Causes Of Inefficiency Research Articles

Identifying and prioritizing inefficiency causes in Iran’s health system

BackgroundEnhancing efficiency is crucial in addressing the escalating scarcity of healthcare resources. It plays a pivotal role in achieving Universal Health Coverage (UHC), with the ultimate goal of ensuring health equity for all. A fundamental strategy to bolster efficiency involves pinpointing the underlying causes of inefficiency within the healthcare system through empirical research. This study aimed to determine and prioritize the causes of inefficiency in Iran’s health system.MethodsThis mixed-method study comprised three phases. The initial phase involved identifying the causes of inefficiency through a comprehensive literature review of relevant studies published between January 1, 2010, to January 1, 2021. The causes were then aligned and prioritized using criteria derived from the literature and expert opinion. Finally, the identified causes were ranked based on their significance using Multiple-Criteria Decision Analysis (MCDA).ResultsFrom an initial pool of 307 causes of inefficiency, they were reduced to 121 causes in the first round of screening which were categorized into 13 thematic topics. The second screening process further narrowed the list to 48 causes. Among these, the leading causes of inefficiency included the inadequate supply and unequal distribution of hospital beds, the overuse of health services, and the mismanagement of the health workforce. In contrast, the use of traditional treatment methods was determined to be the least significant factor contributing to inefficiency.ConclusionThis study identified key inefficiencies in Iran’s health system, such as resource misallocation, overuse of services, and workforce mismanagement. Addressing these issues is essential for optimizing resource utilization, enhancing service delivery, and achieving UHC. The findings suggest that policymakers should prioritize reforms in hospital bed distribution, implement strategies to reduce unnecessary health service use, and strengthen human resource management. Additionally, targeted policies that focus on decentralizing healthcare decision-making and enhancing primary care could significantly improve system-wide efficiency. Future research should evaluate the effectiveness of these interventions and explore the role of digital health solutions in mitigating identified inefficiencies.

The Effect of Lean Manufacturing on Production / Operation for the Small and Medium Enterprise in Malaysia

At the start of 2022, the government announced its focus on supporting the development of small and medium enterprises (SMEs) to improve living standards following the COVID-19 pandemic. SMEs contribute significantly to the national economy, with the clothing industry playing a major role. This research applies lean manufacturing techniques to enhance the performance of SMEs in the clothing sector, specifically in T-shirt printing. Therefore the first objective was to collect, analyze processing times and recording of all issues encountered during production. The second objective involved using value stream mapping (VSM) to analyze the T-shirt printing process from raw material supply to finished product packaging. We also employed a why-why analysis to pinpoint the underlying causes of inefficiencies and devise specific solutions. The last objective focused on process improvement using VSM, along with the Kanban system, 5S and Make to Stock (MTS) to optimize block preparation and T-shirt printing. We selected Flexsilk Printshop as the case study. The findings showed a 66.59 % reduction in waiting time, a 30.77 % improvement in lead time, an increase in overall equipment effectiveness (OEE) from 93.3 to 97.45 % and a 50.41 % increase in efficiency.

Impact of behavioral finance on financial decision making

This paper highlights the disproportionate effect of behavioral finance on investor’s investing decisions. While making any financial decisions, one easily gets influenced by psychological and emotional factors. Past individual experiences, tendency or opportunity for herd behavior, personal judgment, overconfidence in one's abilities, aversion to feelings of regret, reliance on advice from experts, and last but not least, something known as the disposition effect—by which investors tend to hold on to losing investments and professionally sell profitable ones too early. The impact of these factors on the investment decision-making process varies; on the one hand, they may enhance the quality of the decision-making process by aligning investments with risk tolerance and financial goals. However, on the other hand, behavioral factors can be a cause of inefficiency if investment decisions are based more on emotions than objective analysis. In our recent research, we questioned 187 investors, using a questionnaire from whom we acquired crucial information regarding the impact of behavioral finance on financial decisions. The primary objective of the questioning was to determine the effect of behavioral finance on financial decision-making. The secondary objective was to suggest some methods for making one aware of the repercussions of impulsive or emotional decision-making and making prudent investments.

Data Driven Insights to Operating Room Inefficiencies: What’s next? Part 2

We previously discussed the methodologies for improving operating room efficiencies including lean and six sigma methods, the use of scheduling algorithms, and even direct observations. Additionally, we demonstrated the effects of pre-operative factors on efficiency in the operating room and noted that inefficiencies in the operating room are multi-factorial. In the second part of this paper, we discuss intra- and post-operative opportunities for improvement. We recognize that inefficiencies within the intra- and post-operative periods are often similar between institutions (e.g., environmental services, surgery technicians, and nurses responsible for turning over the OR), while the specific causes of inefficiency are unique to each individual institution or department. Given the variability and burden that exists in an efficiency program, there is a substantial opportunity for the development of technologies capable of automating the measuring and analysis of actionable data to transform OR efficiencies.

The Tribunal Visualized Approach: Improving Proceedings by Visualized Case Introduction

Efficiency in international arbitration has long been contentious, as promised benefits often fail to materialize, leading to user dissatisfaction. Despite ongoing debates and procedural innovations, underlying inefficiencies persist. Although existing tools aim to streamline proceedings, they often overlook root causes of inefficiency, including the tendency of parties and counsel to focus on enforceability and prioritize the right to present their case at its fullest, fearing that efficiency compromises quality. This mindset, coupled with uncertainty about arbitrators’ preparedness, leads to bloated submissions and prolonged proceedings. In this article the author, drawing on extensive experience, proposes the Tribunal Visualized Approach (Trivis), which uses detailed visual presentations by arbitrators to improve trust among parties and expedite the settlement of disputes. The Trivis method counters inefficiency by enhancing clarity and transparency through visual aids, fostering the cooperation and confidence in arbitration that is crucial for improving efficiency in international dispute resolution.

AN ANALYSIS OF OVERALL TECHNICAL, PURE AND SCALE EFFICIENCIES OF RICE FARMS IN SATKHIRA DISTRICT OF BANGLADESH: A DATA ENVELOPMENT APPROACH

This study measures efficiency of Aman rice farms and assesses the effect of farm-specific variables on the efficiencies using cross-section data in Bangladesh. Data envelopment analysis (DEA) method is used to measure the efficiency levels of Aman rice farms in Bangladesh. We used multi-stage sampling technique to collect the data of 455 rice farms using face to face interview method. The results show that the mean overall technical efficiency, pure technical efficiency, and scale efficiency are 0.75, 0.91, and 0.83, respectively. The beauty of this article is the use of scale efficiency which identifies the three different stages of production. The finding of the scale efficiency shows that about 0.89 percent of the Aman rice farm is operating at economies of scale that is really higher than optimal level. The Tobit regression model is employed in order to assess the cause of inefficiencies of rice farms. The results of Tobit regression implies that agriculture policy variable, farmers having bank account for receiving government agricultural assistance, positively relates to the technical efficiency of Aman rice farms. The policy implication of these findings implies government assistance such as cash incentive, and extension service need to be extended and implemented with proper targeting.

The performance of Croatian hotel companies – DEA window and Malmquist productivity index approach

The hospitality industry operates in a dynamic and competitive environment whereefficiency and productivity are crucial for sustainable success. The main goal ofthis paper is to assess the dynamic changes in the efficiency and productivity oflarge and very large Croatian hotel companies and to investigate whether theirlocation influences these factors. It also aims to determine how resilient thecompanies are to macroeconomic shocks and to identify the causes of inefficiencyand productivity changes separately for each location. The analysis is conductedfor 70 large and very large hotel companies in total and separately for those incoastal and the continental Croatia from 2017 to 2022 using the Window DataEnvelopment Analysis and the Malmquist Productivity Index. The results show aslight decrease in relative efficiency in 2020 due to the impact of the COVID-19pandemic. The main cause of inefficiency for coastal hotel companies throughoutthe period is management performance and other exogenous factors. Conversely,the main cause of inefficiency for continental hotel companies shifted from non-optimal production size to management and other exogenous factors after 2020.Productivity declined between 2019 and 2020 due to the decline in technologicalchange for companies in both locations. Prior to 2020, coastal and continentalhotel companies followed a similar trend. While coastal hotels recovered faster in2021, continental hotels recovered more steadily and achieved higher productivityin 2022. This research provides valuable insights for hotel managers andacademics seeking to navigate the ever-changing field of hotel management.

Efficiency evaluation of China's transportation system considering carbon emissions: Evidence from big data analytics methods

China's transportation sector is a vital link between production and consumption, but it also has issues with low efficiency, high carbon emissions, and technological bottlenecks. To improve efficiency and provide actionable recommendations and strategies, this study first constructs a comprehensive evaluation index system to gauge the transportation sector's inputs using panel data from different Chinese provinces from 2007 to 2021. Within the assessment system, the principal component analysis (PCA) method is used to reduce the dimension of the indexes, thereby yielding a set of adjusted inputs. Subsequently, the transportation system efficiency (TSE) is evaluated using the super-efficiency SBM-DEA model, which includes unexpected outputs such as carbon emissions, and three-stage DEA modifies the efficiency. Then, we calculate the Malmquist-Luenberger index (TML) and its components: technological change (TTC) and technological efficiency change (TEC). Lastly, the influential factors impacting TSE are analyzed via a truncated regression Tobit model. The following are the conclusions: (1) The transportation industry in China exhibits inefficiency, and the average TSE in Stage I and III is 0.91 and 0.93, respectively. TSE is underestimated due to the influence of external environmental factors and inefficiencies in management in Stage I. (2) TSE in the eastern area also produces significant carbon emissions that surpass the national average. At the same time, other regions face efficiency limitations due to geographical constraints and management obstacles. (3) Insufficient technical capacity is a major cause of inefficiency in the transport sector and is prevalent in the northeast, west, and central regions. (4) Population growth and income per capita advancements foster transportation industry development, while increased GDP, fiscal revenues, and traffic accidents contribute to declining efficiency. The study above findings serve as a foundation for regional and national management initiatives and policies to enhance transportation effectiveness.

Application of Participatory Concept in Minimizing Food Packaging Waste (FPW) in Manufacturing Firms

All the industrialized countries lately focus on the need for the best solutions for the reduction of food waste at the various stages of the supply chain by conducting the participatory concept. It is a solution and stakeholder-oriented concept providing information on how to analyze the status quo identification of organization-specific problems and with the involvement of relevant stakeholders, develop solutions in the processes along the food value chain. The objective of this study is to present a participatory (five-phase) concept to diminish FPW in manufacturing firms. This concept is adapted to the continuous improvement (PDCA cycle) applied in Total Quality Management (TQM), which involves a participatory approach where workers and stakeholders are collaborated to detect causes for inefficiency and advance measures to counteract FPW in the Healthy Food Drink powder Manufacturing firm. The research was conducted by analyzing the data related to FPW such as Aluminum Wrappers (AlWs), Bag in Boxes (BIBs), and Plastic Bottles (PBs) using Microsoft Excel and Power BI software. Also, it paid attention to related operational and supporting processes within the organization and the behavior of the staff to get an impression of the working atmosphere and attitudes of staff. The analysis was done as a comparison with the collected FPW data for 2 months before and after developing, and implementing upgraded, targeted management practices. This analysis provided the basis for the developmental framework with the focus of increasing the effectiveness of FPW management practices by assessing the structure and selecting the best waste management methodologies for FPW. According to the analyzed data, the total wastage of AlWs, BIBs, and PBs showed 5.81%, 1.82% and 1.96% respectively. With the participatory concept, the organizational weaknesses which caused the occurrence of FPW were identified, and developmental measures were implemented to obtain significant reductions of waste of Alws, BIBs, and PBs up to 2.06%, 0% and 0.43% consequently. Counteractive measures, such as join in workforces into the developing and implementing waste reduction measures, workforce training, scheduled preventive maintenance on machines, utilization of removable ink-to-print date codes, efficient demand planning and accurate demand forecasting, enhance workforce motivation and commitment, establishing trust among all employees and proper communication flows within departments which influencing the occurrence of FPW have been proposed to avoid losses. It affirms that the participatory concept either contributes to reducing FPW or enhancing resource efficiency in the food industry, as this would enable companies to benefit economically. 
 Keywords: Food packaging waste, Participatory concept, Continuous improvement, Integration, Resource efficiency

A new set of Lean indicators to assess Greenhouse Gas emissions related to industrial losses

PurposeThis paper presents a new and well-structured framework that aims to assess the current environmental impact from a Greenhouse Gas (GHG) emissions perspective. This tool includes a new set of Lean Key Performance Indicators (KPIs), which translates the well-known logic of Overall Equipment Effectiveness in the field of GHG emissions, that can progressively detect industrial losses that cause GHG emissions and support decision-making for implementing improvements.Design/methodology/approachThe new metrics are presented with reference to two different perspectives: (1) to highlight the deviation of the current value of emissions from the target; (2) to adopt a diagnostic orientation not only to provide an assessment of current performance but also to search for the main causes of inefficiencies and to direct improvement implementations.FindingsThe proposed framework was applied to a major company operating in the plywood production sector. It identified emission-related losses at each stage of the production process, providing an overall performance evaluation of 53.1%. The industrial application shows how the indicators work in practice, and the framework as a whole, to assess GHG emissions related to industrial losses and to proper address improvement actions.Originality/valueThis paper scrutinizes a new set of Lean KPIs to assess the industrial losses causing GHG emissions and identifies some significant drawbacks. Then it proposes a new structure of losses and KPIs that not only quantify efficiency but also allow to identify viable countermeasures.

“Make Known”: Historical Memory, Politics of Memory and Historical Monuments of the Russian Empire

Historical memory is a necessary element of the nation-building process. It has various forms of realization, including visual ones. The article discusses one of the forms of visualization of historical memory through specific historical places – officially confirmed historical monuments. The author proves the thesis that the list of national historical monuments depended on the history politics implemented by the authorities and considers the evolution of this politics from 1826 (the first decree of Emperor Nicholas I on compiling in Russia a list of historical monuments, this was done by the Ministry of the Interior) until 1917. Initially, the authorities sought to recreate the picture of the historical past by fixing the surviving monuments. However historical politics was changing in the late 19th – early 20th centuries. The purpose of the empire was to present Russian history as the apotheosis of the Romanov dynasty, especially its last representatives (Alexander II, Alexander III, Nicholas II). Therefore, according to their description of 1901–1903, most historical monuments were modern monuments to the last emperors and members of the imperial family. They were not historical monuments in the true sense of the term. It was an ideological, a propaganda campaign. The author draws attention to its inefficiency; these monuments could not improve the image of the Romanovs in the eyes of society. The author draws attention to the similarity of the principles of visualization of history through historical monuments in the Russian Empire and the USSR. In both cases, an ideological basis shaped the history politics, which was less about preserving historical memory and more about ideology and channeling specific ideas through selected monuments. Moreover, in both cases, it was a cause of inefficiency of history politics.

Improving empty container management using street-turn: A case study of the Colombian logistics network

This case study addresses the problem of empty container repositioning (ECR) in the Colombian context at a regional scale. The research was motivated by the massive empty container congestion in 2022 in specific nodes of the logistics network. A Mixed methods approach is proposed in this research applying qualitative and quantitative methods that aim to clarify the causes of inefficiency in empty repositioning and to formulate improvement strategies. Street-turn has proven to be a strategy to increase the efficiency in the ECR system. A matching algorithm is developed to pair empty containers in inland destinations with export loads, to achieve a more efficient utilization of trucks in the network. Despite the significant container trade imbalance, the optimization model results confirm significant cost savings and reduction of empty trips of up to 50% for RFT between Colombia's two main ports and their principal hinterland regions. The research also identifies that the actors involved in the ECR system lack incentives to deepen their collaboration, which represents a significant barrier to the implementation of street-turn.

Improving the technical efficiency of public health centers in Cambodia: a two-stage data envelopment analysis

BackgroundCambodia is undergoing a series of reforms with the objective of reaching universal health coverage. Information on the causes of inefficiencies in health facilities could pave the way for a better utilization of limited resources available to ensure the best possible health care for the population.ObjectivesThe purpose of this study is to evaluate the technical efficiency of health centers and the determinants for inefficiencies.MethodsThis cross-sectional study used secondary data from a costing study on 43 health centers in six Cambodian provinces (2016–2017). Firstly, the Data Envelopment Analysis method with output-orientation was applied to calculate efficiency scores by selecting multiple input and output variables. Secondly, a tobit regression was performed to analyze potential explanatory variables that could influence the inefficiency of health centers.ResultsStudy findings showed that 18 (43%) health centers were operating inefficiently with reference to the variable returns to scale efficiency frontier and had a mean pure technical efficiency score of 0.87. Overall, 22 (51%) revealed deficits in producing outputs at an optimal scale size. Distance to the next referral hospital, size and quality performance of the health centers were significantly correlated with health center inefficiencies.ConclusionDifferences in efficiency exist among health centers in Cambodia. Inefficient health centers can improve their technical efficiency by increasing the utilization and quality of health services, even if it involves higher costs. Technical efficiency should be continuously monitored to observe changes in health center performance over time.

A Classification and Regression Tree Analysis for Prediction of Surgical Patient Lengths of Stay

Healthcare demand is growing in Australia and across the world. In Australia, the healthcare system comprises a mix of private and public organizations, such as hospitals, clinics, and aged care facilities. The Australian healthcare system is quite affordable and accessible because a large proportion of the expenditure, around 68%, is funded by the Australian government. The healthcare expenditure in 2015-16 was AUD 170.4 billion which was 10.0% of the GDP. Soaring healthcare costs and growing demand for services are increasing the pressure on the sustainability of the government-funded healthcare system. To be sustainable, we need to be more efficient in delivering healthcare services. We can schedule the care delivery process optimally and subsequently improve the efficiency of the system if demand for services is well known. However, there is a randomness in demand for services, and it is a cause of inefficiency in the healthcare delivery process. Soaring healthcare costs and the growing demand for services require us to use healthcare resources more efficiently. Randomness in resource requirements makes the care delivery process less efficient. Our aim is to reduce the uncertainty in patients’ resource requirements, and we achieve that objective by classifying patients into similar resource user groups. The conventional random forest., k-nearest neighbourhood (KNN) methods were resulted in poor classification, prediction performance. In this work, we develop a two-stage classification model to classify patients into lower variability resource user groups by using electronic patient record. There are various statistical tools for classifying patients into lower variability resource user groups. However, classification and regression tree (CART) analysis is a more suitable method for analyzing healthcare data because it has some distinct features. For example, it can handle the interaction between predictor variables naturally, it is nonparametric in nature, and it is relatively insensitive to the curse of dimensionality.

Comprehensive evaluation of passenger road transportation through dynamic network data envelopment analysis: A case study of state road transport undertakings in India

AbstractState road transport undertakings (STUs) in India are public utility services that link diverse terrains and remote and hilly areas throughout the country and play a vital role in enhancing public mobility. These organizations are motivated to work through a sense of social responsibility. For example, they operate in low‐revenue‐generating regions to serve the public. Therefore, they require regular performance monitoring and constant efforts toward course corrections. Existing literature on the performance evaluation of STUs ignores the internal structures of the passenger transportation process and treats the process as a “black‐box.” Consequently, it fails to identify the precise cause of inefficiencies, making course corrections in a multistage transportation process difficult. To close this research gap and comprehensively evaluate the performance of STUs, considering their internal structure and based on long‐term optimization, this study employs a slacks‐based dynamic network data envelopment analysis (DNDEA) approach to deconstruct India's publicly owned passenger road transportation process into operations and revenue divisions, subjected to a multiperiod performance evaluation from 2014–2015 to 2017–2018. Moreover, we utilize panel data regression to explore other influential factors not included in the DNDEA, explaining the efficiency variation across STUs. This study is the first to explore the internal structure of STUs in India and perform a comprehensive evaluation of STUs, considering their internal divisions and multiple‐period long‐term optimization. The DNDEA results highlight evidence of capital misallocation in India's public road transport sector. While operational inefficiency can be attributed to improper utilization of resources, price regulation is the major source of inefficiency in the revenue division. Fixed effects panel data regression revealed that STUs with higher bus utilization and passenger lead are more efficient. The contribution of this study lies in its innovative approach of using DNDEA to analyze India's passenger road transportation sector and its inner constructs, providing insights into the efficiency scores of STUs and their dynamic changes in one model. Managers and policymakers can use the findings of this study to revise and frame policies targeted at improving STU efficiency.

Electronic Structure of Orthorhombic Bi4V2O11 and Role of Gap States in Photoelectrochemical Water Splitting

A group of bismuth vanadium oxides shows promise as an excellent material for photoanodes in water splitting. However, the efficiency of Bi4V2O11 in water splitting is not satisfactory compared to BiVO4. In this study, we investigated the electronic structure of orthorhombic Bi4V2O11 using density functional theory (DFT) and synchrotron soft X-ray spectroscopy techniques to clarify the causes of inefficiency. Our DFT calculations of the two-fold superlattice, as confirmed by near-edge X-ray absorption fine structure measurements, revealed its indirect-band-gap nature. An angle-resolved photoelectron spectroscopy study identified the states within the band gap, and the resonant photoemission technique and DFT simulation clarified that the origin of the gap states was anisotropic localization of electrons around V–O tetrahedra. Water absorption enhances the gap states, which dramatically impedes the kinetics of water oxidation reactions. Our results reveal the role of gap states in water oxidation reactions and offer new insights into manipulating gap states in 3d transition metal oxides.

Measuring inefficiency of MSEs in the food processing sector

The food processing sector is a sector that consistently contributes to gross domestic product (GDP) for the non-Oil and Gas industry and also a sector that can deal with various economic shocks. A business form in this industry is still dominated by Micro and Small Enterprises (MSEs), which run the business traditionally. Therefore, this research is conducted for various MSE actors to understand their efficiency better. This paper uses secondary data from the results of a business-level survey by the Department of Industry and Trade, Magelang City in 2019 within a random cross-sectional framework of 948 micro-enterprises and 199 small-enterprises for the estimates of the inefficiency determinants of Indonesia MSEs which is divided into 2 categories, namely the type of small-enterprise and micro-enterprise. The results based on the cross-logarithmic production function show that capital and labor significantly impact improving efficiency. In addition, the research results show that the reason for the low efficiency of small enterprises is the gender characteristics of corporate actors. For micro-enterprises, the marketing area is the cause of inefficiency, while the location of the business is the cause of the inefficiency of small enterprises.

Research on Analyzing the Efficiency of R&D Projects for Climate Change Response Using DEA–Malmquist

In responding to climate change, the world is focusing on technology development. Korea also continues to invest in R&D to reduce greenhouse gas emissions and adapt to climate change. However, compared to the government’s continuous investment in R&D, there is a lack of systematic analysis of R&D investment performance. Rather than simply reducing and increasing the investment in R&D to respond to climate change in terms of high and low efficiency, we aim to improve the efficiency of national R&D projects by analyzing the causes of low efficiency and deriving improvement directions. In this study, data envelopment analysis (DEA) was used to analyze the efficiency of climate change response technology development projects conducted by the Ministry of Science and ICT in Korea. The efficiency of 1500 projects conducted during the 2014–2020 period was analyzed from a static and dynamic perspective, focusing on project information. Through static efficiency analysis, total efficiency (TE), pure technical efficiency (PTE), and scale efficiency (SE) were measured, and the causes of inefficiency were identified. In addition, the results of the dynamic efficiency analysis using the Malmquist analysis were presented, and alternatives for each field were suggested by presenting the static and dynamic results as an integrated model.

Permit Simplification for Upstream Oil and Gas Operation in Indonesia: The Development Administration and Good Governance Perspectives

According to the Indonesian Constitution, any Vital and Strategic Sectors for the People's Interests have to be managed by the State. Oil and Gas until now are two of the Strategic and Vital Business Sectors in Indonesia. Therefore Indonesia establishes an institution namely the Special Task Force of Executive Oil and Gas Business Activity (SKK Migas). SKK Migas deals with Production Sharing Contracts with Exploration and Exploitation (Upstream) Oil and Gas Companies. In its activities, there are many regulations apply and required to obtain permits. The current problem nowadays are related to the type of the permits, the regulations and procedures to follow, as well as institutions/permit issuers to deal with are too many so that the permit system for Upstream Oil and Gas have caused handicaps for the industry to grow competitively. While on the other hand Indonesia still has a high dependency on Oil and Gas Industry for State Income reason and Energy Resilience. The old paradigm of the bureaucracy system in one the most causes of inefficiency and ineffectiveness of bureaucracy in Indonesia. Even though the reformation has been started since 1998 however the change of old bureaucratic system and mentality of the bureaucrats into the new paradigm of good governance is still very less and tend to be progressing very slowly. Overlapping and redundancies of regulations, authorities have caused Indonesia is less competitive destination comparing to the neighboring countries in attracting foreign investment.

Performance of cultural heritage institutions: A regional perspective

Most studies on performance evaluation in the cultural sector are based on the efficiency assessment of a network of institutions. Nevertheless, very few works take territorial divisions as the case study. Under this approach, we design a spatial production function which merges several cultural resources in order to optimize the impact of a regional system of cultural institutions in terms of cultural production and use of services provided. The aim of this paper is therefore to evaluate the efficiency of cultural heritage institutions in Spain from a regional perspective. We take regional networks of museums and libraries as emblematic case studies over a long period, from 2002 to 2020. We first apply a dynamic-network DEA model to measure efficiency, which allows the production function to be divided into stages and time intervals, considering inter-reliant inputs between production phases and time lapses. We also apply truncated regression models to study the effect of external variables on regional cultural efficiency, especially those related to socioeconomic conditions in regions, the scope of the cultural and tourist sector, and institutional indicators. Results show that regional cultural efficiency depends on the level of training and on the demographic structure rather than on economic wealth. Differences are also found between the goals of cultural production and cultural consumption (visitor impact). These findings might prove useful for policy implications regarding resource allocation vis-à-vis defining and accomplishing cultural purposes at a regional scale, and also for revealing causes of inefficiency with a view to improving quality in institutions –which ultimately drives economic development.