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In May 2006, the Ministers of Health of all the countries on the African continent, at a special session of the African Union, undertook to institutionalise efficiency monitoring within their respective national health information management systems. The specific objectives of this study were: (i) to assess the technical efficiency of National Health Systems (NHSs) of African countries for measuring male and female life expectancies, and (ii) to assess changes in health productivity over time with a view to analysing changes in efficiency and changes in technology. The analysis was based on a five-year panel data (1999-2003) from all the 53 countries of continental Africa. Data Envelopment Analysis (DEA) − a non-parametric linear programming approach − was employed to assess the technical efficiency. Malmquist Total Factor Productivity (MTFP) was used to analyse efficiency and productivity change over time among the 53 countries' national health systems. The data consisted of two outputs (male and female life expectancies) and two inputs (per capital total health expenditure and adult literacy). The DEA revealed that 49 (92.5%) countries' NHSs were run inefficiently in 1999 and 2000; 50 (94.3%), 48 (90.6%) and 47 (88.7%) operated inefficiently in 2001, 2002, and 2003 respectively. All the 53 countries' national health systems registered improvements in total factor productivity attributable mainly to technical progress. Fifty-two countries did not experience any change in scale efficiency, while thirty (56.6%) countries' national health systems had a Pure Efficiency Change (PEFFCH) index of less than one, signifying that those countries' NHSs pure efficiency contributed negatively to productivity change. All the 53 countries' national health systems registered improvements in total factor productivity, attributable mainly to technical progress. Over half of the countries' national health systems had a pure efficiency index of less than one, signifying that those countries' NHSs pure efficiency contributed negatively to productivity change. African countries may need to critically evaluate the utility of institutionalising Malmquist TFP type of analyses to monitor changes in health systems economic efficiency and productivity over time.

This proceedings volume examines state-of-the art of productivity and efficiency analysis and adds to the existing research by bringing together a selection of the best papers from the 8th North American Productivity Workshop (NAPW). It also aims to analyze world-wide perspectives on challenges that local economies and institutions may face when changes in productivity are observed. The volume comprises seventeen papers that deal with productivity measurement, productivity growth, dynamics of productivity change, measures of labor productivity, measures of technical efficiency in different sectors, frontier analysis, measures of performance, industry instability and spillover effects. These papers are relevant to academia, but also to public and private sectors in terms of the challenges firms, financial institutions, governments and individuals may face when dealing with economic and education related activities that lead to increases or decreases of productivity. The North American Productivity Workshop brings together academic scholars and practitioners in the field of productivity and efficiency analysis from all over the world. It is a four day conference exploring topics related to productivity, production theory and efficiency measurement in economics, management science, operations research, public administration, and related fields. The papers in this volume also address general topics as health, energy, finance, agriculture, utilities, and economic℗ℓ development, among others. The editors are comprised of the 2014 local organizers, program committee members, and celebrated guest conference speakers

Frontier techniques, including data envelopment analysis (DEA) and stochastic frontier analysis (SFA), have been used to measure health care provider efficiency in hundreds of published studies. Although these methods have the potential to be useful to decision makers, their utility is limited by both methodological questions concerning their application, as well as some disconnect between the information they provide and the insight sought by decision makers. The articles in this special issue focus on the application of DEA and SFA to hospitals with the hope of making these techniques more accurate and accessible to end users. This introduction to the special issue highlights the importance of measuring the efficiency of health care providers, provides a background on frontier techniques, contains an overview of the articles in the special issue, and suggests a research agenda for DEA and SFA.

BACKGROUND AND OBJECTIVE: In health preference research, studies commonly hypothesize differences in parameters (i.e., differential or joint effects on attribute importance) and/or in choice predictions (marginal effects) by observable factors. Discrete choice experiments may be designed and conducted to test and estimate these observable differences. This guide covers how to explore and corroborate various observable differences in health preference evidence. METHODS: The analytical process has three steps: analyze the exploratory data, analyze the confirmatory data, and interpret and disseminate the evidence. In this guide, we demonstrate the process using dual samples (where exploratory and confirmatory samples were collected from different sources) on 2020 US COVID-19 vaccination preferences; however, investigators may apply the same approach using split samples (i.e., single source). RESULTS: The confirmatory analysis failed to reject ten of the 17 null hypotheses generated by the exploratory analysis (p < 0.05). Apart from demographic, socioeconomic, and geographic differences, political independents and persons who have never been vaccinated against influenza are among those least likely to be vaccinated (0.838 and 0.872, respectively). CONCLUSIONS: For all researchers in health preference research, it is essential to know how to identify and corroborate observable differences. Once mastered, this skill may lead to more complex analyses of latent differences (e.g., latent classes, random parameters). This guide concludes with six questions that researchers may ask themselves when conducting such analyses or reviewing published findings of observable differences.