Comparative Analysis of SFA and DEA Models: An Application to Health System Efficiency in SSA
Keywords:DEA, SFA, health system efficiency, health expenditure, SSA
The Data Envelopment Analysis (DEA) and Stochastic Frontier Analysis (SFA) are the two major approaches in estimating technical efficiency. However, the two approaches have different underlying assumption and present different efficiency estimates when used in similar situation. In this study we compare the two approaches with an application to health system efficiency across countries in Sub-Saharan Africa (SSA).
The study used cross section data for 45 countries in SSA, sourced from the World Bank world development indicators. Both the DEA and SFA were used to estimate health system efficiency using per capita health expenditure as input while under-five and infant mortality was used as health outcomes. Scatter and Kernel density plots were used to supplement the comparison of estimates from the two models.
The findings suggest that there exist disparities between estimates from the DEA and SFA models. Estimates from the SFA models were relatively higher than those from the DEA models. However, there was not much difference in the ranking of individual countries in terms of efficiency performance. The findings of the various model specifications show average health system efficiency scores of approximately 0.44 and 0.50 for the DEA specifications while 0.70 and 0.72 was estimated for the SFA specifications
The efficiency scores suggest that there is room for improvement in terms health system performance. The choice between the two models should be based on the availability of data and the limitations posed by the data requirements of each of the models.
â€¢ Afonso, A. and M. S. Aubyn (2005) 'Non-parametric approaches to education and health efficiency in OECD countries', Journal of Applied Economics, 8(2), 227-246.
â€¢ Alexander, C. A., G. Busch and K. Stringer (2003) 'Implementing and interpreting a data envelopment analysis model to assess the efficiency of health systems in developing countries', IMA Journal of Management Mathematics, 14(1), 49-63.
â€¢ Belotti, F., S. Daidone, G. Ilardi and V. Atella (2012) 'Stochastic frontier analysis using Stata', Center for Economic and International Studies Tor Vergata Research Paper Series, 10(12), 1-48.
â€¢ Bloom, E. D., D. Canning and J. Sevilla (2004) 'The effect of health on economic growth: a production function approach', World Development, 32(1), 1-13.
â€¢ Bukenya, J. (2009) 'Do fluctuations in health expenditure affect economic growth?', The Open Economic Journal, 2, 31-38.
â€¢ Burgess, J. F. (2006) 'Productivity analysis in health care' in The Eglar Companion to Health Economics, Chaltenham: Elgar, 335-342.
â€¢ Caldwell, J. C. and P. Caldwell (1985) 'Education and literacy as factors in health' in Halstead, S. B., Walsh, J. A. and Warren, K. S., eds., Goof health at low cost, Ney York: The Rochefeller Foundation.
â€¢ Chirikos, T. and A. Sear (2000) 'Measuring hospital efficiency: acomparison of two approaches', Health Services Research, 34, 1389-1408.
â€¢ Danqua, M. and B. Ouattara (2012) 'Comparison of stochastic frontier approaches for estimating national efficiency: an application to sub-Saharan African countries', Paper presented at the African Econometric Society conference, Accra.
â€¢ FÃ¤re, R., S. Grosskopf, M. Norris and Z. Zhang (1994) 'Productivity Growth, Technical Progress, and Efficiency Change in Industrialized Countries', The American Economic Review, 84(1), 66-83.
â€¢ Fiorentino, E., A. Karmann and M. Koetter (2006) 'The cost efficiency of German banks; a comparison of SFA and DEA', Deutsche Bundesbank Discussion Paper No. 10/2006.
â€¢ Greene, W. (2004) 'Distinguishing between heterogeneity and inefficiency: stochastic frontier analysis of World Health Organization's panel data on national health care systems ', Health Economics, 13, 959-980.
â€¢ Grigoli, F. and J. Kapsoli (2013) 'Waste not, want not: efficiency of health expenditure in emerging and developing economies ', IMF Working Paper WP/13/187.
â€¢ Grigoli, F. and E. Levy (2012) 'Quality of government and living standards: adjusting for the efficiency of public spending', IMF Working Paper No.12/182.
â€¢ Gupta, S., M. Verhoeven and E. R. Tiongson (2002) ' The effectivenes of government spending on education and health care in developing and transition economies.', European Journal of Political Economy, 18, 717-737.
â€¢ Hernandez de Cos, P. and E. Moral-Benito (2011) 'Health ecpenditure in the OECD countries: efficiency and regulation', Bank of Spain Occasional Documents No. 1107.
â€¢ Herrera, S. and G. Pang (2005) 'Efficiency of public spending in developing countries: an efficiency frontier approach', World Bank Policy Research Working Paper 3645.
â€¢ Heshmati, A. (2001) 'On the causality between GDP and health care expenditure in augmented Solow growth model', Stockholm School of Economics Working Paper Series No. 423.
â€¢ Hollingsworth, B. and J. Wildman (2003) 'The efficiency of health production: re-estimating the WHO panel data using parametric and non-parametric approaches to provide additional information', Health Economics, 12, 493-504.
â€¢ Jacobs, R. (2000) 'Alternative methods to examine hospital efficiency: data envelopment and stochastic frontier analysis', The University of York Center for Health Economics Discussion Paper 177.
â€¢ Jayasuriya, R. and Q. Wodon (2003) 'Efficiency in reaching the millennium development goals', World Bank Working Paper No.9.
â€¢ Meeusen, W. and J. van den Broeck (1977) 'Efficiency estimation from Cobb-Douglas production function with composed errors', International Economic Review, 18(2), 435-444.
â€¢ Tandon, A., A. J. Lauer, B. D. Evans and L. J. C. Murray (2003) 'Health system efficiency: concepts' in Murray, L. J. C. and Evans, B. D., eds., Health systems performance assessment: debates, methods and empiricism, Geneva: World Health Organization.
â€¢ World Bank (2010) World development indicators, Washington DC: The World Bank.
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