A Comparison of Parametric and Non-Parametric Distance Functions

Nakayama, Noriyoshi

doi:10.4091/iken1991.13.1_83

Cited by 8 publications

(4 citation statements)

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“…These studies used cross-sectional data from Japanese public hospitals and adopted largely traditional DEA approaches. Average efficiency scores ranged from 0.8869 to 0.9456 in terms of revenue efficiency [ 3 , 4 ]; for technical efficiency, they ranged from 0.8585 to 0.90008 [ 5 , 6 ].…”

Section: Methods and Datamentioning

confidence: 99%

Estimation of the efficiency of Japanese hospitals using a dynamic and network data envelopment analysis model

Kawaguchi

Tone

Tsutsui

2013

Health Care Manag Sci

108

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The purpose of this study was to perform an interim evaluation of the policy effect of the current reform of Japan’s municipal hospitals. We focused on efficiency improvements both within hospitals and within two separate internal hospital organizations. Hospitals have two heterogeneous internal organizations: the medical examination division and administration division. The administration division carries out business management and the medical-examination division provides medical care services. We employed a dynamic-network data envelopment analysis model (DN model) to perform the evaluation. The model makes it possible to simultaneously estimate both the efficiencies of separate organizations and the dynamic changes of the efficiencies. This study is the first empirical application of the DN model in the healthcare field. Results showed that the average overall efficiency obtained with the DN model was 0.854 for 2007. The dynamic change in efficiency scores from 2007 to 2009 was slightly lower. The average efficiency score was 0.862 for 2007 and 0.860 for 2009. The average estimated efficiency of the administration division decreased from 0.867 for 2007 to 0.8508 for 2009. In contrast, the average efficiency of the medical-examination division increased from 0.858 for 2007 to 0.870 for 2009. We were unable to find any significant improvement in efficiency despite the reform policy. Thus, there are no positive policy effects despite the increased financial support from the central government.

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Section: Methods and Datamentioning

confidence: 99%

Estimation of the efficiency of Japanese hospitals using a dynamic and network data envelopment analysis model

Kawaguchi

Tone

Tsutsui

2013

Health Care Manag Sci

108

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“…The disadvantages of SFA are strict assumptions about the form of the production function and the distributions of errors, and the inability to explicitly introduce multi‐output functions. Consequently, DEA and SFA may be regarded as alternative or complementary methods for estimating efficiency (Kooreman, ; Jacobs, ; Nakayama, ).…”

Section: Efficiency Measuresmentioning

confidence: 99%

“…Because a considerable amount of DEA and SFA studies (e.g. Aoki and Urushi, ; Nam and Gunji, ; Yamada et al ., ; Fujii, ; Nakayama, ; Kawaguchi, ) use inpatients and outpatients as another possible combination of hospital outputs, we consider inpatients and outpatients as an alternative set of outputs . For each combination of inputs and outputs, we measure technical efficiency, distance function score and cost efficiency score according to the methodology described in Subsections , and , respectively.…”

Section: Datamentioning

confidence: 99%

“…Exogenous variables include drug margin ratio, teaching and rural hospital dummies (Yamada et al ., ), a hospital profitability dummy (Nakayama, ), bed occupancy rate (Yamada et al ., ; Fujii, ), subsidies from regional governments, a dummy for hospital accreditation, and share of emergency beds (Besstremyannaya, ). Because the commonly used variable for severity of illness (i.e.…”

Section: Datamentioning

confidence: 99%

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The impact of Japanese hospital financing reform on hospital efficiency: A difference-in-difference approach

Besstremyannaya

2012

Japanese Economic Review

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With Japanese hospital financing reform, a prospective payment system (PPS) has been established for inpatient care to replace the traditional fee-for-service remuneration of hospitals. This paper evaluates the effect of the reform on technical and cost efficiency of local public hospitals. Efficiency is estimated non-parametrically using two-stage data envelopment analysis with bias correction through bootstrap, and parametrically applying stochastic frontier analysis. The descriptive analysis shows that efficiency declines after the introduction of PPS. Difference-in-difference estimations reveal that PPS results in a limited efficiency gain, which might be related to inadequate incentives created by the two-part PPS tariff in Japan. JEL Classification Codes: I12, I18, C31, C61.

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