Investigating technical efficiency and its determinants: The Case of New Zealand District Health Boards |
| |
| Institution: | 1. Department of Health Information Technology and Management, School of Medical Management and Information Sciences, Isfahan University of Medical Sciences, Hezarjerib St., Isfahan P. O. Box: 81745- 346, Iran;2. School of Medical Management and Information Sciences, Isfahan University of Medical Sciences, Hezarjerib St., Isfahan P. O. Box: 81745- 346, Iran;1. Department of Health Information Technology, Khalkhal University of Medical Sciences, Khalkhal, Iran;2. Department of Health Information Management, Tehran University of Medical Sciences, Tehran, Iran;3. Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran;4. Ph.D. of Health Information Management, School of Allied Medical Sciences, Zabol University of Medical Sciences, Zabol, Iran;5. Social Determinants of Health Research Center, School of Allied Medical Sciences, Semnan University of Medical Sciences, Semnan, Iran;6. Social Determinants of Health Research Center, School of medicine, Semnan University of Medical Sciences, Semnan, Iran;1. Department of Health Management and Economics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran;2. Department of Global Health and Public Policy, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran;3. Health Equity Research Centre (HERC), Tehran University of Medical Sciences, Tehran, Iran;1. Department of Health Management and Informatics, University of Central Florida, 528 West Livingston St, Orlando, FL 32801 USA;2. Owen Graduate School of Management, Vanderbilt University, 401 21st Ave S, Nashville, TN, 37203 USA;3. Department of Economics, Sungkyunkwan University, Seoul, Korea;1. Department of Health Policy and Management, Faculty of Public Health, Medical University of Sofia, Bulgaria;2. Faculty of Public Health, Medical University of Sofia, Bulgaria;1. Department of Applied Health Research, University College London, Gower Street, London WC1E 6BT, UK;2. Department of Biochemical Engineering, University College London, Gower Street, London WC1E 6BT, UK;3. Department of Public Health & Primary Care, University of Cambridge, Institute of Public Health, Forvie Site, Robinson Way, Cambridge CB2 0SR, UK |
| |
| Abstract: | This study investigates the technical efficiency of New Zealand's District Health Boards (DHBs) in providing hospital services, as well as the effect of certain environmental factors on efficiency. This study is the first to use quarterly data on New Zealand DHBs from 2011 to 2017 and apply the two-stage double-bootstrap methodology of Simar and Wilson. The bias-corrected technical efficiency estimates show that on average, DHBs in the areas with high socioeconomic deprivation operate with low technical efficiency. Furthermore, DHB providing secondary hospital services are less efficient than tertiary DHBs. The result from truncated regression indicates that a higher proportion of surgical, elderly, and acute inpatients is associated with increasing levels of technical efficiency. In contrast, the high average length of hospital stay negatively impacts technical efficiency levels. The findings of this study urge policymakers to adopt policies to address the shortages of healthcare staff, barriers to primary healthcare, lack of investment in hospital capacity, and technology to enhance healthcare sector's long-run technical efficiency. In addition, the existing DHB funding formula needs to be revisited as this tends to include perverse incentives for secondary DHBs where patients are kept longer in hospitals, leading to a higher average length of stays in hospitals and is associated with increasing levels of inefficiency. |
| |
| Keywords: | |
| 本文献已被 ScienceDirect 等数据库收录！ |
|
