Measuring Avoidable Health Inequality with Realization of Conditional Potential Life Years (RCPLY)

In a series of papers (Tang, Chin and Rao, 2008; and Tang, Petrie and Rao 2006 & 2007), we have tried to improve on a mortality-based health status indicator, namely age-at-death (AAD), and its associated health inequality indicators that measure the distribution of AAD. The main contribution of these papers is to propose a frontier method to separate avoidable and unavoidable mortality risks. This has facilitated the development of a new indicator of health status, namely the Realization of Potential Life Years (RePLY). The RePLY measure is based on the concept of a ���frontier country��� that, by construction, has the lowest mortality risks for each age-sex group amongst all countries. The mortality rates of the frontier country are used as a proxy for the unavoidable mortality rates, and the residual between the observed mortality rates and the unavoidable mortality rates are considered as avoidable morality rates. In this approach, however, countries at different levels of development are benchmarked against the same frontier country without considering their heterogeneity. The main objective of the current paper is to control for national resources in estimating (conditional) unavoidable and avoidable mortality risks for individual countries. This allows us to construct a new indicator of health status ��� Realization of Conditional Potential Life Years (RCPLY). The paper presents empirical results from a dataset of life tables for 167 countries from the year 2000, compiled and updated by the World Health Organization. Measures of national average health status and health inequality based on RePLY and RCPLY are presented and compared.

Assesing advertising efficiency: does the internet play a role?

This research focuses on a major concern for marketers addressing the claims of inefficiency of the spending on advertising. We examine whether the Internet can help increase overall advertising efficiency. Using a sample from the Spanish automobile industry, we combine a nonparametric method - Data Envelopment Analysis - with recent important insights from statistics and econometrics studies, and we find that online advertising improves the efficiency levels and this effect is more pronounced in the long-term temporal framework.

Determinants of school efficiency : The case of primary schools in the State of Geneva, Switzerland

The public primary school system in the State of Geneva, Switzerland, is characterized by centrally evaluated pupil performance measured with the use of standardized tests. As a result, consistent data are collected among the system. The 2010-2011 dataset is used to develop a two-stage data envelopment analysis (DEA) of school efficiency. In the first stage, DEA is employed to calculate an individual efficiency score for each school. It shows that, on average, each school could reduce its inputs by 7% whilst maintaining the same quality of pupil performance. The cause of inefficiency lies in perfectible management. In the second stage, efficiency is regressed on school characteristics and environmental variables;external factors outside of the control of headteachers. The model is tested for multicollinearity, heteroskedasticity and endogeneity. Four variables are identified as statistically significant. School efficiency is negatively influenced by (1) the provision of special education, (2) the proportion of disadvantaged pupils enrolled at the school and (3) operations being held on multiple sites, but positively influenced by school size (captured by the number of pupils). The proportion of allophone pupils; schools located in urban areas and the provision of reception classes for immigrant pupils are not significant. Although the significant variables influencing school efficiency are outside of the control of headteachers, it is still possible to either boost the positive impact or curb the negative impact. Dans le canton de Gen��ve (Suisse), les ��coles publiques primaires sont caract��ris��es par un financement assur�� par les collectivit��s publiques (canton et communes) et par une ��valuation des ��l��ves �� l'aide d'��preuves standardis��es �� trois moments distincts de leur scolarit��. Cela permet de r��unir des informations statistiques consistantes. La base de donn��es de l'ann��e 2010-2011 est utilis��e dans une analyse en deux ��tapes de l'efficience des ��coles. Dans une premi��re ��tape, la m��thode d'analyse des donn��es par enveloppement (DEA) est utilis��e pour calculer un score d'efficience pour chaque ��cole. Cette analyse d��montre que l'efficience moyenne des ��coles s'��l��ve �� 93%. Chaque ��cole pourrait, en moyenne, r��duire ses ressources de 7% tout en conservant constants les r��sultats des ��l��ves aux ��preuves standardis��es. La source de l'inefficience r��side dans un management des ��coles perfectible. Dans une seconde ��tape, les scores d'efficience sont r��gress��s sur les caract��ristiques des ��coles et sur des variables environnementales. Ces variables ne sont pas sous le contr��le (ou l'influence) des directeurs d'��cole. Le mod��le est test�� pour la multicolin��arti��, l'h��t��rosc��dasticit�� et l'endog��n��it��. Quatre variables sont statistiquement significatives. L'efficience des ��coles est influenc��e n��gativement par (1) le fait d'offrir un enseignement sp��cialis�� en classe s��par��e, (2) la proporition d'��l��ves d��favoris��s et (3) le fait d'op��rer sur plusieurs sites diff��rents. L'efficience des ��coles est influenc��e positivement par la taille de l'��cole, mesur��e par le nombre d'��l��ves. La proporition d'��l��ves allophones, le fait d'��tre situ�� dans une zone urbaine et d'offrir des classes d'accueil pour les ��l��ves immigrants constituent autant de variables non significatives. Le fait que les variables qui influencent l'efficience des ��coles ne soient pas sous le contr��le des directeurs ne signifie pas qu'il faille c��der au fatalisme. Diff��rentes pistes sont propos��es pour permettre soit de r��duire l'impact n��gatif soit de tirer parti de l'impact positif des variables significatives.

Desempenho dos munic��pios paulistas: uma avalia����o de efici��ncia da aten����o b��sica �� sa��de

Neste trabalho, teve-se por objetivo construir uma metodologia de avalia����o de desempenho dos munic��pios paulistas quanto �� efici��ncia t��cnica na aplica����o de recursos p��blicos nas a����es de aten����o b��sica �� sa��de e analisar a influ��ncia de vari��veis n��o control��veis no processo de produ����o em tal ��rea. A efici��ncia t��cnica �� um dos par��metros de avalia����o de desempenho dos gestores p��blicos, refletindo a capacidade de uma entidade obter m��ximos outputs com o menor consumo de inputs. O alcance de tal m��trica pode ser prejudicado ou favorecido pelas vari��veis ambientais ou n��o control��veis que, se n��o forem consideradas na avalia����o de desempenho, podem gerar vieses. Nesse sentido, por meio da metodologia Data Envelopment Analysis (DEA) em dois est��gios, os escores de efici��ncia dos munic��pios foram estimados e depois ajustados com o uso da an��lise de regress��o. Os resultados indicaram que seria poss��vel aumentar, consideravelmente, a quantidade de servi��os prestados �� popula����o sem a necessidade de novas dota����es or��ament��rias na maioria dos munic��pios. Al��m disso, verificou-se que a maior propor����o de idosos em uma jurisdi����o torna a presta����o de servi��os mais cara; por sua vez, maiores densidade populacional, grau de urbaniza����o e escala dos estabelecimentos de sa��de favorecem o gasto p��blico com efici��ncia. Os cinco munic��pios paulistas considerados mais eficientes foram Tuiuti, Nova Guataporanga, Sabino, Lins e Santos.

Impacto de las inversiones en TI en la eficiencia de los bancos argentinos

Las tecnolog��as de informaci��n (TI) constituyen en la actualidad una herramienta fundamental para el logro de ventajas competitivas en un contexto sumamente cambiante. Resulta relevante conocer el impacto de su utilizaci��n sobre el desempe��o de las organizaciones, en particular en sectores como el bancario, que realizan un uso intensivo de informaci��n. En el presente trabajo se desarrolla un modelo que posibilita evaluar el impacto de las inversiones en TI sobre la eficiencia de las entidades bancarias. Se utiliz�� la t��cnica Data Envelopment Analysis (DEA) como herramienta de medici��n de la eficiencia de acuerdo al modelo elaborado sobre la informaci��n obtenida de los estados contables de entidades bancarias de la Rep��blica Argentina. Los resultados obtenidos demostraron que los bancos alcanzaron un buen nivel de eficiencia global. Se encontr�� que los m��s eficientes son las sucursales de entidades financieras del exterior y los bancos locales de capital extranjero.

La evaluaci��n del gasto sanitario en Espa��a en sus niveles y determinantes

El an��lisis emp��rico del presente trabajo trata de evaluar los resultados asociables al gasto sanitario espa��ol y como consecuencia calibrar las distintas orientaciones para el crecimiento futuro del gasto sanitario p��blico. A la vista del estudio de los potenciales impactos procedente de las variaciones de gasto en los m��rgenes sobre los niveles actuales de recursos, se tratar��a de valorar los siguientes objetivos: a) Las mejoras de eficiencia (performance) del sistema sanitario en su conjunto; b) La mejor consecuci��n de cotas de equidad (tanto en contribuciones finacieras como en el acceso a prestaciones); c) El incremento de la capacidad de respuesta por parte de la oferta y del dispositivo asistencial del sistema a las necesidades percibidas (��ndice de responsiveness).Se trata de aproximar con ello la valoraci��n de cuantos recursos se requerir��an para cerrar la brecha entre los niveles de gasto observados en Espa��a y las mejores pr��cticas observadas de la muestra estimada. Ello equivale a la cuantificaci��n del gasto sanitario adicional necesario por punto marginal de ganancia en el valor de los indicadores observados, de acuerdo con los valores estimados en el an��lisis emp��rico.Para la definici��n de las potencialidades en resultados, la aproximaci��n no param��trica del an��lisis envolvente de datos (AED, Data Envelopment Analysis) es particularmente apropiada para ello. El objetivo es evaluar distancias para los valores espa��oles respecto del benchmarking derivado de la estimaci��n, y cuantificar con ello el coste de cierre de brecha ��ptimo (entre los outputs de dimensiones m��ltiples considerados y los diversos recursos puestos a disposici��n del sistema sanitario).

Growth accounting in items of turbulence and death: efficiency, technology, capital accumulation and human capital 1929-1950

We employ a non-parametrical approach to growth accounting (Data Envelopment Analysis,DEA) to disentangle the proximate sources of labour productivity growth in 41 nationsbetween 1929 and 1950 by decomposing productivity growth into four components:technological change; efficiency catch-up (movements towards the production frontier),capital accumulation and human capital accumulation. We show that efficiency catch-upgenerally explains productivity growth, whereas technological change and factoraccumulation were limited and distorted by the effects of war. War clearly hamperedefficiency. Moreover, an unbalanced ratio of human capital to physical capital (a gap to thetechnological leader) was crucial for efficiency catching-up.

Radial measures of public services deficit for regional allocation of public funds

The goal of this paper is to present an optimal resource allocation model for the regional allocation of public service inputs. Theproposed solution leads to maximise the relative public service availability in regions located below the best availability frontier, subject to exogenous budget restrictions and equality ofaccess for equal need criteria (equity-based notion of regional needs). The construction of non-parametric deficit indicators is proposed for public service availability by a novel application of Data Envelopment Analysis (DEA) models, whose results offer advantages for the evaluation and improvement of decentralised public resource allocation systems. The method introduced in this paper has relevance as a resource allocation guide for the majority of services centrally funded by the public sector in a given country, such as health care, basic and higher education, citizen safety, justice, transportation, environmental protection, leisure, culture, housing and city planning, etc.

Market structure and hospital efficiency: Evaluating potential effects of deregulation in a national health service

In this article we examine the potential effect of market structureon hospital technical efficiency as a measure of performance controlled byownership and regulation. This study is relevant to provide an evaluationof the potential effects of recommended and initiated deregulation policiesin order to promote market reforms in the context of a European NationalHealth Service. Our goal was reached through three main empirical stages.Firstly, using patient origin data from hospitals in the region of Cataloniain 1990, we estimated geographic hospital markets through the Elzinga--Hogartyapproach, based on patient flows. Then we measured the market level ofconcentration using the Herfindahl--Hirschman index. Secondly, technicaland scale efficiency scores for each hospital was obtained specifying aData Envelopment Analysis. According to the data nearly two--thirds of thehospitals operate under the production frontier with an average efficiencyscore of 0.841. Finally, the determinants of the efficiency scores wereinvestigated using a censored regression model. Special attention waspaid to test the hypothesis that there is an efficiency improvement in morecompetitive markets. The results suggest that the number of competitors inthe market contributes positively to technical efficiency and there is someevidence that the differences in efficiency scores are attributed toseveral environmental factors such as ownership, market structure andregulation effects.

10

This contribution introduces Data Envelopment Analysis (DEA), a performance measurement technique. DEA helps decision makers for the following reasons: (1) By calculating an efficiency score, it indicates if a firm is efficient or has capacity for improvement; (2) By setting target values for input and output, it calculates how much input must be decreased or output increased in order to become efficient; (3) By identifying the nature of returns to scale, it indicates if a firm has to decrease or increase its scale (or size) in order to minimise the average total cost; (4) By identifying a set of benchmarks, it specifies which other firms' processes need to be analysed in order to improve its own practices. This contribution presents the essentials about DEA, alongside a case study to intuitively understand its application. It also introduces Win4DEAP, a software package that conducts efficiency analysis based on DEA methodology. The methodical background of DEA is presented for more demanding readers. Finally, four advanced topics of DEA are treated: adjustment to the environment, preferences, sensitivity analysis and time series data.

Assessing the assignation of public subsidies: Do the experts choose the most efficient R and D projects?

[spa] La implementaci��n de un programa de subvenciones p��blicas a proyectos empresariales de I+D comporta establecer un sistema de selecci��n de proyectos. Esta selecci��n se enfrenta a problemas relevantes, como son la medici��n del posible rendimiento de los proyectos de I+D y la optimizaci��n del proceso de selecci��n entre proyectos con m��ltiples y a veces incomparables medidas de resultados. Las agencias p��blicas utilizan mayoritariamente el m��todo peer review que, aunque presenta ventajas, no est�� exento de cr��ticas. En cambio, las empresas privadas con el objetivo de optimizar su inversi��n en I+D utilizan m��todos m��s cuantitativos, como el Data Envelopment An��lisis (DEA). En este trabajo se compara la actuaci��n de los evaluadores de una agencia p��blica (peer review) con una metodolog��a alternativa de selecci��n de proyectos como es el DEA.

Assessing the assignation of public subsidies: Do the experts choose the most efficient R and D projects?

[spa] La implementaci��n de un programa de subvenciones p��blicas a proyectos empresariales de I+D comporta establecer un sistema de selecci��n de proyectos. Esta selecci��n se enfrenta a problemas relevantes, como son la medici��n del posible rendimiento de los proyectos de I+D y la optimizaci��n del proceso de selecci��n entre proyectos con m��ltiples y a veces incomparables medidas de resultados. Las agencias p��blicas utilizan mayoritariamente el m��todo peer review que, aunque presenta ventajas, no est�� exento de cr��ticas. En cambio, las empresas privadas con el objetivo de optimizar su inversi��n en I+D utilizan m��todos m��s cuantitativos, como el Data Envelopment An��lisis (DEA). En este trabajo se compara la actuaci��n de los evaluadores de una agencia p��blica (peer review) con una metodolog��a alternativa de selecci��n de proyectos como es el DEA.

Assessing the assignation of public subsidies: Do the experts choose the most efficient R and D projects?

[spa] La implementaci��n de un programa de subvenciones p��blicas a proyectos empresariales de I+D comporta establecer un sistema de selecci��n de proyectos. Esta selecci��n se enfrenta a problemas relevantes, como son la medici��n del posible rendimiento de los proyectos de I+D y la optimizaci��n del proceso de selecci��n entre proyectos con m��ltiples y a veces incomparables medidas de resultados. Las agencias p��blicas utilizan mayoritariamente el m��todo peer review que, aunque presenta ventajas, no est�� exento de cr��ticas. En cambio, las empresas privadas con el objetivo de optimizar su inversi��n en I+D utilizan m��todos m��s cuantitativos, como el Data Envelopment An��lisis (DEA). En este trabajo se compara la actuaci��n de los evaluadores de una agencia p��blica (peer review) con una metodolog��a alternativa de selecci��n de proyectos como es el DEA.

Essays on the measurement of school efficiency

Measuring school efficiency is a challenging task. First, a performance measurement technique has to be selected. Within Data Envelopment Analysis (DEA), one such technique, alternative models have been developed in order to deal with environmental variables. The majority of these models lead to diverging results. Second, the choice of input and output variables to be included in the efficiency analysis is often dictated by data availability. The choice of the variables remains an issue even when data is available. As a result, the choice of technique, model and variables is probably, and ultimately, a political judgement. Multi-criteria decision analysis methods can help the decision makers to select the most suitable model. The number of selection criteria should remain parsimonious and not be oriented towards the results of the models in order to avoid opportunistic behaviour. The selection criteria should also be backed by the literature or by an expert group. Once the most suitable model is identified, the principle of permanence of methods should be applied in order to avoid a change of practices over time. Within DEA, the two-stage model developed by Ray (1991) is the most convincing model which allows for an environmental adjustment. In this model, an efficiency analysis is conducted with DEA followed by an econometric analysis to explain the efficiency scores. An environmental variable of particular interest, tested in this thesis, consists of the fact that operations are held, for certain schools, on multiple sites. Results show that the fact of being located on more than one site has a negative influence on efficiency. A likely way to solve this negative influence would consist of improving the use of ICT in school management and teaching. Planning new schools should also consider the advantages of being located on a unique site, which allows reaching a critical size in terms of pupils and teachers. The fact that underprivileged pupils perform worse than privileged pupils has been public knowledge since Coleman et al. (1966). As a result, underprivileged pupils have a negative influence on school efficiency. This is confirmed by this thesis for the first time in Switzerland. Several countries have developed priority education policies in order to compensate for the negative impact of disadvantaged socioeconomic status on school performance. These policies have failed. As a result, other actions need to be taken. In order to define these actions, one has to identify the social-class differences which explain why disadvantaged children underperform. Childrearing and literary practices, health characteristics, housing stability and economic security influence pupil achievement. Rather than allocating more resources to schools, policymakers should therefore focus on related social policies. For instance, they could define pre-school, family, health, housing and benefits policies in order to improve the conditions for disadvantaged children.

Relative Technical Efficiency of European Transportation Systems

Talouden kasvaessa my��s tavarankuljetusm����r��t kasvavat. Kuljetusj��rjestelm��t ja niiden sujuva toiminta on eritt��in t��rke���� taloudellisen kasvun kannalta t��ll�� hetkell��, ja se tulee olemaan yh�� t��rke��mp���� tulevaisuudessa. Tulevaisuudessa tarvitaan kokonaisvaltainen ja selke��sti tehokkaampi kuljetusj��rjestelm��, mik��li tulevaisuuden kuljetusvirrat halutaan hoitaa kest��v��sti. T��ss�� opinn��ytety��ss��ni tutkin kolmen eurooppalaisen kuljetusj��rjestelm��n (rautatiet, lentoliikenne ja konttiliikenne meritse) suhteellista teknist�� tehokkuutta ja menetelm��n�� on data envelopment analysis (DEA). Vertailtaessa kuljetusj��rjestelmi�� l��ytyi suuria eroja kuljetusmuotojen v��lille. lentoyhti��t suoriutuivat huomattavan tasaisesti eli tehokkaiden ja ei-tehokkaiden toimijoiden v��lill�� ei ollut suuria eroja. Rautatiepuolella erot venyiv��t huomattavan suuriksi niin eri yritysten v��lill�� kuin jopa saman yrityksen sis��ll�� eri vuosina. Pikaisemmassa laivayhti��iden tarkastelussa erot niiden v��lill�� olivat l��hes yht�� pieni�� kuin lentoyhti��iden v��lill��. Tarkasteltaessa omistajuuden vaikutusta lentoyhti��iden toiminnassa huomattiin, ett�� yksityisess�� omistuksessa olevat yritykset olivat huomattavasti tehokkaampia matkustajien kuljettamisessa. Rahtipuolella merkitt��vi�� eroja ei havaittu. Merkitt��v��t korrelaatiot eri mallien v��lill�� antoivat joitain viitteit�� my��s kuljetuspoliittiseen p����t��ksentekoon; investoinnit matkustajienkuljetuksiin raiteilla parantaisivat koko rautatiepuolen teokkuutta, mutta my��s samalla lentopuolen matkustajakuljetuksen tehokkuutta.