Manuela Deidda

Using Data Envelopment Analysis to Analyse the Efficiency of Primary Care Units

In this paper we analyse the efficiency of primary care centres (PCCs) adopting Information and Communication Technology (ICT) devices, using a new database on primary care centres in the Basque Region in Spain. Using a four-stage Data Envelopment Analysis methodology, we are able to explicitly take into account the role of ICT in affecting the efficiency of primary care centres. We understand that this is the first time that ICT enters into the determination of efficiency of the health sector. The role of exogenous factors is explicitly considered in this analysis and shows that including these variables is not neutral to the efficiency evaluation, but leads to an efficiency indicator that only encompasses the effect of managerial skills. The paper provides some useful policy implications regarding the role of ICT in improving the efficiency of primary care units.

Exploring the dynamics of the efficiency in the Italian hospitality sector. A regional case study

Highlights? A dynamical tool to describe the performance of economic efficiency is introduced. ? Static DEA, clustering and metric distances are the ingredients of the methodology. ? Case study is used to demonstrate the validity of the methodology. ? Policy and management implications for the Italian hospitality sector are presented. This paper introduces a methodology to describe and compare the economic relative performance of the hospitality sector of the Italian regions during the period 2000-2004. Dynamics of the hospitality sector of each region is represented by the evolution of its economic efficiency. The investigation involves the following steps: a static Data Envelopment Analysis (DEA) to estimate the pure economic efficiency; two different notions of distances between time series and hierarchical clustering techniques are used to classify the economies in the sample. By using a correlation-based distance, three main clusters are detected, while two clusters are identified when the average distance is used. The trend patterns, identified by employing the correlation distance, can be interpreted in terms of exogenous factors that influence the economic efficiency of the group of regions, causing shocks picked up by the high volatility as well as structural breaks. By employing the average distance, one infers information on the cluster that have had similar efficiency values over the period under analysis. This efficiency can be also interpreted in terms of a particular type of hospitality management as well as the firm structure. Following the analysis, some policy and management implications are presented.

Investigating economic efficiency in Italy: a regional comparison

This paper provides a comparative analysis of the hospitality sector using the island of Sardinia and the autonomous province of Bolzano as a case study. The comparison holds its own interest since they are both tourism destinations, though characterised by different features as far as seasonality is concerned. Employing a large sample set, pure technical and scale efficiency are computed using a panel data envelopment analysis. Overall, the empirical findings reveal that the hospitality sector in Sardinia and in Bolzano can be regarded as economically inefficient and mostly depicting decreasing returns to scale. Nevertheless, some distinctive features are detected amongst firms classified by size. Policy implications are drawn to help economic agents to improve their efficiency scores, thus leading to an optimal revenue management strategy.

Protocol for the economic evaluation of a complex intervention to improve the mental health of maltreated infants and children in foster care in the UK (The BeST? services trial)

Introduction Children who have experienced abuse and neglect are at increased risk of mental and physical health problems throughout life. This places an enormous burden on individuals, families and society in terms of health services, education, social care and judiciary sectors. Evidence suggests that early intervention can mitigate the negative consequences of child maltreatment, exerting long-term positive effects on the health of maltreated children entering foster care. However, evidence on cost-effectiveness of such complex interventions is limited. This protocol describes the first economic evaluation of its kind in the UK. Methods and analysis An economic evaluation alongside the Best Services Trial (BeST?) has been prospectively designed to identify, measure and value key resource and outcome impacts arising from the New Orleans intervention model (NIM) (an infant mental health service) compared with case management (CM) (enhanced social work services as usual). A within-trial economic evaluation and long-term model from a National Health Service/Personal Social Service and a broader societal perspective will be undertaken alongside the National Institute for Health Research (NIHR)–Public Health Research Unit (PHRU)-funded randomised multicentre BeST?. BeST? aims to evaluate NIM compared with CM for maltreated children entering foster care in a UK context. Collection of Paediatric Quality of Life Inventory (PedsQL) and the recent mapping of PedsQL to EuroQol-5-Dimensions (EQ-5D) will facilitate the estimation of quality-adjusted life years specific to the infant population for a cost–utility analysis. Other effectiveness outcomes will be incorporated into a cost-effectiveness analysis (CEA) and cost-consequences analysis (CCA). A long-term economic model and multiple economic evaluation frameworks will provide decision-makers with a comprehensive, multiperspective guide regarding cost-effectiveness of NIM. The long-term population health economic model will be developed to synthesise trial data with routine linked data and key government sector parameters informed by literature. Methods guidance for population health economic evaluation will be adopted (lifetime horizon, 1.5% discount rate for costs and benefits, CCA framework, multisector perspective). Ethics and dissemination Ethics approval was obtained by the West of Scotland Ethics Committee. Results of the main trial and economic evaluation will be submitted for publication in a peer-reviewed journal as well as published in the peer-reviewed NIHR journals library (Public Health Research Programme). Trial registration number NCT02653716; Pre-results.