Data envelopment analysis efficiency in the public sector using provider and customer opinion: An application to the Spanish health system

Abstract

Measuring the relative efficiency of a finite fixed set of service-producing units (hospitals, state services, libraries, banks,...) is an important purpose of Data Envelopment Analysis (DEA). We illustrate an innovative way to measure this efficiency using stochastic indexes of the quality from these services. The indexes obtained from the opinion-satisfaction of the customers are estimators, from the statistical view point, of the quality of the service received (outputs); while, the quality of the offered service is estimated with opinion-satisfaction indexes of service providers (inputs). The estimation of these indicators is only possible by asking a customer and provider sample, in each service, through surveys. The technical efficiency score, obtained using the classic DEA models and estimated quality indicators, is an estimator of the unknown population efficiency that would be obtained if in each one of the services, interviews from all their customers and all their providers were available. With the object of achieving the best precision in the estimate, we propose results to determine the sample size of customers and providers needed so that with their answers can achieve a fixed accuracy in the estimation of the population efficiency of these service-producing units through the use of a novel one bootstrap confidence interval. Using this bootstrap methodology and quality opinion indexes obtained from two surveys, one of doctors and another of patients, we analyze the efficiency in the health care system of Spain.

Regional Differences, Distribution Dynamics, and Convergence of the Green Total Factor Productivity of China’s Cities under the Dual Carbon Targets

“…Most existing research on measuring public sector efficiency in a socioeconomic system have been conducted in two ways: One is by constructing comprehensive indicators to measure the efficiency, including the public sector efficiency index in policy areas of administration, education, infrastructure, and so on [14], and public service technology efficiency through the supplier and customer satisfaction opinion index [15], a comprehensive index combining the expenditure efficiency index and income efficiency index [16]. The other is using the DEA model to measure efficiency, such as the research and development efficiency of public and private sectors in EU countries [17], the Indian banking system's efficiency [18,19], 39 public sector entities operating efficiency in the province of Poland [20], and the effect of accrual accounting on efficiency of the state of Bavaria in Germany [21].…”

Optimizing immunization services: A Data Envelopment Analysis (DEA) of child immunization facilities in Pakistan

“…A variety of techniques have been used to investigate efficiency in public health service delivery, such as WHO's National Immunization Program Reviews, to reveal components adversely impacting overall performance [11]. This and other techniques seek to explore waste or underutilization of resources, either by reducing the number of inputs to achieve minimal constant outputs-e.g., through a Data Envelopment Analysis (DEA) [12][13][14][15][16][17][18]-or to increase output levels while keeping the number of inputs fixed. DEA is employed to construct an empirical efficient surface for decision-making units (DMUs) with multiple inputs and outputs [19].…”