Do adjustment costs constrain public healthcare providers' technical efficiency? Evidence from the New Zealand Public Healthcare System.

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.

An application of PCA-DEA with the double-bootstrap approach to estimate the technical efficiency of New Zealand District Health Boards.

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.

It's what's on the outside that matters: an advantage for external features in children's word recognition.

The relative importance of internal and external letter features of words in children's developing reading was investigated to clarify further the nature of early featural analysis. In Experiment 1, 72 6-, 8-, and 10-year-olds read aloud words displayed as wholes, external features only (central features missing, thereby preserving word shape information), or internal features only (central features preserved). There was an improvement in the processing of external features compared with internal features as reading experience increased. Experiment 2 examined the processing of the internal and external features of words employing a forward priming paradigm with 60 8-, 10-, and 12-year-olds. Reaction times to internal feature primes were equivalent to a nonprime blank condition, whereas responses to external feature primes were faster than those to the other two prime types. This advantage for the external features of words is discussed in terms of an early and enduring role for processing the external visual features in words during reading development.