RESUMO
In Latin American and Caribbean countries, the main concern of public health care managers has been traditionally placed on problems related to funding, payment mechanisms, and equity of access. However, more recently, there is a growing interest in improving the levels of efficiency and reducing costs in the provision of health services. In this paper we focus on measuring the technical efficiency and productivity change of public hospitals in Panama using bootstrapped Malmquist indices, which allows us to assess the statistical significance of changes in productivity, efficiency, and technology. Specifically, we are interested in comparing the performance of hospitals belonging to the two different management schemes coexisting in the country, the Social Security Fund (SSF) and the Ministry of Health (MoH). Our dataset includes data about 22 public hospitals (11 for each model) during the period between 2005 and 2015. The results showed that the productivity growth of hospitals belonging to the SSF has been much higher than that of the hospitals belonging to the Ministry of Health over the evaluated period (almost 4% compared to 1.5%, respectively). The main explanation for these divergences is the superior growth of technological change in the former hospitals, especially in the final years of the evaluated period.
Assuntos
Eficiência Organizacional , Hospitais Públicos , Panamá , TecnologiaRESUMO
The water industry plays an important role in reducing greenhouse gas (GHG) emissions and therefore, moving to a low-carbon urban water cycle is of great importance. However, traditional performance assessment of water companies ignores GHG emissions. To overcome this limitation and to compare productivity change estimations of water companies excluding and including GHG emissions, this study computes the Luenberger productivity indicator (LPI) and the Malmquist-Luenberger productivity index (MLPI), respectively. Moreover, in a second stage, we investigate the impact of exogenous variables on environmentally sensitive productivity change estimations. The empirical application conducted for a sample of water and sewerage companies in England and Wales over the period 201-2019 has illustrated that when GHG emissions were considered in the assessment (i.e., MLPI estimations), average productivity decreased. By contrast, when productivity estimation ignored GHG emissions (i.e., LPI), average productivity increased. Hence, it is concluded that the inclusion of GHG emissions in productivity analysis impacted the results. This finding is very relevant from a policy perspective as it illustrates the importance of considering GHG emissions when evaluating the performance of water companies for regulatory purposes.
Assuntos
Gases de Efeito Estufa , Eficiência , Efeito Estufa , Gases de Efeito Estufa/análise , Indústrias , Água , Abastecimento de ÁguaRESUMO
Assessing the productivity change of water companies provides relevant information for both water regulators and companies' managers. Past research has illustrated that different indicators and indexes have been applied although not all of them are equally reliable. Thus, this study evaluates the total factor productivity (TFP) change and its drivers employing the Luenberger-Hicks-Moorsteen productivity indicator (LHMPI) including, for the first time, quality of service variables as undesirable outputs. Moreover, unlike the previous studies, LHMPI was decomposed into three drivers; namely technical change, technical efficiency change and scale efficiency change. Our empirical application conducted on a sample of Chilean water companies over 2007-2018 embracing full private water companies (FPWCs) and concessionary water companies (CWCs). Results evidenced that, on average, TFP increased at an annual rate of 2.2%, mainly due to outputs rise. The main driver of productivity growth was scale efficiency change suggesting that adjustments in the water companies' scale of operations could lead to lower operational costs. It was also evidenced that FPWCs performed better than CWCs over the period analyzed.