No abstract

Since demand for hospital services is subject to substantial variability, the relationship between uncertain demand, excess capacity, hospital costs and performance should be investigated thoroughly. In this paper a waiting time indicator to proxy hospital standby capacity is incorporated into a multi-product translog cost function for Belgian general care hospitals. The indicator is derived from queuing theory and improves on the conventionally used (inverse of the) occupancy rate. The multi-product stochastic frontier specification allows calculation of cost elasticities and marginal cost of seven hospital departments, as well as the degree of economies of scale and scope and enables identification of differences in efficiency. Copyright Springer Science+Business Media, LLC 2007Hospital costs, Stochastic demand, Efficiency, Productivity, Stochastic frontier analysis, Econometrics, Queuing theory, Multi-product cost function, C01, C13, C21, D24, H51, l11, l12,

This paper proposes an innovative approach to evaluate the causal impact of a policy change in a multi-input multi-output setting. It combines insights from econometric impact evaluation techniques and efficiency analysis. In particular, the current paper accounts for endogeneity issues by introducing a quasi-experimental setting within a conditional multi-input multi-output efficiency framework and by decomposing the overall efficiency between 'group-specific' efficiency (i.e., reflecting internal managerial inefficiency) and 'program' efficiency (i.e., explaining the impact of the policy intervention on performance). This framework allows the researcher to interpret the efficiency scores in terms of causality. The practical usefulness of the methodology is demonstrated through an application to secondary schools in Flanders, Belgium. By exploiting an exogenous threshold, the paper examines whether additional resources for disadvantaged students impact the efficiency of schools. The empirical results indicate that additional resources do not causally influence efficiency around the threshold.

No abstract

This study estimates a multiproduct translog cost function for the entire population of 1011 Flemish secondary schools in order to determine the degree of ray and product specific (dis)economies of scale as well as the degree of (dis)economies of scope. Three types of schools and seven major study fields can be distinguished. Student loads in these study fields are used as outputs produced by the schools. Evidence is found for ray economies of scale for the three types of schools, even at output levels of 300% of the actual means. Although the cost elasticities of six out of seven outputs are close to zero, most of the values indicating the degree of product specific economies of scale are negative (suggesting diseconomies of scale). However, this can be explained by the considerable scope effects which are incorporated in the definition of the product specific economies of scale.