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论环境恶化在医疗基础设施中的作用:基于数据包络分析和截断回归方法对意大利的实证评估

On the role of environmental corruption in healthcare infrastructures: An empirical assessment for Italy using DEA with truncated regression approach.

作者信息

Cavalieri Marina, Guccio Calogero, Rizzo Ilde

机构信息

Department of Economics and Business, University of Catania, Italy.

Department of Economics and Business, University of Catania, Italy.

出版信息

Health Policy. 2017 May;121(5):515-524. doi: 10.1016/j.healthpol.2017.02.011. Epub 2017 Feb 27.

Abstract

OBJECTIVES

This paper investigates empirically whether the institutional features of the contracting authority as well as the level of 'environmental' corruption in the area where the work is localised affect the efficient execution of public contracts for healthcare infrastructures.

METHODS

A two-stage Data Envelopment Analysis (DEA) is carried out based on a sample of Italian public contracts for healthcare infrastructures during the period 2000-2005. First, a smoothed bootstrapped DEA estimator is used to assess the relative efficiency in the implementation of each single infrastructure contract. Second, the determinants of the efficiency scores variability are considered, paying special attention to the effect exerted by 'environmental' corruption on different types of contracting authorities.

RESULTS

Our results show that the performance of the contracts for healthcare infrastructures is significantly affected by 'environmental' corruption. Furthermore, healthcare contracting authorities are, on average, less efficient and the negative effect of corruption on efficiency is greater for this type of public procurers.

CONCLUSIONS

The policy recommendation coming out of the study is to rely on 'qualified' contracting authorities since not all the public bodies have the necessary expertise to carry on public contracts for healthcare infrastructures efficiently.

摘要

目标

本文实证研究了采购机构的制度特征以及工程所在地的“环境”腐败程度是否会影响医疗基础设施公共合同的有效执行。

方法

基于2000年至2005年期间意大利医疗基础设施公共合同样本进行两阶段数据包络分析(DEA)。首先,使用平滑自抽样DEA估计量来评估每个基础设施合同执行中的相对效率。其次,考虑效率得分变异性的决定因素,特别关注“环境”腐败对不同类型采购机构的影响。

结果

我们的结果表明,医疗基础设施合同的绩效受到“环境”腐败的显著影响。此外,医疗采购机构平均效率较低,且腐败对效率的负面影响对这类公共采购者更大。

结论

该研究得出的政策建议是依靠“合格的”采购机构,因为并非所有公共机构都具备有效执行医疗基础设施公共合同所需的专业知识。

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