Technical efficiency and its convergence among village clinics in rural China: evidence from Shanxi Province.

Introduction: Village clinics (VCs) are the foundation of the three-tiered health service system in China, delivering basic and routine outpatient services to citizens in rural China. VC technical efficiency and its convergence play a critical role in policy decisions regarding the distribution of health service resources in rural China. Methods: This study measured VC technical efficiency (using the slacks-based measure model), its convergence (using the convergence model), and the factors that influence the convergence in Shanxi Province, China. Data were obtained from the Shanxi Rural Health Institute 2014-2018 Health Statistics Report, which involved 3,543 VCs. Results: The results showed that VC technical efficiency was low and differed by region. There was no α convergence in VC technical efficiency, but evidence of ß convergence was found in Shanxi. The main factors that influence convergence were the building area of each VC (BA), proportion of government subsidies (PGS), and ratio of total expenditure to total income of each VC (RTETI). Conclusion: The government should increase investments in VCs and improve VC technical efficiency. Meanwhile, the government should be aware of and take measures to curb the inequity in VC technical efficiency among different regions and take suitable measures to curb this disparity.

Technical efficiency of teff farms in Ethiopia: Do neighborhood effects matter? A copula stochastic frontier and spatial Durbin regression.

Teff is essential to most Ethiopians, but its production is hampered by farmers' characteristics and spatially related neighborhood variables. This study analyzes the neighborhood effect on the technical efficiency of teff farms in Ethiopia using panel data from the Ethiopian socioeconomic survey. The spatial Durbin regression models (SDM) and Copula stochastic frontier were used with 858 teff-growing farmers. The mean value of teff's technical efficiency was found to be 53 %, meaning that farmers had a 47 % likelihood of improving teff farm efficiency. The results from the SDM indicate a significant contribution of neighborhood effects for improving technical efficiency in teff farms. Thus, policymakers could explore implementing localized interventions and knowledge-sharing initiatives to disseminate best practices, innovative technologies, and agronomic knowledge within specific spatial clusters. By doing so, they can leverage the observed influence of neighborhood dynamics on teff farm efficiency.

Measuring Technical Efficiency and Productivity of Secondary Maternal and Child Health Hospitals in Hubei, China: Some Evidences from Hubei Province of China 2019 to 2021.

Environmental factors like COVID-19 can have significant impact on technical efficiency (TE) and total factor productivity (TFP) of health services provided. In this study, focusing on Maternal and Child Health (MCH) hospitals in Hubei Province of China in 2019 to 2021, we aimed to measure their TE and TFP, identify some influential environmental factors, and propose some policy recommendations. Altogether 62 secondary MCH hospitals were selected as the study sample. Four input indicators, 3 output indicators, and 4 environmental indicators were selected to analyze the panel data from 2019 to 2021. Three-stage Data Envelopment Analysis (DEA) and Malmquist Productivity Index (MPI) model were employed to estimate the TE and TFP of these hospitals. During 2019 to 2021, the inputs of the sample hospitals had increased, while the outputs had decreased. The inputs redundancy was negatively associated with birth rate, number of residents, and GDP per capita (P < .05). It was positively associated with number of COVID-19 infections (P < .05). The adjusted TE scores in 2019 to 2021 were 0.822, 0.784, and 0.803, respectively. The TFP declined in 2020 and 2021 compared to 2019, with scores being 0.845 and 0.762. The technical efficiency change (TEC) scores from 2019 to 2021 were 0.926 and 1.063. The technological change (TC) scores from 2019 to 2021 were 0.912 and 0.716. During 2019 to 2021, the operation of sample hospitals had been significantly influenced by environmental factors like COVID-19 pandemic, low birth rate, number of residents, and GDP per capita. The inputs had increased but outputs had decreased, leading to an increase in inputs redundancy and a decline in TE. The TFP showed a downward trend, with TC and SEC being the priority directions for improvement. Some recommendations are made for both hospitals and government to continuously improve the TE and TFP.

Efficiency dynamics among onion growers in Maharashtra: a comparative analysis of drip irrigation adopters and non-adopters.

BACKGROUND: Onions are economically and nutritionally important vegetable crops. Despite advances in technology and acreage, Indian onion growers face challenges in realizing their full productivity potential. This study examines the technical efficiency of onion growers, the factors influencing it, and the constraints faced by those adopting drip irrigation in the Ghod river basin of western Maharashtra. A sample of 480 farmers including those practicing drip irrigation and those not practicing it, was selected from Junnar, Shirur, Parner, and Shrigonda blocks of the basin. The primary data was collected through semi-structured interviews. Analytical tools such as the Cobb-Douglas production function (represents technological relationship between multiple inputs and the resulting output), a single-stage stochastic frontier model, the Tobit model, and descriptive statistics were used to assess the technical efficiency of onion production at the farm level. RESULTS: According to the maximum likelihood estimates of the stochastic frontier analysis, drip adopters exhibited a mean technical efficiency of 92%, while for non-adopters it was 65%. It indicates that the use of drip irrigation technology is associated with higher technical efficiency. The association of technical efficiency and socio-economic characters of households showed that education, extension contacts, social participation, and use of information sources had a positive influence on technical efficiency, while family size had a negative influence on the drip irrigation adopters. For non-drip adopters, significant positive effects were observed for landholding, extension contact, and information source use. The major constraints faced by drip system adopters included a lack of knowledge about the proper operating techniques for drip systems and the cost of maintenance. CONCLUSION: The differences with inputs associated with two irrigation methods showed that the response of inputs to increase onion yield is greater for farmers who use drip irrigation than for farmers who do not, and are a result of the large differences in the technical efficiencies. These inefficiencies and other limitations following the introduction of drip irrigation, such as lack of knowledge about the proper operations, need to be addressed through tailored training for farmers and further interventions.

Evaluating bank technical efficiency in SADC region.

Efficiency is generally defined as the capacity to deliver desirable results with little effort or input. A bank cannot afford to allocate limited resources at random in a competitive market. Only once the efficiency factors have been identified can resources be allocated in a conscious and effective manner. The study investigates the determinants of technical efficiency of banks in the SADC region. The study is significant in the SADC region as the block is trying to create a robust and stable banking system. This is driven by the desire to stay away from the current global financial system volatility and the region is working to develop an integrated banking system. The results show that the banks are relatively inefficient with the level of inefficiency around 40 percent. The efficiency of the banks is determined by the level of capitalisation, size of the bank, research costs and automation of the banks. The results of the study imply that that there is great scope for the banks in the SADC region to increase their efficiency. Improved efficiency will ensure banks provide services at a lower cost to clients. The study recommends adequately capitalizing banks, increasing the asset base of the banks, investing in research and the automation of the banking systems.

Level of technical efficiency and associated factors among health centers in East Gojjam Zone, Northwest Ethiopia: an application of the data envelopment analysis.

BACKGROUND: Besides the scarcity of resources, inefficient utilization of available health service resources has been the bottleneck to deliver quality health services in Ethiopia. However, Information regarding the efficiency of health service providers is limited in the country. Health service managers and policy makers must be well informed about the efficiency of health service providers and ways of using limited resources efficiently to make evidence-based decisions. This study aimed to assess the level of technical efficiency and associated factors among health centers in East Gojjam Zone, Northwest Ethiopia. METHODS: A facility-based cross-sectional study was conducted among 27 randomly selected health centers in East Gojjam zone, Northwest Ethiopia, from October 30, 2022, to April 30, 2023. Using an interviewer-administered questionnaire and document review checklist, health centers' data was collected and entered to Epi-Data version 4.6. The data was exported to Microsoft office excel and Stata version 14 for analysis. A two-stage output-oriented data envelopment analysis with a variable return to scale assumption was employed to determine the level of technical efficiencies. Finally, the tobit regression model was applied to identify the associated factors at 5% level of significance. RESULTS: In this study, 59.3% of the health centers were technically efficient. The mean technical efficiency score of the health centers was 0.899 ± 0.156. Inefficient health centers could provide more 22, 433 outpatient visits, 1,351 family planning visits, 155 referral services, 206 skilled deliveries and 385 fully vaccinations of children if they were technically efficient as their peer health centers for the same year. From the tobit regression, the catchment population and number of administrative staffs were statistically significant determinants of the technical efficiency of health centers. CONCLUSIONS: The mean technical efficiency of the health centers in East Gojjam zone, Northwest Ethiopia was high. However, nearly half of the health centers were technically inefficient, which indicates the exitance of a space for further improvements in the productivity of these health centers. Employing excess number administrative staffs (above the optimal level) should be discouraged and selecting appropriate sites where the health centers to be constructed (to have large catchment population coverage) could improve the productivity of health centers.

Assessing the wastewater reclaim system consisted of wastewater plant - hybrid constructed wetland - ultra filtration and reverse osmosis in a chemical industrial park, a multi-criteria decision-making analysis.

Wastewater reclaim in industrial parks can effectively reduce the dependence on external water resources, few literatures evaluated the reclaim system from perspectives of economy, technology, and environmental impact. It is very popular across China that a constructed wetland is linked with a wastewater plant and then discharged the tailwater into surface waters, based on current situation, pilot experiment, and other available techniques, six scenarios for wastewater reclaim system were designed for Shanghai Chemical Industrial Park. Using life cycle assessment, it was found that in scenario of pilot experiment, most environmental impact was derived from wastewater plant and ultra filtration - reverse osmosis, in which ultra filtration - reverse osmosis accounted >20 % for POCP, AP, and EP, Wastewater plant accounted >86 % for ADP, ODP. It was showed that electricity and sludge were most important parameters affecting LCA, when electricity consumption was reduced by 20 %, total standardized environmental impact would be changed in the range of 1.40 %-1.65 %, the most significant change was HTP (6.12 %-6.32 %) when 20 % up and downward change in sludge amount, followed by MAETP (5.27 %-5.36 %). A multi-criteria decision-making analysis was conducted on all the scenarios based on environmental impact, life cycle cost, technical efficiency, it was showed that the scenario designed for pilot experiment was the best available technique, which was consisted of wastewater plant, hybrid constructed wetland, ultra-filtration and reverse osmosis, and reused as desalted water. A wastewater reclaim plant is suggested from the result of this paper. It was believed that this study could provide references for construction of wastewater reclaim system in industrial parks of the world.

Evaluating health systems' efficiency towards universal health coverage: A data envelopment analysis.

To estimate the technical efficiency of health systems toward achieving universal health coverage (UHC) in 191 countries. We applied an output-oriented data envelopment analysis approach to estimate the technical efficiency of the health systems, including the UHC index (a summary measure that captures both service coverage and financial protection) as the output variable and per capita health expenditure, doctors, nurses, and hospital bed density as input variables. We used a Tobit simple-censored regression with bootstrap analysis to observe the socioeconomic and environmental factors associated with efficiency estimates. The global UHC index improved from the 2019 estimates, ranged from 48.4 (Somalia) to 94.8 (Canada), with a mean of 76.9 (std. dev.: ±12.0). Approximately 78.5% (150 of 191) of the studied countries were inefficient (ϕ < 1.0) with respect to using health system resources toward achieving UHC. By improving health system efficiency, low-income, lower-middle-income, upper-middle-income, and high-income countries can improve their UHC indices by 4.6%, 5.5%, 6.8%, and 4.1%, respectively, by using their current resource levels. The percentage of health expenditure spent on primary health care (PHC), governance quality, and the passage of UHC legislation significantly influenced efficiency estimates. Our findings suggests health systems inefficiency toward achieving UHC persists across countries, regardless of their income classifications and WHO regions, as well as indicating that using current level of resources, most countries could boost their progress toward UHC by improving their health system efficiency by increasing investments in PHC, improving health system governance, and where applicable, enacting/implementing UHC legislation.

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.

Technical efficiency of Fishers under the condition of water hyacinth infestation: Evidence from Lake Tana fisheries, Ethiopia.

Measuring technical efficiency plays a magnificent role in identifying the possible sources of productivity gain with the existing fish resources and technologies. However, there is no any efficiency study that has been conducted in the study area. Because of this gap, the causes, magnitude and possible solutions for the inefficiency of fishers have remained unknown. Thus, the paper aims to estimate the level of technical efficiency (TE) and its determinants in the fishery of Lake Tana. To address these objectives, data from 367 randomly selected fishers were collected using a multi-stage random sampling procedure. A Cobb Douglass functional form with a single-stage estimation procedure was employed to estimate the level of TE and its determinants simultaneously. The study reveals that the level of TE among sampled fishers varied from 13.5 % to 91.2 %, with a mean TE of 70.8 %. The prevailing TE level and the average yield gap of 6.46 kg per trip per fisher, substantiate the potential for improving (by 29.2 %) the current volume of fish production, with the existing fishing technologies. In addition, fishers who are situated around water hyacinth infested areas are technically less efficient (68.7 %) compared to the non-infested areas (72.9 %). The efficiency level was positively influenced by factors, such as training and marketing site. Whereas, number of non-fishing months and distance from home to the Lake were the hindering factors for the efficiency. The study confirms that no fishers in the study area are operating at their full potential and this could have a short-run implication for the substantial improvement of fish catch without additional input and technology.

A multidimensional analysis of corporate governance mechanisms and their impact on sustainable economic development: A case study of Ghana's financial sector.

Efficiency remains pivotal to the banking sector, serving as a linchpin for resource allocation and competitive prowess. This study delves into the intricate dynamics between corporate governance and banking efficiency in Ghana, with an analytical lens on cost efficiency (CE) and total efficiency (TE). Utilizing Data Envelopment Analysis (DEA), our investigation spans over a decade (2008-2019) and encompasses a data set of 23 Ghanaian banks. The study findings unveils that rigorous corporate governance mechanisms, as quantified by the Corporate Governance Index (CGI), exert a salutary influence on both cost and total efficiencies. Moreover, a well-defined Risk Management Index (RMI) positively correlates with cost efficiency, albeit without a substantial impact on total efficiency. Conversely, the study identifies a counterintuitive effect: the current make-up of supervisory boards, as gauged by the Supervisory Board Index (SBI), inversely impacts both efficiency metrics, signaling sub-optimal governance structures. Significantly, the research also highlights a pressing concern: the average total efficiency of Ghanaian banks lags behind the global benchmarks prescribed by the World Bank. This discrepancy underscores an exigency for efficiency optimization within the sector. The study thereby offers invaluable insights for multiple stakeholders-including regulatory bodies, investment communities, and policymakers-by delineating the governance variables that can enhance or impede banking efficiency. It also identifies actionable avenues for improvement, specifically in the realms of risk management and board composition, with the potential to catalyze a transformation in Ghana's banking landscape.

Factors influencing the technical efficiency of diabetes care at primary care level in Mexico.

Diabetes prevalence is rising globally, especially in low- and middle-income countries like Mexico, posing challenges for healthcare systems that require efficient primary care to manage the disease. However, healthcare efficiency is influenced by factors beyond decision-makers, including socioeconomic and political conditions. This study aims to evaluate the technical efficiency of primary healthcare for diabetes patients in Mexico over a 12-year period and explore the impact of contextual variables on efficiency. A longitudinal analysis was conducted using administrative and socio-demographic data from 242 health jurisdictions between 2009 and 2020. Data envelopment analysis with bootstrapping and output orientation was used to measure the technical efficiency; health resources in infrastructure and human resources were used as inputs. As outcome, the number of patients receiving treatment for diabetes and the number of patients with controlled diabetes were considered. Machine learning algorithms were employed to analyse multiple factors affecting the provision of diabetes health services and assess heterogeneity and trends in efficiency across different health jurisdictions. The average technical efficiency in primary healthcare for diabetes patients was 0.44 (CI: 0.41-0.46) in 2009, reaching a peak of 0.71 (CI: 0.69-0.72) in 2016, and moderately declining to 0.60 (CI: 0.57-0.62) in 2020; these differences were statistically significant. The random forest analysis identified the marginalization index, primary healthcare coverage, proportion of indigenous population and demand for health services as the most influential variables in predicting efficiency levels. This research underscores the crucial need for the formulation of targeted public policies aimed at extending the scope of primary healthcare services, with a particular focus on addressing the unique challenges faced by marginalized and indigenous populations. According to our results, it is necessary that medical care management adjust to the specific demands and needs of these populations to guarantee equitable care in Mexico.

Improving long-term operation performance of hazardous waste rotary kiln incineration facilities: An evaluation with DEA model.

Hazardous waste rotary kiln incineration, as the most effective and comprehensive technology to reduce and detoxify waste, generally faces problems such as low load rate and short continuous operating periods. However, there are few studies on the actual operation of such facilities and evaluation of their technical efficiency. Based on the 77-week time-series data of the case company, this study introduces in-depth key operating parameters and evaluates long-term technical efficiency through the data envelopment analysis (DEA) method. The results show that the continuous operating period of the rotary kiln incineration facility can reach more than half a year, with an average load rate of 91.7%. In the analysis of 9 input indicators, the amount of injected activated carbon could not be effectively evaluated due to the lack of relevant standards and online real-time monitoring of dioxins, which might become a weak link in the control of flue gas pollution. The average comprehensive technical efficiency of rotary kiln incineration facilities was 0.939, of which the average pure technical efficiency was 0.949 while the average scale efficiency was 0.989. With 33 of the 77 decision-making units being invalid, there is scope for improvement. The amount of incineration could be increased by 5.34%, and among the input variables, dosage of urea, calcium hydroxide and lye with a relatively high improvement ratio. Based on the results, targeted suggestions were proposed to advance the scientific and precise compatibility of hazardous waste, strengthen the control of dioxin emissions, and promote the intelligent control of the entire process.

Dataset for analysing the ESG-oriented technical efficiency of VNSI listed companies.

In tandem with the evolution of the "green economy and finance" paradigm, a number of sustainability assessment metrics tailored to businesses has been meticulously researched and refined. Among the established benchmarks, the Environmental, Social, and Governance (ESG) index has emerged prominently. With the strategic guidance of governments across diverse nations, this index has progressively assumed a central role as a guiding compass for enterprises with aspirations of sustainable development and the pursuit of long-term investment strategies coveted by discerning investors. The fundamental objective underpinning the dataset presented in this paper is to appraise the technical efficiency exhibited by listed companies on the Ho Chi Minh City Stock Exchange (HOSE), encompassed within the purview of the Vietnam Sustainability Index (VNSI). The assessment of information disclosure practices by these corporate entities adheres rigorously to the Global Reporting Initiative (GRI) standards of 2020. Complementing this are assorted financial metrics gleaned from financial and annual reports, underpinning an analytical framework predicated on Network Data Envelopment Analysis (NDEA), affording a ranking of corporate efficiency. This empirical dataset not only facilitates enhanced comprehension for investors and financial market overseers regarding the pivotal significance of ESG disclosures and practices but also serves as a catalyst for researchers, encouraging the exploration of broader research avenues or the development of novel, more efficacious evaluation frameworks.

Exploring the association between primary care efficiency and health system characteristics across European countries: a two-stage data envelopment analysis.

BACKGROUND: Primary care is widely seen as a core component of resilient and sustainable health systems, yet its efficiency is not well understood and there is a lack of evidence about how primary care efficiency is associated with health system characteristics. We examine this issue through the lens of diabetes care, which has a well-established evidence base for effective treatment and has previously been used as a tracer condition to measure health system performance. METHODS: We developed a conceptual framework to guide the analysis of primary care efficiency. Using data on 18 European countries during 2010-2016 from several international databases, we applied a two-stage data envelopment analysis to estimate (i) technical efficiency of primary care and (ii) the association between efficiency and health system characteristics. RESULTS: Countries varied widely in terms of primary care efficiency, with efficiency scores depending on the range of population characteristics adjusted for. Higher efficiency was associated with bonus payments for the prevention and management of chronic conditions, nurse-led follow-up, and a financial incentive or requirement for patients to obtain a referral to specialist care. Conversely, lower efficiency was associated with higher rates of curative care beds and financial incentives for patients to register with a primary care provider. CONCLUSIONS: Our results underline the importance of considering differences in population characteristics when comparing country performance on primary care efficiency. We highlight several policies that could enhance the efficiency of primary care. Improvements in data collection would enable more comprehensive assessments of primary care efficiency across countries, which in turn could more effectively inform policymaking.

Research on the Operational Efficiency of Basic Medical Insurance for Urban Employees in China-Based on Three-Stage DEA Model.

Purpose: To conduct a three-stage data envelopment analysis (DEA) of the operational efficiency of urban employee basic medical insurance (UEBMI) across 31 provinces in China from 2012 to 2021. Methods: Utilized a three-stage DEA model, this study measured and evaluated the operational efficiency of urban employee basic medical insurance within China's 31 provinces. Results: The operational efficiency of urban employee basic medical insurance in China was notably low, displaying significant disparities across different regions and periods. Substantial room for improvement exists. Environmental factors, including urbanization level and unemployment rate, wielded a pronounced influence on the operational efficiency of China's employee medical insurance. Conversely, the fiscal revenue and expenditure ratio hindered the enhancement of employee medical insurance efficiency. Conclusion: This study held valuable insights for enhancing the operational efficiency of China's urban employee basic medical insurance. To effectively improve insurance efficiency, the following recommendations are put forth: firstly, relevant departments should escalate resource investments and optimize resource utilization based on rational allocation; secondly, enhance legislation and regulations, fortify fund oversight, and ensure equitable and judicious utilization of the medical insurance fund; finally, leveraging modern high-tech advancements can comprehensively elevate the operational efficiency of the employee medical insurance fund. Ultimately, with the advent of cutting-edge technology, the operational efficiency of employee medical insurance fund can be comprehensively elevated.

Impact of the workforce allocation on the technical performance of mental health services: the collective case of Helsinki-Uusimaa (Finland).

BACKGROUND: Long-term mental health (MH) policies in Finland aimed at investing in community care and promoting reforms have led to a reduction in the number of psychiatric hospital beds. However, most resources are still allocated to hospital and community residential services due to various social, economic and political factors. Despite previous research focussing on the number and cost of these services, no study has evaluated the emerging patterns of use, their technical performance and the relationship with the workforce structure. OBJECTIVE: The purpose of this study was to observe the patterns of use and their technical performance (efficiency) of the main types of care of MH services in the Helsinki-Uusimaa region (Finland), and to analyse the potential relationship between technical performance and the corresponding workforce structure. METHODS: The sample included acute hospital residential care, non-hospital residential care and outpatient care services. The analysis was conducted using regression analysis, Monte Carlo simulation, fuzzy inference and data envelopment analysis. RESULTS: The analysis showed a statistically significant linear relationship between the number of service users and the length of stay, number of beds in non-hospital residential care and number of contacts in outpatient care services. The three service types displayed a similar pattern of technical performance, with high relative technical efficiency on average and a low probability of being efficient. The most efficient acute hospital and outpatient care services integrated multidisciplinary teams, while psychiatrists and nurses characterized non-hospital residential care. CONCLUSIONS: The results indicated that the number of resources and utilization variables were linearly related to the number of users and that the relative technical efficiency of the services was similar across all types. This suggests homogenous MH management with small variations based on workforce allocation. Therefore, the distribution of workforce capacity should be considered in the development of effective policies and interventions in the southern Finnish MH system.

Impact of credit access on farm performance: Does source of credit matter?

Access to credit is crucial to improve farm performance as it allows farmers to procure inputs and technology. However, on the empirical front, evidence of the impact of agricultural credit access remains scanty. This study examines how access to credit from formal and informal sources influences the productivity and technical efficiency of maize farming in ten major maize-producing provinces in Indonesia. Secondary Food Crops Survey data by Statistics Indonesia were employed and analyzed using a quasi-experimental approach, i.e., the propensity score matching (PSM). The estimation shows that agricultural credit access improves farm performance. In fact, the ability to obtain credit from institutions increased productivity and technical efficiency more effectively than from informal sources. This study suggests that agricultural credit access remains relevant in Indonesia and needs to be improved continuously.

Technical efficiency of the urban gas industry in china.

China's Paris Agreement Pledge and recent introduction of an Emissions Trading Scheme have created a need for information on where it makes the most economic sense to use different sources of energy. With lower carbon dioxide emissions, natural gas and liquefied petroleum gas provide cleaner sources of energy relative to coal. Although it is practically crucial to investigate the use of these two sources, empirical studies are limited due to lack of data. To fill the research gap, this paper studies the efficiency of natural gas and liquefied petroleum gas sector in China by using data from 24 major province-level divisions over the years 2006-2015. Efficiency is defined as the utility's ability to produce the highest output given fixed inputs. We find that: (1) GDP per capita and high customer density are associated with higher levels of efficiency and (2) utilities that serve higher proportions of households (as opposed to industry and firms) are associated with lower levels of efficiency. Policy makers can use this information to address China's energy needs due to rapid urbanization while also pursuing Paris Agreement goals.

Measuring Productivity and Relative Efficiency of Public Tertiary Traditional Chinese Medicine Hospitals in Hubei, China.

Improving the productivity and relative efficiency of traditional Chinese medicine (TCM) hospitals is pivotal for hospital managers and policymakers to optimize the utilization of TCM resources in China. This study aimed to measure the productivity and relative efficiency of public tertiary TCM hospitals in Hubei Province. The input and output indicators data were extracted from the Health Commission of Hubei Province (HCHP) from 2019 to 2021. The Bootstrap-Malmquist-DEA model was employed to measure the productivity and relative efficiency of the hospitals. The statistical significance was set at P < .05. The numbers of total diagnostic patients and discharged patients declined by 23.44% and 28.34% from 2019 to 2020, and then increased by 25.76% and 20.44% respectively from 2020 to 2021. The average bias-corrected technical efficiency (TE) scores of the TCM hospitals from 2019 to 2021 were 0.8391, 0.8048, and 0.8559, indicating good efficiency. The average total factor productivity (TFP) in 2020 and 2021 decreased compared to that in 2019, with scores of 0.7479 and 0.8996, respectively. Between 2019 and 2020, the TFP changes among 19 out of 21 (90.48%) TCM hospitals and the technological changes (TC) among 20 out of 21 (95.24%) were less than 1.0000 (P < .05). The TFP changes of 17 out of 21 (80.95%) TCM hospitals and the TC of 20 out of 21 (95.24%) were less than 1.0000 (P < .05) between 2019 and 2021. COVID-19 might have constrained the provision of healthcare services by the public tertiary TCM hospitals in Hubei Province. Priority should be given to the utilization of healthcare resources, performance evaluation, information system strengthening, and internal hospital management to boost technical efficiency. TCM hospitals need to focus further on technology innovation to improve their technological progress.