Rosa Giaimo

Evaluating the effect of organization and context on technical efficiency: a second-stage DEA analysis of Italian hospitals

Objective: the purpose of this study was to compare the technical efficiency of Italian hospitals at a regional level and to examine if differences could be explained by organisational and contextual factors. Technical efficiency was defined as the ability of the operating units evaluated to use optimal resource levels for their level of output. Methods: the effect of external factors was explored through a second stage Data Envelopment Analysis (DEA). Efficiency scores were calculated for each hospital using the DEA method (Stage I). Through Tobit regression analysis, the estimated efficiency scores were regressed against a set of organisational and contextual characteristics beyond managerial control, which reflected differences in the population demographics and regional health expenditure (Stage II). Stage I and Stage II efficiency scores were compared in order to indirectly assess managerial contribution in relation to hospital efficiency. Results: the highest efficiency (M±SD) was observed in hospitals in the North-West (75.7±15.1), followed by those in the North-East (75.5±15.1), Central Italy (73.9±16.4) and then Southern Italy (70.6±17.9). Hospital Trusts (HTs) were shown to be more technically efficient than Local Public Hospitals (LPHs). Organisational and contextual indicators were statistically significantly different at Tobit regression analysis for HTs and LPHs. Emilia Romagna and Lombardia were the regions whose management contributed to increased efficiency. Conclusions: in our study, the distribution of regions according to technical efficiency only partly reflected the North-South gradient shown by other studies regarding the gap of expenditure. The important role of organisation and environment in establishing efficiency differences among hospitals was demonstrated.

Sustainable European fishery and the Friend of the Sea scheme: tools to achieve sustainable development in the fishery sector

This paper investigates the role of the Friend of the Sea (FOS) scheme as a market tool for sustainable competitive advantage. To capture this effect, we apply a theoretical framework based on the stakeholder theory (SHT) and the natural-resource-based view (NRBV) to two case studies each in Italy and Spain. Our model allows us to explain the main factors determining an effective and competitive sustainable business model in the fishery sector. The results confirm the relevant influence of market forces in acquiring FOS certification and the role of the same as a counterpart to state authority.

A distributional approach for measuring wage discrimination and occupational discrimination separately

The well-known Blinder–Oaxaca [Blinder, J. Hum. Resour. 8(4), 436–455 (1973); Oaxaca, Int. Econ. Rev. 14(3), 693–709 (1973)] decomposition divides the wage differential between men and women into a part, which can be explained by differences in individual characteristics, and another part, which is usually interpreted as discrimination. This decomposition neglects any distributional issues in evaluating discrimination, thus permitting undesirable compensation between positively and negatively discriminated women. Jenkins [J. Econ. 61(1), 81–102 (1994)] has criticized this aspect, instead, preferring a distributional approach, where the entire distribution of experienced discrimination is evaluated. Following Jenkins [J. Econ. 61(1), 81–102 (1994)], Del Rio et~al. [J. Econ. Inequal. 9(1), 57–86 (2011)] use a distributional approach, adapting the Foster–Greer–Thorbecke [Econometrica 52(3), 761–766 (1984)] class of poverty indices to the study of discrimination.