Abstract
This paper analyses the cost efficiency of the Tunisian public hospitals over the period 2000–2007, using a Bayesian frontier model (random and fixed models). Unlike the traditional stochastic frontier models, this model allows to separate the cost efficiency estimates from the technological difference (i.e., heterogeneity) within the hospitals and the inclusion of “prior” information about the parameters in inference. Results indicate that the random frontier was a better fit to the data, therefore providing further evidence that the Tunisian public hospitals operate in different environmental and technological characteristics. Policy implications of the results are derived.
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References
Aigner, D., Lovell, C., & Schmidt, P. (1977). Formulation and estimation of stochastic frontier production models. Journal of Econometrics, 6, 21–37.
Alchian, A. A., & Harold, D. (1972). Production, information costs, and economic organization. The American Economic Review, 62, 777–795.
Assaf, A. G., & Josiassen, A. (2012). Time-varying production efficiency in the health care foodservice industry: a Bayesian method. Journal of Business Research, 65, 617–625.
Barros, C. P., De Menezes, A. G., & Vieira, J. C. (2013). Measurement of hospital efficiency, using a latent class stochastic frontier model. Applied Economics, 45, 47–54.
Blank, J. L. T., & Van Hust, B. L. (2011). Governance and performance: the performance of Dutch hospitals explained by governance characteristics. Journal Medical System, 35, 991–999.
Byrnes, V., & Valdmanis, V. (1994). Analysing technical and allocative efficiency of hospitals. In A. Charnes, W. Cooper, A. Lewin, & L. Seiford (Eds.), Data envelopment analysis: theory, methodology and applications. Dordrecht: Kluwer Academic Publishers.
Chaabouni, S., & Abdnnadher, C. (2012). Efficiency of public hospitals in Tunisia: a DEA with bootstrap application. International Journal Behavioral and Healthcare Research, 3, 198–211.
Charnes, A., Cooper, W. W., & Rhodes, E. (1978). Measuring the efficiency of decision-making units. European Journal of Operations Research, 2(4), 429–444.
Coelli, T., Prasada Rao, D. S., & Battese, G. E. (1998). An introduction to efficiency and productivity analysis. Boston: Kluwer Academic Publishers.
Greene, W. (2005). Reconsidering heterogeneity in panel data estimators of the stochastic frontier model. Journal of Econometrics, 126(2), 269–303.
Greene, W. (2008). The econometric approach to efficiency analysis. The measurement of productive efficiency and productivity growth. New York: Oxford University.
Grossman, S. J., & HART, O. D. (1983). An analysis of the principal-agent problem. Econometrica, 51, 7–45.
Kontodimopoulos, N., & Niakas, D. (2005). Efficiency measurement of Hem dialysis units in Greece with data envelopment analysis. Health Policy, 71, 195–204.
Koop, G., Steel, M. F. J., & Osiewalski, J. (1995). Posterior analysis of stochastic frontiers models using Gibbs sampling. Computational Statistics, 10, 353–373.
Koop, G., Osiewalski, J., & Steel, M. F. J. (1997). Bayesian efficiency analysis through individual effects: hospital cost frontiers. Journal of Econometrics, 76, 77–105.
Meeusen, W., & Van Den Broeck, J. (1977). Efficiency estimation from Cobb-Douglas production functions with composed error. International Economics Review, 18, 435–444.
Morey, R., Fine, D., & Loree, S. (1990). Comparing the allocative efficiencies of hospitals. OMEGA, 18, 71–83.
Mutter, R. L., Rosko, M. D., & Wong, H. S. (2008). Measuring hospital inefficiency: the effects of controlling for quality and patient burden of illness. Health Services Research, 43, 1992–2013.
Nyhan, R. C., & Martin, L. L. (1999). Comparative performance measurement: a primer on data envelopment analysis. Public Productivity and Management Review, 22(3), 348–364. 22.
Ozcan, Y. A., Lins, M. E., Lobo, M. S. C., Da Silva, A. C. M., Fiszman, B., & Pereira, B. B. (2010). Evaluating the performance of Brazilian university hospitals. Annual Operational Research, 178, 247–261.
Sherman, H. D. (1984). Hospital efficiency measurement and evaluation. Empirical test of a new technique. Medical Care, 22(10), 922–938.
Tsionas, E. G. (2002). Stochastic frontier models with random coefficients. Journal of Applied Econometrics, 17, 127–147.
Van den Broeck, J., Koop, G., Osiewalski, J., & Steel, M. (1994). Stochastic frontier models: a Bayesian perspective. Journal of Econometrics, 61, 273–303.
Williamson, O. E. (1981). The economics of organization: the transaction cost approach. The American Journal of Sociology, 87, 548–577.
Ying, C. N. (2011). The productive efficiency of Chinese hospitals. China Economic Review, 22, 428–448.
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Chaabouni, S., Abednnadher, C. Cost Efficiency of Tunisian Public Hospitals: a Bayesian Comparison of Random and Fixed Frontier Models. J Knowl Econ 7, 771–781 (2016). https://doi.org/10.1007/s13132-015-0245-8
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DOI: https://doi.org/10.1007/s13132-015-0245-8