Smith, ASJ, Buckell, J, Wheat, P et al. (1 more author) (2016) Hierarchical Performance and Unobservable Heterogeneity in Health: A Dual-Level Efficiency Approach Applied to NHS Pathology in England. In: Greene, WH, Khalaf, L, Sickles, R, Veall, M and Voia, M-C, (eds.) Productivity and Efficiency Analysis. Springer Proceedings in Business and Economics . Springer International Publishing , Switzerland , pp. 119-143. ISBN 978-3-319-23227-0
Abstract
Understanding the source of inefficiency within health system organisational structures is a key aspect of performance measurement and management; and is of increasing importance to policy makers. This study uses a unique panel dataset to study the efficiency performance of pathology services in the National Health Service (NHS) in England for the first time. We apply a dual-level stochastic frontier (DLSF) model (J Prod Anal 37(1):1–27, 2012) to isolate the source of inefficiency at two vertically distinct organisational levels: an upper level of Strategic Health Authorities (SHAs); and a lower level of laboratories grouped within SHAs. Wedevelop the DLSF framework—in line with recent developments in the wider panel data literature—to control for the influence unobserved heterogeneity, which is a key issue for healthcare performance analysis. We find statistically significant variation in inefficiency performance at both organisational levels in pathology services. Weuse these measures to compute overall inefficiency for NHS pathology services, and corresponding savings estimates. Finally we comment on the wider modelling implications of our research with respect to the separation of inefficiency and unobserved heterogeneity when applied to multi-level data structures.
Metadata
Item Type: | Book Section |
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Authors/Creators: |
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Editors: |
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Keywords: | Stochastic Frontier Analysis; Dual-level Efficiency; Unobserved Heterogeneity; Costs; Regional variation; Pathology |
Dates: |
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Institution: | The University of Leeds |
Academic Units: | The University of Leeds > Faculty of Environment (Leeds) > Institute for Transport Studies (Leeds) > ITS: Economics and Discrete Choice (Leeds) The University of Leeds > Faculty of Medicine and Health (Leeds) > School of Medicine (Leeds) > Leeds Institute of Health Sciences (Leeds) > Academic Unit of Health Economics (Leeds) |
Depositing User: | Symplectic Publications |
Date Deposited: | 20 Apr 2015 09:02 |
Last Modified: | 24 May 2016 13:17 |
Published Version: | http://dx.doi.org/10.1007/978-3-319-23228-7_8 |
Status: | Published |
Publisher: | Springer International Publishing |
Series Name: | Springer Proceedings in Business and Economics |
Refereed: | Yes |
Identification Number: | 10.1007/978-3-319-23228-7_8 |
Open Archives Initiative ID (OAI ID): | oai:eprints.whiterose.ac.uk:85194 |