efficiency, change, technical progress and productivity growth in the national health systems of continental African countries

In May 2006, the Ministers of Health of all the countries on the African continent, at a special session of the African Union, undertook to institutionalise efficiency monitoring within their respective national health information management systems. The specific objectives of this study were: (i) to assess the technical efficiency of National Health Systems (NHSs) of African countries for measuring male and female life expectancies, and (ii) to assess changes in health productivity over time with a view to analysing changes in efficiency and changes in technology. The analysis was based on a five-year panel data (1999-2003) from all the 53 countries of continental Africa. Data Envelopment Analysis (DEA) - a non-parametric linear programming approach - was employed to assess the technical efficiency. Malmquist Total Factor Productivity (MTFP) was used to analyse efficiency and productivity change over time among the 53 countries' national health systems. The data consisted of two outputs (male and female life expectancies) and two inputs (per capital total health expenditure and adult literacy). The DEA revealed that 49 (92.5%) countries' NHSs were run inefficiently in 1999 and 2000; 50 (94.3%), 48 (90.6%) and 47 (88.7%) operated inefficiently in 2001, 2002, and 2003 respectively. All the 53 countries' national health systems registered improvements in total factor productivity attributable mainly to technical progress. Fifty-two countries did not experience any change in scale efficiency, while thirty (56.6%) countries' national health systems had a Pure Efficiency Change (PEFFCH) index of less than one, signifying that those countries' NHSs pure efficiency contributed negatively to productivity change. All the 53 countries' national health systems registered improvements in total factor productivity, attributable mainly to technical progress. Over half of the countries' national health systems had a pure efficiency index of less than one, signifying that those countries' NHSs pure efficiency contributed negatively to productivity change. African countries may need to critically evaluate the utility of institutionalising Malmquist TFP type of analyses to monitor changes in health systems economic efficiency and productivity over time. African national health systems, per capita total health expenditure, technical efficiency, scale efficiency, Malmquist indices of productivity change, DEA

World knowledge competitiveness index 2002:benchmarking the globes high-performing regions

The World Knowledge Competitiveness Index 2002 is the first composite and relative measure of the knowledge economies of the globe's best performing regions. It represents an integrated and overall benchmark of the knowledge capacity, capability and sustainability of each region and the extent to which this knowledge is translated into economic value and transferred into the wealth of the citizens of each region. This publication has over 50 pages and covers the following sections: The Economics of Knowledge Competitiveness The Rankings - World Knowledge Competitiveness Index Human Capital Components Knowledge Capital Components Regional Economy Outputs Knowledge Sustainability Components Driving Knowledge-Based Growth

Lobe connections and lobe crowding are associated with growth rate in the lichen Xanthoparmelia conspersa

The association between lobe connections and the degree of lobe crowding and radial growth was studied in thalli of the foliose lichen Xanthoparmelia conspersa. In 35 thalli, 15% of the lobes were not physically connected to either of their neighbours before the lobes merged into the centre of the thallus. Twenty-five percent of the lobes were connected in pairs and 29% in groups of three. Approximately 5% of the lobes were interconnected in larger groups of six or more. The mean number of lobes per group in a thallus was positively correlated with thallus diameter and with the degree of lobe growth variation but was unrelated to annual radial growth rate (RGR). The degree of crowding of the lobes in a thallus was defined as a 'crowding index', viz., the product of lobe density and mean lobe width. Crowding index increased rapidly with size in smaller thalli but changed less with size in larger thalli. Crowding index was positively correlated with RGR but was unrelated to lobe growth variation. Lobes removed from large thalli and glued in various configurations to simulate different degrees of crowding did not demonstrate an association between lobe crowding and RGR over one year. These results suggest that the pattern of lobe connectivity of a thallus is associated with lobe growth variation in X. conspersa. The degree of lobe crowding is associated with the increase in RGR with thallus size in smaller thalli and by restricting lobe width, could also be a factor associated with the more constant growth of larger thalli.

The Generalized Malmquist index and capacity utilization change: an application to the Italian manufacturing, 1989-1994

Several indices of plant capacity utilization based on the concept of best practice frontier have been proposed in the literature (Fare et al. 1992; De Borger and Kerstens, 1998). This paper suggests an alternative measure of capacity utilization change based on Generalized Malmquist index, proposed by Grifell-Tatje' and Lovell in 1998. The advantage of this specification is that it allows the measurement of productivity growth ignoring the nature of scale economies. Afterwards, this index is used to measure capacity change of a panel of Italian firms over the period 1989-94 using Data Envelopment Analysis and then its abilities of explaining the short-run movements of output are assessed.

Nondestructive index profiling of long period gratings in photonic crystal fibres

A numerical model of a long period grating in photonic crystal fibre fabricated by an electric arc is proposed that allows for the spectral characterisation of the grating. In the combination with the suggested model of the photonic crystal and the experimentally recorded grating growth it is used to find the index change induced by the electric arc.

The measurement and decomposition of economy-wide productivity growth:Assessing the accuracy and selecting between different approaches

Productivity at the macro level is a complex concept but also arguably the most appropriate measure of economic welfare. Currently, there is limited research available on the various approaches that can be used to measure it and especially on the relative accuracy of said approaches. This thesis has two main objectives: firstly, to detail some of the most common productivity measurement approaches and assess their accuracy under a number of conditions and secondly, to present an up-to-date application of productivity measurement and provide some guidance on selecting between sometimes conflicting productivity estimates. With regards to the first objective, the thesis provides a discussion on the issues specific to macro-level productivity measurement and on the strengths and weaknesses of the three main types of approaches available, namely index-number approaches (represented by Growth Accounting), non-parametric distance functions (DEA-based Malmquist indices) and parametric production functions (COLS- and SFA-based Malmquist indices). The accuracy of these approaches is assessed through simulation analysis, which provided some interesting findings. Probably the most important were that deterministic approaches are quite accurate even when the data is moderately noisy, that no approaches were accurate when noise was more extensive, that functional form misspecification has a severe negative effect in the accuracy of the parametric approaches and finally that increased volatility in inputs and prices from one period to the next adversely affects all approaches examined. The application was based on the EU KLEMS (2008) dataset and revealed that the different approaches do in fact result in different productivity change estimates, at least for some of the countries assessed. To assist researchers in selecting between conflicting estimates, a new, three step selection framework is proposed, based on findings of simulation analyses and established diagnostics/indicators. An application of this framework is also provided, based on the EU KLEMS dataset.

Nondestructive index profiling of long period gratings in photonic crystal fibres

A numerical model of a long period grating in photonic crystal fibre fabricated by an electric arc is proposed that allows for the spectral characterisation of the grating. In the combination with the suggested model of the photonic crystal and the experimentally recorded grating growth it is used to find the index change induced by the electric arc. © Springer Science+Business Media B.V. 2007.

Age-related macular degeneration is associated with increased vascular endothelial growth factor, hemorheology and endothelial dysfunction

OBJECTIVE: To investigate laboratory evidence of abnormal angiogenesis, hemorheologic factors, endothelial damage/dysfunction, and age-related macular degeneration (ARMD). DESIGN: Comparative cross-sectional study. PARTICIPANTS: We studied 78 subjects (26 men and 52 women; mean age 74 years; standard deviation [SD] 9.0) with ARMD attending a specialist referral clinic. Subjects were compared with 25 healthy controls (mean age, 71 years; SD, 11). INTERVENTION AND OUTCOME MEASURES: Levels of vascular endothelial growth factor (VEGF, an index of angiogenesis), hemorheologic factors (plasma viscosity, hematocrit, white cell count, hemoglobin, platelets), fibrinogen (an index of rheology and hemostasis), and von Willebrand factor (a marker of endothelial dysfunction) were measured. RESULTS: Median plasma VEGF (225 vs. 195 pg/ml, P = 0.019) and mean von Willebrand factor (124 vs. 99 IU/dl, P = 0.0004) were greater in ARMD subjects than the controls. Mean plasma fibrinogen and plasma viscosity levels were also higher in the subjects (both P < 0.0001). There were no significant differences in other indices between cases and controls. When "dry" (drusen, atrophy, n = 28) and "exudative" (n = 50) ARMD subjects were compared, there was no significant differences in VEGF, fibrinogen, viscosity, or von Willebrand factor levels. There were no significant correlations between the measured parameters. Stepwise multiple regression analysis did not demonstrate any significant clinical predictors (age, gender, smoking, body mass index, history of vascular disease, or hypertension) for plasma VEGF or fibrinogen levels, although smoking status was a predictor of plasma von Willebrand factor levels (P < 0.05). CONCLUSIONS: This study suggests an association between markers of angiogenesis (VEGF), hemorheologic factors, hemostasis, endothelial dysfunction, and ARMD. The interaction between abnormal angiogenesis and the components of Virchow's triad for thrombogenesis may in part contribute to the pathogenesis of ARMD.

Cardiac dysfunction and cell damage across clinical stages of severity in growth-restricted fetuses

Objective - The purpose of this study was to assess cardiac function and cell damage in intrauterine growth-restricted (IUGR) fetuses across clinical Doppler stages of deterioration. Study Design - One hundred twenty appropriate-for-gestational-age and 81 IUGR fetuses were classified in stages 1/2/3 according umbilical artery present/absent/reversed end-diastolic blood flow, respectively. Cardiac function was assessed by modified-myocardial performance index, early-to-late diastolic filling ratios, cardiac output, and cord blood B-type natriuretic peptide; myocardial cell damage was assessed by heart fatty acid–binding protein, troponin-I, and high-sensitivity C-reactive protein. Results - Modified-myocardial performance index, blood B-type natriuretic peptide, and early-to-late diastolic filling ratios were increased in a stage-dependent manner in IUGR fetuses, compared with appropriate-for-gestational-age fetuses. Heart fatty acid–binding protein levels were higher in IUGR fetuses at stage 3, compared with control fetuses. Cardiac output, troponin-I, and high-sensitivity C-reactive protein did not increase in IUGR fetuses at any stage. Conclusion - IUGR fetuses showed signs of cardiac dysfunction from early stages. Cardiac dysfunction deteriorates further with the progression of fetal compromise, together with the appearance of biochemical signs of cell damage.

Power industry restructuring and eco-efficiency changes:a new slacks-based model in Malmquist-Luenberger Index measurement

Measuring variations in efficiency and its extension, eco-efficiency, during a restructuring period in different industries has always been a point of interest for regulators and policy makers. This paper assesses the impacts of restructuring of procurement in the Iranian power industry on the performance of power plants. We introduce a new slacks-based model for Malmquist-Luenberger (ML) Index measurement and apply it to the power plants to calculate the efficiency, eco-efficiency, and technological changes over the 8-year period (2003-2010) of restructuring in the power industry. The results reveal that although the restructuring had different effects on the individual power plants, the overall growth in the eco-efficiency of the sector was mainly due to advances in pure technology. We also assess the correlation between efficiency and eco-efficiency of the power plants, which indicates a close relationship between these two steps, thus lending support to the incorporation of environmental factors in efficiency analysis. © 2014 Elsevier Ltd.

Productivity growth and efficiency measurements in fuzzy environments with an application to health care

Health care organizations must continuously improve their productivity to sustain long-term growth and profitability. Sustainable productivity performance is mostly assumed to be a natural outcome of successful health care management. Data envelopment analysis (DEA) is a popular mathematical programming method for comparing the inputs and outputs of a set of homogenous decision making units (DMUs) by evaluating their relative efficiency. The Malmquist productivity index (MPI) is widely used for productivity analysis by relying on constructing a best practice frontier and calculating the relative performance of a DMU for different time periods. The conventional DEA requires accurate and crisp data to calculate the MPI. However, the real-world data are often imprecise and vague. In this study, the authors propose a novel productivity measurement approach in fuzzy environments with MPI. An application of the proposed approach in health care is presented to demonstrate the simplicity and efficacy of the procedures and algorithms in a hospital efficiency study conducted for a State Office of Inspector General in the United States. © 2012, IGI Global.

Regional competitiveness, economic growth and stages of development

This paper positions the concept of regional competitiveness within theories concerning regional economic growth and stages of economic development. It examines the sources of regional competitiveness encompassing an analysis based on the particular stage of economic development that the nations within which regions are situated have reached. As a means to achieve this, the paper undertakes an empirical analysis of data stemming from the World Competitiveness Index of Regions, and identifies regional competitiveness as a dual concept that explains relative differences in rates of economic development across regions, as well as an understanding of the future economic growth trajectories of regions at a similar stage of economic development. As with endogenous growth and development theory, the notion of regional competitiveness presented here places knowledge, innovation and entrepreneurship at the forefront of conceptualisations of regional economic differentiation.

A framework for measuring global Malmquist–Luenberger productivity index with CO2 emissions on Chinese manufacturing industries

China has achieved significant progress in terms of economic and social developments since implementation of reform and open policy in 1978. However, the rapid speed of economic growth in China has also resulted in high energy consumption and serious environmental problems, which hindering the sustainability of China's economic growth. This paper provides a framework for measuring eco-efficiency with CO2 emissions in Chinese manufacturing industries. We introduce a global Malmquist-Luenberger productivity index (GMLPI) that can handle undesirable factors within Data Envelopment Analysis (DEA). This study suggested after regulations imposed by the Chinese government, in the last stage of the analysis, i.e. during 2011–2012, the contemporaneous frontier shifts towards the global technology frontier in the direction of more desirable outputs and less undesirable outputs, i.e. producing less CO2 emissions, but the GMLPI drops slightly. This is an indication that the Chinese government needs to implement more policy regulations in order to maintain productivity index while reducing CO2 emissions.