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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
111

A indústria de reciclagem e a questão ambiental / The recycling industry and environmental issues

Helio Francisco Corrêa Lino 02 August 2011 (has links)
Esta tese pesquisou a questão da reciclagem no Brasil, destacando quatro dos mais significativos resíduos sólidos recicláveis: as latas de alumínio, o papel, as garrafas polipolietileno-tereftalato (PET) e o vidro. Busca oferecer maiores subsídios sobre um tema que só recentemente tem sido melhor estudado, dada a sua ligação com o meio ambiente e a polêmica sobre o desenvolvimento sustentável. / This thesis researched about recycling in Brazil highlighting four of the most significatives recyclily solid residues, e.g. tin (aluminium) cans, paper, bottles made of polyethylene terephthalate (PET) and the glass. Due to its liaison with the environment and the controversies about the sustainable development, this thesis offer great subsidies about a theme that only recently has been deeply studied.
112

Strategische Allianzen im europäischen Eisenbahngüterverkehr

Buttermann, Volker 19 June 2003 (has links)
Seit den 90er Jahren ist die Wettbewerbsstruktur im europäischen Eisenbahngüterverkehr starken Veränderungen unterworfen. Die Auflösung staatlicher Monopole sowie die Öffnung nationaler Märkte implizieren einen intensivierten Wettbewerb, bieten jedoch gleichzeitig die Möglichkeit, sich über neuartige Formen der Allianzbildung Wettbewerbsvorteile zu sichern bzw. Eintrittschancen in neue Transportmärkte zu nutzen. Die Einführung wettbewerblicher Marktstrukturen im Eisenbahngüterverkehr betrifft einerseits die Schaffung gleicher Wettbewerbsvoraussetzungen im Verhältnis der Verkehrsträger untereinander (intermodal). Weiterhin steht die Einführung von Wettbewerb zwischen Eisenbahnverkehrsunternehmen im Vordergrund (intramodal). Die vorliegende Arbeit betrachtet Allianzmöglichkeiten entlang beider Dimensionen: im Mittelpunkt stehen Partnerschaften zwischen Eisenbahnverkehrsunternehmen und/oder intermodalen Partnern, die grundsätzlich auf die Gestaltung des intramodalen Wettbewerbs ausgerichtet sind. Aufgrund des Einbezugs intermodaler Partner, der vor dem Hintergrund integrierter Logistikketten immer bedeutsamer wird, gelangt die Perspektive der Beeinflussung des Wettbewerbs der Verkehrsträger untereinander mittels Allianzen ebenfalls in das Blickfeld der Untersuchung. Übergeordnetes Ziel der Arbeit stellt die Analyse des Allianzphänomens und die Systematisierung spezifischer Allianzmodelle im europäischen Eisenbahngüterverkehr vor dem Hintergrund der sich fortlaufend verändernden Marktstruktur und fortgesetzten Deregulierung dieser Branche dar. Das Hauptinteresse gilt der Allianzrelevanz in dieser Branche im allgemeinen und der Verdeutlichung branchenstrukturprägender Allianzmuster im besonderen. Betriebswirtschaftlicher Forschung in diesem Branchenumfeld soll damit ein stärkeres Gewicht beigemessen werden.
113

Three Essays on Financial Reporting and Auditing

Beer, Juliane 09 August 2022 (has links)
Diese Dissertation umfasst drei Studien über Finanzberichterstattung gemäß International Financial Reporting Standards (IFRS) und Wirtschaftsprüfung. Da die IFRS ein prinzipienbasiertes Standardsystem sind, haben Abschlussersteller beabsichtigte Ermessensspielräume bei der Erstellung ihrer Finanzberichte. Die ersten beiden Studien widmen sich den Fragen, wie genau Abschlussersteller entsprechende Ermessensspielräume ausüben und inwieweit dies von der Wahl des Abschlussprüfers abhängt. Die erste Studie untersucht die Anhangangaben zu Ermessensentscheidungen und Schätzunsicherheiten (gemäß IAS 1). Sie liefert deskriptive Belege für ein insgesamt zunehmendes Niveau der Offenlegung dieser Anhangangaben und dafür, dass das Offenlegungsniveau über verschiedene Abschlussprüfer hinweg variiert. Inspiriert durch die Ergebnisse der ersten Studie widmet sich die zweite Studie der Frage, welche Arten von Abschlussprüfern (d.h. dominierende im Vergleich zu nicht dominierenden Abschlussprüfern) Unternehmen dazu motivieren, (mehr) relevante Angaben zu den erwarteten Auswirkungen der erstmaligen Anwendung des neuen IFRS 16 „Leasingverhältnisse“ im Erstanwendungsjahr offenzulegen. Die Ergebnisse deuten darauf hin, dass Mandanten dominierender Abschlussprüfer weniger standardisierte Angaben („boilerplate disclosures“) machen und der Zusammenhang zwischen der Leasingintensität und dem Detaillierungsgrad der Angaben bei diesen Mandanten stärker ist. Die dritte Studie nimmt die Ergebnisse der ersten beiden Studien zum Anlass, die Struktur des Prüfungsmarktes zu untersuchen. Der Fokus liegt hierbei auf der Entwicklung der Konzentration des Abschlussprüfermarktes in Großbritannien und Deutschland rund um eine regulatorische Änderung auf EU-Ebene, die neue Prüfungsanforderungen mit sich bringt, einschließlich der obligatorischen regelmäßigen Rotation von Prüfungsgesellschaften. Während die Ergebnisse auf einen etwa gleichstarken Rückgang der Konzentration der Prüfungsmärkte in beiden Ländern hindeuten, zeigen weitere statistische Tests, dass dieser Rückgang auf nationale Besonderheiten zurückzuführen ist. / This dissertation comprises three papers on financial reporting and auditing. The first two papers examine whether the extent to which the principles-based character of International Financial Reporting Standards (IFRS) allows management to exercise judgement in the preparation of firms’ disclosures is contingent on auditor-type. The first paper explores judgment and estimation uncertainty disclosures (IAS 1) and provides descriptive evidence on an overall increasing trend of disclosure levels and that disclosure levels vary in the cross-section, among other things, by auditor. Inspired by that, the second paper goes a step further and emphasises on the question what type of auditors (i.e., dominant in comparison to non-dominant auditors) motivate firms to provide (more) relevant disclosures on how they expect IFRS 16 – a new standard on leasing – to affect their financial statements in the period of initial application. Results suggest that clients of dominant auditors use less boilerplate disclosures and that the association between leasing intensity and disclosure detail is stronger for those clients. Due to the results of both papers suggesting that the auditor choice matters when firms face judgement in the preparation of their disclosures, the (development of the) audit market structure underlying certain regulations becomes relevant. Thus, the third paper takes these findings of the first two papers as motivation to examine the audit market concentration in the UK and Germany around a regulatory change at the EU level that entails new audit requirements including mandatory audit firm rotation on a regular basis. While aggregate statistics suggest a decrease in market concentration of similar size in both countries, further tests reveal that these decreases are driven by national peculiarities.
114

Pengar, piller och policy : En marknadsanalys av den svenska och italienska antibiotikamarknaden och effekterna på antimikrobiell resistens / Pennies, pills and policy : A market analysis of the Swedish and Italian antibiotic market and the effects on antimicrobial resistance

Jonsson, Julia, Åkerman, Ylva January 2024 (has links)
Över - eller felanvänd antibiotika leder till ökad risk för antimikrobiell resistens. När en bakterie har blivit resistent så har det skapats en motståndskraft, vilket gör antibiotikan verkningslös. Antibiotika är ett livsnödvändigt läkemedel, då det används rutinmässigt vid kirurgiska ingrepp och för att bekämpa bakteriella infektioner. Det finns inget alternativt läkemedel, vilket innebär att om antibiotika blir verkningslös är de globala konsekvenserna katastrofala. Den negativa utvecklingen har resulterat i att EU - kommissionen klassificerar antimikrobiell resistens (AMR) som ett av de tre största hälsohoten i världen. Internationella organisationer har presenterat krav och rekommendationer för hur länder ska hantera antibiotika och dess resistens, vilket har implementerats olika väl. Sverige har en av de lägsta frekvenserna av resistenta bakterier inom EU, medan Italien har en av de högsta. Hypotesen är att de nämnda ländernas resistensgrad har ett samband med hur väl man implementerat strukturer, regleringar och strategier på antibiotikamarknaden. Hypotesen undersöks genom en marknadsanalys baserat på en anpassad SCP - modell där Sveriges och Italiens respektive utfall värderas.  I utfallen framgår det att Sveriges antibiotikamarknad är mer kontrollerad än den italienska. En mer styrd marknad skapar möjligheten att kontrollera antibiotikakonsumtionen, vilket i sin tur bestämmer resistensgraden. Å andra sidan innebär en mer kontrollerad marknad att läkemedelsföretagens vinstgaranti försvinner, dessa kan tvingas lämna marknaden vilket leder till brist på antibiotika. En mindre styrd marknad gynnar däremot läkemedelsföretagen då det finns en vinstgaranti och en större konsumtion. Nackdelen är att resistensgraden ökar. I marknadsanalysen presenterades även att länderna skiljer sig i ansvarsfördelning, då hälso - och sjukvård är mer decentraliserad i Italien jämfört med Sverige. Strukturer, regleringar och strategier för att hantera AMR implementerades nationellt i Sverige, medan det i Italien är upp till varje region att agera. Italiens ansvarsfördelning resulterar i att resistensgraden skiljer mellan det södra och norra regionerna, då regionernas styren skiljer i kvalitet.  Slutligen lämnas förslag på förändringar för respektive land. Sverige behöver erbjuda en vinstgaranti för läkemedelsföretagen för att kunna säkerställa tillgången till antibiotika. Det råder brist idag, vilket medför att marknaden behöver bli mer attraktiv för företagen. Italien behöver förändra ansvarsfördelningen och införa nationella strukturer, regleringar och strategier. Det kommer öka möjligheten för mer påkostade åtgärder som gäller för alla regioner, vilket hanterar AMR mer effektivt. / An excessive or incorrect use of antibiotics can result in an increased prevalence of antimicrobial resistance. When a bacterium has become resistant, resilience against antibiotics is created, which makes the drug ineffective. Antibiotics are vital drugs, as they are routinely used in surgical procedures and combat bacterial infections. Often, there is no alternative medicine, which means that when an antibiotic becomes ineffective, the consequences are catastrophic for the global population. The global increase in resistance has forced the European Commission to classify antimicrobial resistance (AMR) as the world's third largest public health threat. International organizations have presented requirements and recommendations for how countries should handle antibiotics and their resistance. However, it has been the nation’s responsibility to implement these changes. Sweden has one of the lowest prevalence of antibiotic resistant bacteria in the EU, while Italy has one of the highest. The essay hypothesizes that the mentioned countries' degree of resistance can be explained by how well structures, regulations, and strategies are implemented. The hypothesis is evaluated through a market analysis where a reconstructed SCP - model is applied where Sweden’s and Italy’s respective performance is presented. The essay found that the Swedish antibiotic market is more regulated than the Italian. A more regulated market creates the opportunity to control antibiotic consumption, which further controls the degree of resistance. On the other hand, an over - regulated market means that there is no guarantee of profit for the pharmaceutical companies which often forces the companies to leave the market. A less regulated market benefits pharmaceutical companies as there is a guarantee of profit and larger consumption. The disadvantage is that the degree of resistance increases. In the market analysis, it is also presented that the countries differ in the distribution of responsibilities, as healthcare is more decentralized in Italy compared to Sweden. The structures, regulations, and strategies to manage AMR were implemented nationally in Sweden, while in Italy it is up to each region to act. Italy's division of responsibility results in that the degree of resistance differs between the southern and northern regions, as the regions' governments differ in quality. Finally, the essay presents proposals for changes for each country. Sweden should offer a profit guarantee for pharmaceutical companies, as they need access to a broad selection of antibiotics. The existing shortage should be dealt with, which is why the market needs to be more attractive for companies. Italy needs to change the distribution of responsibilities and introduce national structures, regulations, and strategies. This will increase the possibility of more costly measures that apply to all regions, which will manage AMR more effectively.
115

One-to-One Marketing in Grocery Retailing

Gabel, Sebastian 28 June 2019 (has links)
In der akademischen Fachliteratur existieren kaum Forschungsergebnisse zu One-to-One-Marketing, die auf Anwendungen im Einzelhandel ausgerichtet sind. Zu den Hauptgründen zählen, dass Ansätze nicht auf die Größe typischer Einzelhandelsanwendungen skalieren und dass die Datenverfügbarkeit auf Händler und Marketing-Systemanbieter beschränkt ist. Die vorliegende Dissertation entwickelt neue deskriptive, prädiktive und präskriptive Modelle für automatisiertes Target Marketing, die auf Representation Learning und Deep Learning basieren, und untersucht deren Wirksamkeit in Praxisanwendungen. Im ersten Schritt zeigt die Arbeit, dass Representation Learning in der Lage ist, skalierbar Marktstrukturen zu analysieren. Der vorgeschlagene Ansatz zur Visualisierung von Marktstrukturen ist vollständig automatisiert und existierenden Methoden überlegen. Die Arbeit entwickelt anschließend ein skalierbares, nichtparametrisches Modell, das Produktwahl auf Konsumentenebene für alle Produkte im Sortiment großer Einzelhändler vorhersagt. Das Deep Neural Network übertrifft die Vorhersagekraft existierender Benchmarks und auf Basis des Modells abgeleitete Coupons erzielen signifikant höhere Umsatzsteigerungen. Die Dissertation untersucht abschließend eine Coupon-Engine, die auf den entwickelten Modellen basiert. Der Vergleich personalisierter Werbeaktionen mit Massenmarketing belegt, dass One-to-One Marketing Einlösungsraten, Umsätze und Gewinne steigern kann. Eine Analyse der Kundenreaktionen auf personalisierte Coupons im Rahmen eines Kundenbindungsprogrammes zeigt, dass personalisiertes Marketing Systemnutzung erhöht. Dies illustriert, wie Target Marketing und Kundenbindungsprogramme effizient kombiniert werden können. Die vorliegende Dissertation ist somit sowohl für Forscher als auch für Praktiker relevant. Neben leistungsfähigeren Modellansätzen bietet diese Arbeit relevante Implikationen für effizientes Promotion-Management und One-to-One-Marketing im Einzelhandel. / Research on one-to-one marketing with a focus on retailing is scarce in academic literature. The two main reasons are that the target marketing approaches proposed by researchers do not scale to the size of typical retail applications and that data regarding one-to-one marketing remain locked within retailers and marketing solution providers. This dissertation develops new descriptive, predictive, and prescriptive marketing models for automated target marketing that are based on representation learning and deep learning and studies the models’ impact in real-life applications. First, this thesis shows that representation learning is capable of analyzing market structures at scale. The proposed approach to visualizing market structures is fully automated and superior to existing mapping methods that are based on the same input data. The thesis then proposes a scalable, nonparametric model that predicts product choice for the entire assortment of a large retailer. The deep neural network outperforms benchmark methods for predicting customer purchases. Coupon policies based on the proposed model lead to substantially higher revenue lifts than policies based on the benchmark models. The remainder of the thesis studies a real-time offer engine that is based on the proposed models. The comparison of personalized promotions to non-targeted promotions shows that one-to-one marketing increases redemption rates, revenues, and profits. A study of customer responses to personalized price promotions within the retailer’s loyalty program reveals that personalized marketing also increases loyalty program usage. This illustrates how targeted price promotions can be integrated smoothly into loyalty programs. In summary, this thesis is highly relevant for both researchers and practitioners. The new deep learning models facilitate more scalable and efficient one-to-one marketing. In addition, this research offers pertinent implications for promotion management and one-to-one marketing.
116

聚醯亞胺薄膜在軟性電路板市場上之行銷策略研究 / Marketing strategy of polyimide film for flexible printed circuit board applications

張春來, Chang, Michael Unknown Date (has links)
聚醯亞胺薄膜用於軟性電路板市場從2006年起,由於競爭者眾多,整個產業環境變得十分嚴苛,事業屬性從獨佔性變成競爭十分激烈的寡佔性市場。此篇論文通過產業的總體環境分析及產業分析來對軟板市場進行區隔,並針對不同目標市場擬定行銷策略,將產品重新定位來滿足不同目標市場的需求,以期達到杜邦公司聚醯亞胺薄膜產品在軟性電路板市場的永續成長。 從含有產品價格因素在內的問卷調查中找到產業鏈中最有議價能力廠商的最重要需求及預估用量,進而做為公司開發下一世代聚醯亞胺薄膜產品的依據。 / Start from 2006, Polyimide films industry has become very competitive in flexible printed circuits applications. The polyimide film industry has transformed from monopoly to oligopoly, major players in flexible printed circuits market are DuPont, Kaneka, SKC-Kolon and Taimide companies. After analyzing the political, economics, social, technical and industrial trends, The FPC industry has been re-segmented into two segments – Basic market and Niche market. With different strategies been developed for different markets, we re-position our different type of Kapton® polyimide films for different markets and developed an executable marketing plan which will be test in selected customers. Through price included questionarries, we also found the key industrial decision makers’ unmet needs, price expectation and potential volume. Base on the findings, we are able to develop the next generation polyimide films to satisfy customers.
117

台灣地區醫院效率與生產力變動之研究-非參數DEA方法之應用 / Efficiency and Productivity Growth of Hospitals in Taiwan: Nonparametric Data Envelopment Analysis

王媛慧 Unknown Date (has links)
本論文對於醫療市場的生產績效研究,係由兩篇獨立的學術研究報告所組成,研究重點在於利用非參數資料包絡分析方法 ( nonparametric DEA approach ),估計醫院的生產技術,以衡量醫院的技術效率及不同年度間之生產力變動,進而分析不同醫院間,生產績效差異的主要原因。本論文所採用的研究方法與探討的主題,不同於國內既有的相關文獻。 第一部分:生產不確定性與醫院效率 本部分主要探討在醫院面對不確定性時的效率評估。一般而言,醫院有兩種生產上的不確定性來源:醫師或醫院的診療結果所導致的生產不確定性;及消費者對醫療服務需求的不確定性 (Arrow, 1963)。當醫院面對生產不確定性時,醫院效率將與廠商如何處理不確定性問題有關,亦即,當廠商事前規劃愈縝密,未來可能的產出失靈水準愈低,則其生產效率表現愈佳。本文利用民國 82 及 83 年(準)醫學中心與(準)區域醫院資料,模擬醫院在面對生產不確定性時,各種可能的產出失靈水準,以chance constrained DEA 模式 (Land, Lovell and Thore, 1993) 估算醫院的隨機技術效率,並與傳統、確定性的DEA模式所得到之結果,做一比較。 Chance constrained DEA模式與傳統DEA模式的不同,在於前者估計出的生產前緣,並不總是包絡所有的樣本點,亦即,允許某廠商之產出超越生產前緣或說允許產出失靈可能性之存在,而後者則否。實證結果發現,在chance constrained DEA模式下,私立醫院的技術效率高於公立醫院,且呈現統計顯著性的差異,但兩者間的差異隨著醫院事前準備程度的提高而縮小;而傳統DEA模式也顯示,私立醫院的技術效率確實顯著地高於公立醫院。此外,若產出失靈水準夠低,則chance constrained DEA模式的效率值與傳統DEA模式的效率值,兩者間的分配會呈現統計顯著性差異。 在面對生產不確定性時,欲提升公立醫院的生產效率,應提高廠商事先規劃的程度,才能與私立醫院之生產效率並駕齊驅。一般而言,廠商事先準備的程度高低,與醫院本身的特性有關,因此,欲改善公立醫院緩衝產能的準備程度,以降低產出失靈水準,有必要進行體制層面的改革,亦即,從進行人事變革、財務之授權與彈性化等方向開始做起,如此應可提高公立醫院的生產效率。 第二部分:全民健康保險制度與醫院生產力變動 全民健保實施後,民眾對醫療服務的可近性提高,醫院間的市場結構改變,因此,醫院生產力與效率的提升,成為眾所關切的焦點。為瞭解醫院在全民健保實施後,資源是否有效配置,本部分利用民國 82 至 86 年醫學中心、區域醫院與地區醫院等大小型醫院資料,以範疇DEA模式估計Malmquist生產力變動指標,並將之分解為技術變動、純技術效率變動、及規模效率變動等三項變動來源。 實證結果發現,從82至86年醫院整體平均效率而言,CRS(VRS)生產技術下的平均效率為 66.00%(74.87%),表示不論大小型醫院,平均而言,皆存在技術不效率的情形。再者,在民國84年,亦即全民健保實施的年度,其效率水準明顯較其他年度為低,其餘年度的效率水準都相對較高,此一結果意謂,政策干擾對於醫院效率表現的影響,是短期性的。另外,小型醫院皆較大型醫院不效率,兩者的效率差異呈現統計顯著性;以權屬別而言,不論是大型醫院或小型醫院中的私立醫院,其生產效率均優於公立醫院,且兩者的效率差異呈現統計顯著性。而透過迴歸分析顯示,全民健保實施、權屬別之虛擬變數、佔床率、平均住院日、及以醫院產出衡量的集中度指標等,是影響醫院生產效率的重要因素。 從Malmquist生產力變動( et al., 1994)來看,平均而言,82-86年間醫院生產力成長率約在 -3.06 % 左右。就生產力變動來源而言,技術成長率(-2.74 %)與整體效率成長率(-0.33 %)均為負,而技術變動則是阻礙生產力成長的主要原因。此外,若以醫院整體效率變動來源來看,平均而言,整體效率退步是由於規模效率變動所致(-0.74%)。 此外,本文著重在 et al.(1994)、Ray and Desli (1997) 及Grifell and Lovell (1998) 三種定義下的Malmquist生產力變動指標之比較。研究結果發現,Grifell and Lovell (1998) 的一般化Malmquist生產力指數,並沒有正確衡量廠商的生產力變動及其變動來源項。而利用Kruskal-Wallis檢定結果發現,三個模式中的生產力變動差異,並不具統計顯著性,而變動來源項(技術變動與規模效率變動)亦顯示相同的結果。 / This dissertation is focused on the efficiency and productivity studies of hospitals in Taiwan. It includes two independent academic papers. The primary intention is to introduce the newly developed ideas in the measurement of efficiency and productivity, rather than to create new ones. The utilization of these ideas has not, however, been discussion in print. And some of the arguments we used and brought together are new regarding to the literature of hospital efficiency and productivity measurement. Utilizing the non-parametric data envelopment analysis (DEA) approaches, efficiency scores and productivity change indexes were estimated. Efforts were made to explain the difference of productivity performance among individual hospitals. Nevertheless, the methods we used and the economic approach behind them distinguish this study from other empirical studies of the medical market. Part I  Market Uncertainty and Hospital Efficiency This part of the dissertation is focused on the measurement of efficiency of hospitals, incorporating uncertainty. There are stochastic variations in production relationships for hospitals. Generally speaking, the uncertainty of hospitals comes from two major sources: the natural uncertainty of medical cares; and the uncertainty of demands for medical cares (Arrow, 1963). Given the uncertainty in the medical market, the efficiency of hospitals hinges on how decision-makers deal with it. Undoubtedly, an optimal planning of the output buffers improves the efficiency performance. Using the hospital survey data in 1993 and 1994, and employing the chance constrained DEA model (Land, Lovell and Thore, 1993), the stochastic efficiency indexes of public and private medical centers and regional hospitals were estimated. Compared with deterministic frontier enveloping a given set of sample observations all the time, the chance-constrained frontier envelops them most of the time. That is, the chance constrained DEA allows the possibilities of output failure. Imposing different values of output failure probability, the estimation results were compared with the traditional (deterministic) DEA models. The empirical evidences of the chance constrained DEA model showed that, on average, private hospitals performed significantly better than public hospitals. This result matches with the result of the traditional DEA model. With Mann-Whitney U test, we compared the distributions of efficiency indexes under chance constrained DEA and deterministic DEA models. The test results showed that the difference between these two different models is statistically significant given a higher probability of output failure. These results imply that the nature of risk and the manipulation for risk are different for public and private hospitals. We also find that that the efficiency performance of public hospitals could be improved by the increasing of its reserve capacity. Part II  National Health Insurance and Hospital Productivity Change In this part of the dissertation, we examine the impact of NHI on hospitals, and trace the sources of hospital productivity growth in Taiwan. To pursue our goal, we employ a data consisting of 157 medical centers, regional hospitals and district hospitals over the period 1993 to 1997, and resort to the Malmquist productivity index to measure total factor productivity change. The index could be decomposed into three components: technical change, pure technical efficiency change and scale efficiency change. The estimation technique used in the study is the deterministic non-parametric DEA approach. The results we find are revealing and suggestive to the public and the government in order to promote and assure the efficient delivery of quality health care. The average efficiency scores are 66.00% (74.87%) for CRS (VRS) technology and it means that there are substantial efficiency losses for the sample hospitals during the study period. The efficiency score of the hospitals as a whole in 1995 (the beginning year of NHI) was much lower than the other 4 years' efficiency scores. A censored Tobit regression analysis is used and identifies that NHI policy, ownership, rate of bed occupancy, average length of stay and the output-specific concentration level were all the significant determinants of technical efficiency. Empirical results indicate that most medical care regions became more output-specific concentrated. Total factor productivity on average deteriorated at an annual rate of -3.1%, and it was dominated by substantial technical regresses at an annual rate of -2.74%. The small hospitals were severely affected by NHI. Furthermore, within large and small hospital groups, the difference in technical change was statistically significant, but the differences in TFP and the associated components between ownership were not. Special attention was paid to compare  et al.(1994), Ray and Desli (1997) and Grifell and Lovell (1998) approaches to decomposing the Malmquist productivity index. Empirical results indicate that the first 2 approaches yield accurate productivity changes, while GL doesn't. However, they produce almost the same magnitude of average TFP. In addition, no significant differences in the measured technical change and efficiency change were found among the three approaches.

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