Do adjustment costs constrain public healthcare providers' technical efficiency? Evidence from the New Zealand Public Healthcare System.

Abstract

Efficiency analysis is crucial in healthcare to optimise resource allocation and enhance patient outcomes. However, the prompt adaptation of inputs can be hindered by adjustment costs, which impact Long-Run Technical Efficiency (LRTE). To bridge this gap in healthcare literature, this research employs a Bayesian Dynamic Stochastic Frontier Model to estimate parameters and explore healthcare efficiency dynamics over time. The study reveals the LRTE for New Zealand District Health Boards (DHBs) as 0.76, indicating around 32% more input utilisation due to adjustment costs. Most DHBs exhibit consistent short-run operational efficiency, with the national Short-Run Technical Efficiency (SRTE) very close to the LRTE. Among the tertiary providers, Auckland and Capital & Coast DHBs operate below the LRTE level, setting them apart from other tertiary providers. Similarly, Tairawhiti and West Coast DHBs also fall below the LRTE level, as indicated by their SRTE scores, potentially influenced by their unique healthcare settings and resource challenges. This research brings a new perspective to policy discussions by incorporating the temporal dynamics of decision-making and considering adjustment costs. It underscores the need to balance short-term and long-term technical efficiency, underlining their collective significance in fostering a sustainable and efficient healthcare system in New Zealand.