An alternative assessment approach to national higher education system evaluation.

While the assessment of higher education systems is informative to both policy makers and individuals, it is subjective and performed according to experts' judgment. The present study proposes a relatively objective approach, hierarchical data envelopment analysis (H-DEA), to rank higher education systems. Unlike the subjective approach, H-DEA utilizes endogenous weight determination, allowing assessors to identify the relative importance of each attribute and subattribute. Utilizing the U21 Ranking of National Higher Education System 2020 data, our analysis indicates that the output attribute is a crucial factor influencing the overall performance of higher education systems, even considering countries' stage of development and culture. The computed weights of the H-DEA framework show various attributes' different contributions by group. Resources allocated to the higher education system are important for developing countries, while a high degree of internationalization and a strong link between academia and industry matter for advanced countries. Surprisingly, Asian and Western cultures experience similar performance in their higher education systems, reflecting the Asian higher education system's development toward the Western style. The performance of countries with non-Asian-non-Western cultures, as expected, lags behind, and putting more resources into these countries' higher education system is a way to enhance the overall performance.

Assessing the efficiency of Malaysia health system in COVID-19 prevention and treatment response.

Malaysia was faced with a life-threatening crisis in combating COVID-19 with a number of positive cases reaching 5305 and 88 deaths by 18th April 2020 (the first detected case was on 25th January 2020). The government rapidly initiated a public health response and provided adequate medical care to manage the public health crisis during the implementation of movement restrictions, starting 18th March 2020, throughout the country. The objective of this study was to investigate the relative efficiency level of managing COVID-19 in Malaysia using network data envelopment analysis. Malaysia state-level data were extracted from secondary data sources which include variables such as total number of confirmed cases, death cases and recovered cases. These variables were used as inputs and outputs in a network process that consists of 3 sub processes i) community surveillance, ii) medical care I and iii) medical care II. A state-level analysis was performed according to low, medium and high population density categories. The efficiency level of community surveillance was highest compared to medical care processes, indicating that the overall inefficiency is greatly influenced by the inefficiency of the medical care processes rather than the community surveillance process. Results showed that high-density category performed well in both community surveillance and medical care II processes. Meanwhile, low-density category performed better in medical care I process. There was a good overall performance of the health system in Malaysia reflecting a strong preparedness and response level to this pandemic. Furthermore, resource allocation for rapid response was distributed effectively during this challenging period.

Productivity growth and quality changes of hospitals in Taiwan: does ownership matter?

As the competition in the Taiwanese medical industry becomes increasingly fierce, public hospitals are confronted with challenges in orientation and operations. This study measured changes in the operational efficiency of public and their competitors, non-public hospitals, in Taiwan. This study considered differences in technology and scale between public and non-public hospitals and adopted the quality-incorporating metafrontier Malmquist productivity index to analyze inputs, outputs, and quality achievements of hospitals. The data consisted of 40 public hospitals and 79 non-public hospitals in Taiwan during the period 2008-2014. This study measured productivity growth and quality changes. Moreover, it further identified technological gaps and quality gaps in different types of hospitals with respect to the metafrontier. At the same time, comparisons of changes in quality between public and non-public hospitals were also examined. The empirical results showed that public hospitals were better than non-public ones in terms of productivity. Meanwhile, it was also found that most of the decomposition in productivity was higher in public hospitals than in non-public ones, especially in terms of improvements in technology and quality. This paper presented public hospitals outperformed non-public ones during the research period in spite of the fact that private hospitals had become larger and group-oriented. Therefore, public hospitals and regulators made appropriate adjustments and responses in the face of the pressure of competition in the market.

Metafrontier frameworks for studying hospital productivity growth and quality changes.

OBJECTIVE: The objective of this study was to evaluate productivity growth and quality changes among different levels of accredited hospitals. DESIGN: This study used an attribute-incorporating Malmquist productivity index (MPI) under the metafrontier framework. This is the first attempt to compare productivity changes among hospitals operating under different production frontiers. PARTICIPANTS: The data consisted of 20 academic medical centers (AMCs), 61 metropolitan hospitals (MPs) and 112 local community hospitals (LCs) in Taiwan during the period 2007-2010. MAIN OUTCOME MEASURES: This study measured productivity growth and further identified technological gaps and catch-ups in different groups of hospitals with respect to the metafrontier. At the same time, comparisons of changes in quality among different levels of hospitals were also examined. RESULTS: We found that the sample hospitals of AMCs and MPs experienced productivity improvements mainly due to technological progress, but their efficiency and technology gap ratio (TGR) deteriorated. As for LCs, progress in technology along with improvements in their efficiency and TGR led to the highest productivity upgrade among the three groups of hospitals. We also found that the sample hospitals among the three groups showed improvements in quality. Moreover, hospitals in the local community group exhibited greater quality progress than the AMCs and MPs over the sample period. CONCLUSION: This paper presents a number of useful decompositions of the metafrontier MPI, which can provide useful insights into changes that are due to efficiency, quality improvements and/or technological changes in the healthcare sector.

Performance measurement for incineration plants using multi-activity network data envelopment analysis: The case of Taiwan.

This study proposes the use of multi-activity network data envelopment analysis to appraise how incineration plants in Taiwan perform. Sample data from 2006 is used to examine the trade-offs between efficiency enhancement and pollution abatement. The respective efficiencies of the waste treatment and electricity generation are also assessed in a unified framework. The empirical results indicate that it is more important to improve the efficiency of waste treatment activity than of electricity generation activity in order to enhance the overall performance of Taiwan's incinerators. Since ownership, location and length of operations do not in general affect their performance, any improvement has to come from the careful monitoring of each process of the waste treatment operations. Furthermore, given that the policy in Taiwan has moved away from incineration to recycling, the problem of an over-supply of incinerators may become apparent in the near future. Our results indicate that the availability of capacity size may be an important factor when policy-makers consider whether to close down some existing incinerators.