Search

This study uses quarterly longitudinal data to examine the cost efficiency of 20 New Zealand District Health Boards between 2011 and 2018. A random-effects dynamic stochastic frontier model is applied to estimate the persistence of Health Boards' cost efficiency while considering both observed and unobserved heterogeneity. The findings reveal that New Zealand Health Boards, on average, spent approximately 7.5% more than the estimated costs of efficient operation, primarily due to high persistence in cost inefficiency. Notably, Health Boards serving rural areas faced even higher levels of long-run cost inefficiency, resulting in an overspending of about 15% of annual budgets. The results of this study highlight that most Health Boards demonstrated excellent short-term performance relative to the long-run equilibrium level of cost inefficiency. However, the more significant concern lies in high long-run cost inefficiency within the sector attributed to structural and regulatory issues. Policymakers are urged to address these underlying problems to improve overall cost efficiency in the health sector. [ABSTRACT FROM AUTHOR]

Using Bayesian Structural Time Series analysis, this study examines the causal impact of loan‐to‐value (LTV) restrictions imposed by the Reserve Bank of New Zealand in October 2013. By incorporating state‐space components, such as local linear trend, seasonality and regression, counterfactual values of house price indices are predicted. Surprisingly, the study reveals that the implementation of LTV restrictions had no significant effect on national house price indices, contradicting prior Central Bank studies that reported a nearly 3 percentage‐point decrease in housing cost inflation. This contradictory evidence challenges existing perceptions of the effectiveness of LTV restrictions in curbing house price inflation. [ABSTRACT FROM AUTHOR]

Efficiency analysis is crucial in healthcare to optimise resource allocation and enhance patient outcomes. However, the prompt adaptation of inputs can be hindered by adjustment costs, which impact Long-Run Technical Efficiency (LRTE). To bridge this gap in healthcare literature, this research employs a Bayesian Dynamic Stochastic Frontier Model to estimate parameters and explore healthcare efficiency dynamics over time. The study reveals the LRTE for New Zealand District Health Boards (DHBs) as 0.76, indicating around 32% more input utilisation due to adjustment costs. Most DHBs exhibit consistent short-run operational efficiency, with the national Short-Run Technical Efficiency (SRTE) very close to the LRTE. Among the tertiary providers, Auckland and Capital & Coast DHBs operate below the LRTE level, setting them apart from other tertiary providers. Similarly, Tairawhiti and West Coast DHBs also fall below the LRTE level, as indicated by their SRTE scores, potentially influenced by their unique healthcare settings and resource challenges. This research brings a new perspective to policy discussions by incorporating the temporal dynamics of decision-making and considering adjustment costs. It underscores the need to balance short-term and long-term technical efficiency, underlining their collective significance in fostering a sustainable and efficient healthcare system in New Zealand. [ABSTRACT FROM AUTHOR]

Using the longitudinal data on New Zealand District Health Boards (DHBs) for the period 2011-2018, the total factor productivity (TFP) change and its components are evaluated using an input distance function and a cost function. The empirical results indicate that TFP decreased at an average rate of between 0.73 and 0.98 per cent annually, mainly due to the deterioration of the technological component, which averaged close to −2 per cent between 2011 and 2018. However, contrary to the technological component, the scale component improved every year at an average rate of 1–1.16 per cent, thus cushioning some of the effects of the deteriorating technological component of the TFP. The TFP also posted a one-off positive growth in 2016, following the nationwide implementation of an 'elective initiative' programme in the 2015–2016 year, which raised both the scale and efficiency (technical and cost) components to their highest levels. Furthermore, the study also demonstrates the consistency in the effect of scale and technological change components on the TFP under both primal and dual approaches. [ABSTRACT FROM AUTHOR]

This article introduces the Bayesian structural time series (BSTS) as a potential tool for forecasting in the tourism literature. Using data on Australian tourist arrivals in New Zealand, the forecasting accuracy of the estimated model is evaluated using a fixed partitioning approach. The MAPE of the fitted model is 3.11 per cent for the validation stage and 2.75 per cent for the test stage. The BSTS outperforms two other competing models both in the validation and test stage. In addition to forecasting, BSTS also estimates the trend, trend slope, and seasonality that change over time. [ABSTRACT FROM AUTHOR]

The purpose of this study is to explore the trade‐off between technical efficiency and the quality of hospital services when the state is the sole provider. Data from 20 New Zealand District Health Boards from 2011 to 2017 is used to estimate technical efficiency using the data envelopment analysis technique, which employs an additive inverse formulation for undesirable outcomes. The estimated average quality‐adjusted technical efficiency score is 0.69. In comparison, when the quality variable was removed, the efficiency declined to 0.66. More importantly, the ranking of district health boards stays consistent across both models, indicating that there is very little trade‐off between quality and efficiency. A sensitivity analysis also confirms the lack of a trade‐off between quality and efficiency. [ABSTRACT FROM AUTHOR]

In this study, we test for asymmetries in the tourism‐led growth hypothesis. Asymmetric causality tests allow us to examine whether positive or negative changes in tourism cause growth. Our specification is based on an extended Solow growth model and draws from recent articles on tourism and growth. Using Tonga as a case study over the period 1981–2018, we find that tourism asymmetrically Granger causes economic growth. The magnitude of effects from the nonlinear ARDL model shows that economic growth is more sensitive to a downward movement compared to an upward movement in visitor arrivals. [ABSTRACT FROM AUTHOR]

Using yearly panel data from 2011 to 2017 on New Zealand District Health Boards (DHBs), this study combines principal component analysis and data envelopment intertemporal analysis with the double-bootstrap approach to estimate the technical efficiency of health care providers along with the trend of efficiency performances. The results show that although most large DHBs have improved their level of technical efficiency between 2011 and 2017, the majority of medium- and small-sized DHBs have not seen any noticeable improvement in their level of technical efficiency. The results also show that large and tertiary DHBs operate at a high level of technical efficiency. In contrast, most of the medium- and small-sized DHBs posted some of the lowest technical efficiency scores. Furthermore, the results show that medium- and small-sized DHBs have a higher average length of hospital stays which is found to be associated with decreasing levels of technical efficiency scores. [ABSTRACT FROM AUTHOR]

This study uses quarterly data from 2011 to 2018 to evaluate the technical efficiency of New Zealand District Health Boards (DHBs) in providing hospital services. It examines how efficiency is affected by various patient structures and contextual factors. An intertemporal data envelopment analysis and bootstrap approach are used to compute the bias-corrected technical efficiency scores, followed by highly flexible beta regression to assess the relationship between technical efficiency and related factors. The results indicate that the technical efficiency levels of New Zealand DHBs have not improved since 2011, and on average DHBs could increase their provision of hospital services by approximately 12%. Furthermore, most of the poor performing DHBs operate in the area of high socio-economic deprivation. The results from beta regression show that DHBs providing hospital services in highly deprived areas are associated with a decreasing level of technical efficiency as the proportion of surgical, acute, Māori and Pacific inpatient increases. However, an increase in capital to labour ratio improves the technical efficiency of these DHBs. Therefore, policymakers need to formulate comprehensive strategies involving a longer time horizon that facilitates capital investments in critical technology and capacity development to improve the long-run efficiency performance of DHBs operating in the area of high deprivation. [ABSTRACT FROM AUTHOR]

Current literature on public hospital efficiency in Australia only reveals information on how efficient public hospitals are in the short run. The presence of persistent technical inefficiency arising from long‐term systemic problems and government‐related regulatory constraints does not appear to have been addressed. Using the aggregated hospital panel data for the period 2002–2018 on eight Australian states and territories, this study incorporates the measure of both transient and persistent technical inefficiency while controlling for unobserved heterogeneity to obtain a more precise measure of technical efficiency. This study's findings estimate the national average transient efficiency to be 0.96. In contrast, the national average persistent efficiency is estimated to be 0.83. Further, Queensland (0.67), Victoria (0.66) and New South Wales (0.60) posted the lowest overall technical efficiency driven by the high level of persistent inefficiency. On the other hand, Northern Territory (0.96), Australian Capital Territory (0.95) and Tasmania (0.95) are the top performers. This study's findings call on policy‐makers and regulators to disclose hospital‐level data to researchers to gain further insight into the causes of persistence in inefficiency, especially among bigger states, which will help formulate more targeted policy interventions. [ABSTRACT FROM AUTHOR]

Inefficiency persistence is often ignored in empirical studies that assess school efficiency levels. Using longitudinal data on state and state‐dependent private schools from 62 New Zealand territories, a dynamic random‐effect stochastic frontier model is employed to obtain the magnitude of inefficiency persistence along with the measure of cost efficiency estimates. The results show that a naive non‐dynamic model incorrectly shows New Zealand schools to be highly cost‐efficient in short run. However, the dynamic model exposes the fact that New Zealand state schools face high persistence in cost inefficiency, which is limiting their ability to provide cost‐efficient schooling in long run. Furthermore, an estimated 9% of the annual state school funding is lost due to the persistence in cost inefficiency. The findings of this study indicate that cost inefficiency among New Zealand schools appears to be long run, requiring significant policy change from the national government. [ABSTRACT FROM AUTHOR]

Demographic and economic shifts around the world have put the question of school size and efficiency at the centre of public administration. The decline in enrolment numbers over the past three decades has seen many small, rural and remote schools closed or consolidated. Despite the importance of the scale effects on policy decisions, the literature on this issue is thin, with most of the studies focusing solely on school data from the United States (US). This study uses New Zealand school data at the territorial level and uses a fixedeffect stochastic frontier production model to decompose the sources of total factor productivity. Empirical results show that productivity among New Zealand public schools decreased at an average rate of 5 per cent between 2004-2017, mainly due to a 5 per cent decline in scale effects. The results of this study underscore the fact that New Zealand state schools operate at diseconomies of scale and therefore, increasing school size through mergers and closures of small and rural schools would not necessarily result in increased productivity. For this reason, policymakers need to carefully examine the region-specific factors that contribute to the heterogeneity in scale effects that affect school performance before actively adopting overseas experience, which, on the downside, may lead to cost increases and worsen student outcomes in small and rural communities. [ABSTRACT FROM AUTHOR]

• This study examines the technical efficiency of New Zealand's District Health Boards (DHBs). • Simar and Wilson's (2007) two-stage bootstrap approach is used. • DHBs operating in the areas with high socioeconomic deprivation appear to have low levels of technical efficiency. • Secondary DHBs have a low level of technical efficiency compared to tertiary DHBs • Lack of investment in technology, the high average length of hospital stays and staff shortages may be contributing to inefficiencies. • The current funding model for DHBs needs to be revisited. This study investigates the technical efficiency of New Zealand's District Health Boards (DHBs) in providing hospital services, as well as the effect of certain environmental factors on efficiency. This study is the first to use quarterly data on New Zealand DHBs from 2011 to 2017 and apply the two-stage double-bootstrap methodology of Simar and Wilson. The bias-corrected technical efficiency estimates show that on average, DHBs in the areas with high socioeconomic deprivation operate with low technical efficiency. Furthermore, DHB providing secondary hospital services are less efficient than tertiary DHBs. The result from truncated regression indicates that a higher proportion of surgical, elderly, and acute inpatients is associated with increasing levels of technical efficiency. In contrast, the high average length of hospital stay negatively impacts technical efficiency levels. The findings of this study urge policymakers to adopt policies to address the shortages of healthcare staff, barriers to primary healthcare, lack of investment in hospital capacity, and technology to enhance healthcare sector's long-run technical efficiency. In addition, the existing DHB funding formula needs to be revisited as this tends to include perverse incentives for secondary DHBs where patients are kept longer in hospitals, leading to a higher average length of stays in hospitals and is associated with increasing levels of inefficiency. [ABSTRACT FROM AUTHOR]

The majority of secondary and tertiary healthcare services in New Zealand are provided through public hospitals managed by 20 local District Health Boards. Due to data issues and ill-judged generic public perceptions, efficiency studies are insufficient in spite of the extensive empirical literatures available. This inevitably leads to criticisms about the perverse incentives which might be created by the National Health Targets designed to improve the performance of public health services. Utilizing a multifaceted administrative hospital dataset, this is the first case study to measure both the technical and cost efficiency of New Zealand public hospitals during the period of 2011–2017. More specifically, it deals with the question of how hospital efficiency varies with respect to activities accounted for by the National Health Targets. The empirical results show no evidence that these targets are achieved at the expenses of lowering the overall efficiency of hospital operations. The national technical efficiency is averaged at 86 percent over the period and cost efficiency is 85 percent. The results are derived by stochastic input distance function and cost frontier in order to accommodate multiple outputs and limited number of census observations. Efficiency ranking is sensitive to specifications of the inefficiency error term, but reasonably robust to the choice of functional form and different proxies for capital input. [ABSTRACT FROM AUTHOR]