Degrees of Shortage and Uncovered Ratios for Long-Term Care in Taiwan’s Regions: Evidence from Dynamic DEA

Abstract

The government is facing the country’s aging population and low birth rate have led to a severe shortage of its healthcare workforce in Taiwan after 2003. In order to explore the status of the country’s degree of long-term care shortage and uncovered ratio, this research uses the Push-Pull-Mooring (PPM) theory to explain long-term care efficiency during 2010–2019 in each city and county. We collect longitudinal-sectional data for 2010–2019 from the Ministry of Health and Welfare’s Department of Statistics for 22 administrative regions in Taiwan in each year and employ dynamic data envelopment analysis (DEA) to evaluate the overall technical efficiency and the disaggregate output insufficiency to explain the research results. The main findings are as follows: (1) Cities near the capital Taipei have the highest degree of shortages in long-term caregivers and high uncovered ratios of people who need long-term care. (2) Presently, there is no demand to increase the number of long-term care institutions in Taiwan. (3) The government should introduce new long-term care certificates through national examinations in order to develop a stronger professional workforce in this field.

Efficiency Measurement Using Data Envelopment Analysis (DEA) in Public Healthcare: Research Trends from 2017 to 2022

“…While most studies used simple CCR or BCC models, modified DEA models such as the Slack-Based Model, the Supper efficiency model, the Network-DEA model, the Bootstrapping model, and the Metafrontier model were also employed. In addition, new DEA application techniques, such as Dynamic DEA [38] and context-dependent DEA [41], have been developed. It was also noteworthy that the combination with other research methods is increasing.…”

“…Studies that analyzed panel data used the techniques of the Malmquist Index [32,[34][35][36] and Window-DEA [5], as well as the Malmquist-Luenberger index, which is a more advanced technique of the Malmquist Index [37]. Besides these techniques, the use of the latest DEA techniques, such as Dynamic DEA [38,39], context-dependent DEA [40,41], and game-cross efficiency model [15,42] were also witnessed. These techniques were counted as etc.…”

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“…Overall NHI cost containment impacts personnel costs. Taiwan recommends a lower ratio of nurses to patients especially in EDs (medical center 1:9, regional hospital 1:12, local hospital 1:15, ED 1:12) (Taiwan Ministry of Health and Welfare, 2015) than most other countries (ranging from 1:4 to 1:8) (Driscoll et al., 2018; Sharma & Rani, 2020; Wu et al., 2021), and such lower ratios are known to lead to adverse patient outcomes, including in‐hospital cardiac arrests or mortality, 30‐days mortality, unplanned readmission, falls and infections, especially in ED and acute care settings (Driscoll et al., 2018). The continuing shortage of health workers is further exacerbated by nurses' burnout, job dissatisfaction, and higher intent to leave (Chao et al., 2013; Li & Yamamoto‐Mitani, 2021; Lin et al., 2019).…”

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