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In many OECD countries, changes in demography and health conditions are putting pressure on public finance. To prevent further expansion of government spending as a percentage of GDP, public spending efficiency will need to be raised. This paper uses data envelopment analysis (DEA) to assess the efficiency of welfare spending (normalized by the working-age population) in a sample of OECD countries around 2012, focussing on health care, secondary education, and general public services. The DEA model has a two input-one output structure, with at least one of the variables representing a composite indicator controlling for country-specific factors (socio-economic environment and lifestyle factors, for example). We find wide dispersion in efficiency measures across OECD countries and provide possible quantified improvements for both output and input efficiency.

We compute Public Sector Performance (PSP) and Public Sector Efficiency (PSE) indicators and Data Envelopment Analysis (DEA) efficiency scores for a sample of twenty-three Latin American and Caribbean Countries (LAC) to measure efficiency of public spending for the period 2001-2010. Our results show that the PSE is inversely correlated with the size of the government, while the efficiency frontier is essentially defined by Chile, Guatemala, and Peru. Moreover, on average, output quantities could theoretically be proportionally increased by 19 percent with the same level of inputs. In addition, the performed Tobit analysis suggests that more transparency and regulatory quality improve the efficiency scores, while more transparency and control of corruption increase output-oriented efficiency. ; info:eu-repo/semantics/publishedVersion

Aim: In 1988, Brazil implemented profound changes in the organization and financing of its public health system, with the creation of the Unified Health System (Sistema Unico de Saúde - SUS), establishing universal health coverage. The gradual expansion of the health system and entitlements to services has been accompanied by the debate about the appropriate level of government spending and health system efficiency. Design / Research methods: The study uses VRS - output oriented, Dynamic Network SBM DEA model, period 2008-2013, to depict the relationships that take place between diverse levels of care (primary health care/PHC and secondary-tertiary health care/STC). DMUs are Brazilian state capitals, which implement key health policies and assist patients from smaller surrounding municipalities, especially for STC. Inputs are PHC and STC budgets; outputs are their respective services provided and avoidable deaths. The link variable is PHC medical consultation, entrance door to the system and gatekeeper for more complex levels of care. Dynamic model evaluates efficiency across time. Conclusions / findings:Overall performance was 0.86; for PHC, 0.90; for STC, 0.85 (SD=0.15). 8 out of 27 capitals were fully efficient. Capitals increased average scores in both levels of care, but only STC had a positive technological change (frontier shift >1). Link variable behavior denotes a bottleneck between levels of care. Projections onto the frontier enable establish own management diagnosis and goals for financing and development. Originality / value of the article: Network models mimic hierarchically organized health systems. The appliance of results aids health policy. ; Cel: W 1988 roku Brazylia wdrożyła dogłębne zmiany w organizacji oraz finansowaniu systemu służby zdrowia, powołując do życia Zunifikowany System Opieki Zdrowotnej ("Sistema Unico de Saúde" - SUS), zakładający powszechny dostęp do służby zdrowia. Stopniowemu rozszerzaniu systemu opieki zdrowotnej oraz uprawnień do usług medycznych towarzyszyła debata dotycząca odpowiedniego poziomu wydatków rządowych i wydajności systemu. Metodyka badań: W badaniu wykorzystano zmienne efekty skali zorientowane na wyniki, model Slacks-Based-Measure oparty na dynamicznej sieciowej metodzie obwiedni danych (ang.: Data Envelopment Analysis (DEA)) dla danych z lat 2008-2013, aby zobrazować zależność, jaka zachodzi pomiędzy różnymi poziomami opieki (podstawowa opieka zdrowotna (ang. primary health care (PHC)) oraz opieka zdrowotna drugiego i trzeciego stopnia (ang. secondary-tertiary health care (STC)). Jednostkami podejmującymi decyzje są brazylijskie stolice stanowe, które wdrażają kluczowe założenia polityki zdrowotnej oraz wspierają pacjentów z okolicznych, mniejszych jednostek administracyjnych, szczególnie w zakresie STC. Nakłady stanowią budżety PHC i STC, natomiast wynikami są wynikające z nich usługi oraz przypadki zagrożenia życia, w których udało się uratować pacjentów. Powiązana zmienna to konsultacje medyczne w ramach PHC, drzwi wejściowe do systemu oraz strażnik bramy do bardziej kompleksowych poziomów opieki. Dynamiczny model pozwala oceniać wydajność w czasie. Wnioski: Ogólny stan wyniósł 0,86, przy czym dla PHC kształtował się na poziomie 0,90, a dla STC 0,85 (SD=0,15). 8 z 27 stolic okazało się w pełni wydajnych. Stolice zdołały zwiększyć wyniki w obu poziomach opieki zdrowotnej, ale tylko STC doświadczyło pozytywnej zmiany technologicznej (frontier shift > 1). Zmienna powiązana wykazała wąskie gardło pomiędzy poziomami opieki. Projekcje dotyczące granic (frontier shift) pozwoliły ustalić własną diagnozę dotyczącą zarządzania oraz cele związane z finansowaniem i rozwojem. Wartość artykułu: Modele sieciowe naśladują hierarchicznie zorganizowane systemy opieki zdrowotnej. Wykorzystanie wyników wspiera politykę służby zdrowia.

We use Data Envelopment Analysis (DEA) efficiency scores to show that clustering municipalities into encompassing regional clusters improves spending efficiency of single stand-alone municipalities. We propose a new geographic aggregation based on municipalities-to-municipalities commuting flows, defined using hierarchical cluster analysis. Our example for Portugal shows that from an output oriented perspective, between 85 and 95 percent of municipalities would increase their efficiency scores, while from an input oriented perspective, between 81 and 97 percent of municipalities would also be better off in terms of efficiency. Our strategy and results are naturally quite relevant in a context of public spending control. ; UECE is supported by Fundacão para a Ciência e a Tecnologia (Portuguese Foundation for Science and Technology) through the project PEst-OE/EGE/UI0436/2011. Financial support was provided by the Fundacão para a Ciência e a Tecnologia (Portuguese Foundation for Science and Technology) through the project PTDC/IIM-ECO/3513/2012

International financing institutions (IFIs) spend more than US$50 billion each year, most of it for development, but also some for environmental and other purposes. Yet the question which of the IFIs spend a given amount in the most efficient way seems not to have been researched. Such information would help donor and recipient countries to put pressure on badly performing IFIs and to farther the better ones. The authors therefore discuss the subject of the efficient use of financial resources by IFIs. They develop a set of determinants of spending efficiency, structured by (1) the general features of an institution, such as being public or private; (2) the organisational elements of an institution; and (3) the type of problem an institution deals with. This set of determinants also constitute a research design for the comparative analysis of the spending efficiency of IFIs.