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Efficiency potential and determinants of efficiency: an analysis of the care for the elderly sector in Norway

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Abstract

The paper provides an analysis of efficiency in the care for the elderly sector in Norway. In a first step, we perform DEA analysis to calculate the degree of efficiency in each municipality and the national level efficiency potential. The analysis reveals substantial variation in efficiency across municipalities, and the national level efficiency potential is calculated to 10%. Tobit regressions and recently developed bootstrap methods are applied in a second stage to explain the variation in efficiency. The second stage analyses indicate that high fiscal capacity, a low degree of user charge financing, and a fragmented local council are associated with low efficiency.

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References

  • Afonso, A., & St. Aubyn, M. (2006). Cross-country efficiency of secondary education provision: a semi–parametric analysis with non-discretionary inputs. Economic Modelling, 23, 476–491.

    Article  Google Scholar 

  • Ashworth, J., Geys, B., Heyndels, B., & Wille, F. (2006). Political competition and local government performance: evidence from Flemish municipalities. Paper presented at the annual meeting of the European public choice society, Turku.

  • Assous, L. (2001). Long-term health and social care for the elderly: an international perspective. Geneva Papers on Risk and Insurance, 26, 667–683.

    Article  Google Scholar 

  • Banker, R. D., Charnes, A., & Cooper, W.W. (1984). Some models for estimating technical and scale inefficiencies in data envelopment analysis. Management Science, 30, 1078–1092.

    Article  Google Scholar 

  • Borge, L.-E., & Rattsø, J. (1995). Demographic shift, relative costs and the allocation of local public consumption in Norway. Regional Science and Urban Economics, 25, 705–726.

    Article  Google Scholar 

  • Borge, L.-E., & Rattsø, J. (2005). The relationships between costs and user charges: the case of a Norwegian utility service. FinanzArchiv, 61, 98–119.

    Article  Google Scholar 

  • Borge, L.-E., & Naper, L. R. (2006). Efficiency potential and efficiency variation in Norwegian lower secondary schools. FinanzArchiv, 62, 221–249.

    Article  Google Scholar 

  • Borge, L.-E., Falch, T., & Tovmo, P. (2008). Public sector efficiency: the roles of political and budgetary institutions, fiscal capacity, and democratic participation. Public Choice, 136, 475–495.

    Article  Google Scholar 

  • Charnes, A., Cooper, W. W., & Rhodes, E. (1978). Measuring the efficiency of decision making units. European Journal of Operational Research, 3, 392–444.

    Google Scholar 

  • Crivelli, L., Fillipini, M., & Lunati, D. (2002). Regulation, ownership and efficiency in the Swiss nursing home industry. International Journal of Health Care Finance and Economics, 2, 79–97.

    Article  Google Scholar 

  • De Borger, B., & Kerstens, K. (2000). What is known about municipal efficiency? The Belgian case and beyond. In J.L.T. Blank (Ed.), Public provision and performance. Amsterdam: North-Holland.

    Google Scholar 

  • Edvardsen, D. F., Førsund, F. R., & Aas, E. (2000). Effektivitet i pleie- og omsorgssektoren (Efficiency in the care for the elderly sector) (Report No. 2/2000). University of Oslo, Ragnar Frisch Centre for Economic Research.

  • Farrel, M. J. (1957). The measurement of productive efficiency. Journal of the Royal Statistical Society, Series A, 120, 253–281.

    Article  Google Scholar 

  • Fillippini, M. (2001). Economies of scale in the Swiss nursing home industry. Applied Economic Letters, 8, 43–46.

    Article  Google Scholar 

  • Herfindahl, O. C. (1950). Concentration in the US steel industry. Doctoral dissertation, Columbia University.

  • Hirschman, A. O. (1945). National power and the structure of foreign trade. Berkeley: University of California Press.

    Google Scholar 

  • Hirschman, A. O. (1964). The paternity of an index. American Economic Review, 54, 761–762.

    Google Scholar 

  • Hougaard, J. L., Kronborg, D., & Overgård, C. (2004). Improvement potential in the Danish elderly care. Health Care Management Science, 7, 225–235.

    Article  Google Scholar 

  • Kalseth, J. (2003). Political determinants of efficiency variation in municipal service production: an analysis of long-term care in Norway. Mimeo, Department of Economics, Norwegian University of Science and Technology, Trondheim.

  • Kalseth, J., & Rattsø, J. (1998). Political control of administrative spending: The case of local governments in Norway. Economics and Politics, 10, 63–83.

    Article  Google Scholar 

  • Kooreman, P. (1994). Nursing home care in the Netherlands: a non-parametric efficiency analysis. Journal of Health Economics, 13, 301–316.

    Article  Google Scholar 

  • Laine, J., Linna, M., Häkkinen, U., & Noro, A. (2005). Measuring the productive efficiency and clinical quality of institutional long-term care for the elderly. Health Economics, 14, 245–256.

    Article  Google Scholar 

  • Latruffe, L., Davidova, S., & Balcombe, K. (2008). Application of a double bootstrap to investigation of determinants of technical efficiency of farms in Central Europe. Journal of Productivity Analysis, 29, 183–191.

    Article  Google Scholar 

  • Ministry of Local Government (2006). Beregningsteknisk dokumentasjon til St.prp. nr. 1 (Technical appendix to the block grant system) (Report H-2193).

  • Niskanen, W. A. (1975). Bureaucrats and politicians. Journal of Law and Economics, 18, 617–643.

    Article  Google Scholar 

  • Nyman, J. A., & Bricker, D. L. (1989). Profit incentives and technical efficiency in the production of nursing home care. Review of Economics and Statistics, 56, 586–594.

    Article  Google Scholar 

  • Perelman, S., & Santín, D. (2008). How to generate regularly behaved production data? A Monte Carlo experimentation on DEA scale efficiency measurement. European Journal of Operational Research. doi:10.1016/j.ejor.2008.11.013.

  • Simar, L., & Wilson, P. W. (2007). Estimation and inference in two-stage, semiparametric models of production processes. Journal of Econometrics, 136, 31–64.

    Article  Google Scholar 

  • Vitaliano, D. F., & Toren, M. (1994). Cost and efficiency in nursing homes: a stochastic frontier approach. Journal of Health Economics, 13, 281–300.

    Article  Google Scholar 

  • Xue, M., & Harker, P. T. (1999). Overcoming the inherent dependency of DEA efficiency scores: a bootstrap approach. Mimeo, The Wharton School, University of Pennsylvania.

  • Zhang, Y., & Bartels, R. (1998). The effect of sample size on the mean efficiency in DEA with an application to electricity distribution in Australia, Sweden and New Zealand. Journal of Productivity Analysis, 9, 187–204.

    Article  Google Scholar 

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Correspondence to Lars-Erik Borge.

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Borge, LE., Haraldsvik, M. Efficiency potential and determinants of efficiency: an analysis of the care for the elderly sector in Norway. Int Tax Public Finance 16, 468–486 (2009). https://doi.org/10.1007/s10797-009-9110-7

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