Efficiency of Health Care Production in Low-Resource Settings: A Monte-Carlo Simulation to Compare the Performance of Data Envelopment Analysis, Stochastic Distance Functions, and an Ensemble Model

• DOI: 10.1371/journal.pone.0147261
• Publication Date: 2016-01-26T18:38:00Z
• Authors: Laura Di Giorgio; Abraham D. Flaxman; Mark W. Moses; Nancy Fullman; Michael Hanlon; Ruben O. Conner; Alexandra Wollum; Christopher J. L....
• Keywords: Resource Efficiency

Low-resource countries can greatly benefit from even small increases in efficiency of health service provision, supporting a strong case to measure and pursue improvement low- middle-income (LMICs). However, the knowledge base concerning measurement remains scarce for these contexts. This study shows that current estimation approaches may not be well suited technical LMICs offers an alternative approach settings. We developed simulation environment which reproduces characteristics production LMICs, evaluated performance Data Envelopment Analysis (DEA) Stochastic Distance Function (SDF) assessing efficiency. found ensemble (ENS) combining estimates restricted version DEA (rDEA) SDF (rSDF) is preferable method across range scenarios. first analyze setting LMICs. Our findings aim heighten validity reliability analyses thus inform policy dialogues about improving