Infraestructura Vial; Gasto Público; Eficiencia Técnica; Análisis de Eficiencia; SFA. Road Infrastructure; Public spending; Technical Efficiency; Efficiency Analysis; SFA / La literatura menciona que la brecha en infraestructura vial puede representar una limitante al crecimiento económico, en especial, a nivel regional. El presente documento se centra en el análisis de la eficiencia técnica de la infraestructura vial en las regiones de Perú, durante el periodo comprendido entre 2007 y 2018. La metodología se compone por dos etapas. La primera tiene por objetivo determinar un índice que recoja la eficiencia del gasto público en infraestructura vial, sobre la base del análisis de eficiencia estocástica. Mediante el cual se encuentra que, un mayor gasto a nivel regional no necesariamente se refleja en una mejora en la infraestructura vial. Así, existen regiones con un menor monto destinado al gasto en carreteras, pero que cuentan con un mejor desempeño en la ejecución. En la segunda etapa, se busca asociar este indicador de eficiencia con el crecimiento de las actividades económicas a nivel regional, mediante la aplicación de Método Generalizado de Momentos. Los resultados muestran que el índice de eficiencia explica en gran parte el crecimiento de las actividades económicas. / The literature shows that the gap in road infrastructure can represent a limitation to economic growth, especially at the regional level. This article analyzes the technical efficiency of the road infrastructure in the 24 regions of Peru for the period between 2007-2018. The methodology consists of two stages. The first one aims to determine an index that collects the efficiency of public spending on road infrastructure, based on the Stochastic Efficiency Analysis. For the construction of the efficiency index, the following are identified as outputs: (i) Total National Length, (ii) Total Departmental Length and (iii) Total District Length. The main input used was spending on regional road infrastructure. The results suggest that higher spending at the regional level does not imply an improvement of the roads. There are regions with a lower amount earmarked for public spending on road infrastructure, but that have a better performance in execution. In the second stage, we seek to associate this efficiency indicator with the growth of economic activities at the regional level, through the application of Generalized Least Squares. The dependent variable was the domestic product and the explanatory variables are made up of variables such as the efficiency index, electricity consumption, hectares worked, educated EAP, mobile service lines, among others. The results confirm that the efficiency index largely explains the growth of economic activities. / Trabajo de investigación

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地方稅捐稽徵機關績效之良窳攸關地方政府庫收，更直接影響地方經濟成長、資源配置效率與所得分配之公平；本文試圖採用能排除外在因素與隨機干擾之三階段產出導向資料包絡分析法（以下簡稱DEA），針對23個地方稅捐稽徵機關2004年迄2008年資料進行管理效率評估，再以隨機邊界分析法（以下簡稱SFA）分離外生因素及隨機干擾以調整各機關產出至相同基準後，再評估排除外在與隨機干擾因素的管理效率。 未考慮外生因素與隨機干擾的DEA效率評估結果顯示，有高達88.7%及82.6%的地方稅捐稽徵機關分別於技術效率及純技術效率上尚有改善空間。第二階段SFA估計結果顯示，土地移轉現值、機關內大專畢業以上員額之比例及員額平均年齡對管理效率皆有正向影響；而總統大選期間及有高鐵停靠站之縣市除對部分產出無顯著影響外，對管理效率之提升亦具優勢；然而，服務轄區土地面積與實徵淨額之效率呈負相關，卻與違章漏稅裁罰效率呈正相關；地方首長選舉期間除為避免清理欠稅招致民怨而降低技術效率外，對其他管理效率則皆呈正相關；又都市計畫面積占稽徵區域比例與地方稅實徵淨額之管理效率呈正相關，卻與欠稅清理效率呈負相關。調整後之DEA結果顯示各項效率值與調整前比較皆存在顯著差異，顯示排除外生因素與隨機干擾影響以避免效率值被錯估確有其必要性；但仍有高達93.05%及68.7%之地方稅捐稽徵機關分別於技術效率及純技術效率上存有改善空間；又多數稽徵機關處於規模報酬遞增階段，即產能過剩而造成資源浪費。另與財政部稽徵業務考核成績比較分析，在規模效率平均值排名方面，除臺南市外，甲組機關排名普遍優於乙組機關；但純技術平均效率值之排名卻有一半以上之甲組機關表現反而不如部分乙組受評單位；顯示甲、乙組之分類歷經多年仍沿襲舊有分組將使各機關未能於適合之群組中受考而錯估其績效。 基於上述實證研究結果，本文提出下列政策性建議： 一、建議逐期分階段調整人力及預算至最適規模，以善加運用資源降低產能過剩情形。 二、建議各機關應引用環保之共乘概念，加強政府機關間橫向溝通、聯繫與合作。 三、若情況允許，建議可不區分甲乙組針對全體地方稅捐稽徵機關進行考核。若人力、時間或其他情況不允許，建議研擬具體方案隨各機關規模改變而有重新分級之機制。 四、建議甲組機關亦可選擇純技術效率較佳之乙組機關作為觀摩學習之對象。 五、建議財政當局可考慮將外在因素之影響納入評核，以提升考核之信度與效度。 最後，臺灣自2010年底起將有部分縣市改制為直轄市，考核編組方式勢將有所變革，有待後續研究者追蹤探討；而改制後所引起之資源重分配亦可作為未來之研究議題。 / The Performance of Local Tax Bureaus is relevant to the revenue of Public Treasury, and even has direct impacts on local economic growth, efficiency of resource allocation and equity of income distribution. This paper attempts to use three-stage out-oriented DEA which can rule out the external factors and the statistical noises to evaluate the efficiency of 23 Local Tax Bureaus in Taiwan during the period of 2004 to 2008. After measuring slack variables of each Bureau in the first stage, the Stochastic Frontier Analysis (SFA) model is used to separate the external factors from the statistical noises, and then adjust the output of each Bureau to the same benchmark. Finally, DEA is again used to evaluate the efficiency of 23 Local Tax Bureaus. The DEA efficiency evaluation results in the first stage show that up to 88.7% and 82.6% of the Local Tax Bureaus still have an ample room to improve their technical and pure technical efficiency. In the second stage, the SFA model estimates show that “the present value of land transfer”, “the proportion of post-graduates in the Bureaus” and “the average age of the staff” have positive effects on the efficiency. “The period of Presidential Election” and “the cities or counties that Taiwan High Speed Rail have set station up” have insignificant impact on part of the outputs, but still have the advantages to enhance the efficiency. However, “the expanse of land in service area” has a negative correlation with the efficiency of net taxation, but is positively related to the efficiency with the fine of illegal tax evasion. “The election period of Local County Executive” has a positive correlation with the efficiency except that tax arrears liquidation might reduce technical efficiency. “The ratio of urban-planed area to the tax levy regional” and the efficiency of net taxation are positively correlated, but negatively related to the efficiency of tax arrears liquidation. After excluding external factors and the statistical noises, the third-stage DEA evaluation results are significantly different from those in the first stage, indicating that it is necessary to exclude impacts of external factors and statistical noises in order to avoid the misjudged value of efficiency. There are still as high as 93.05 % and 68.7% of the Local Tax Bureaus have an ample space for improvement respectively on technical efficiency and pure technical efficiency. Most of the Tax Bureaus are at the increasing return of scale stage, implying that the surplus of capacity cause the waste of resources. Finally, compared with the performance evaluation held by Ministry of Finance, the empirical results in this study show that although the classification of Local Tax Bureaus has been adopt for many years, Bureaus’ performance evaluation results might be misjudged in the unsuitable group. Based on the above empirical results, this research attempts to propose the following policy suggestions: 1. It is recommended to adjust the phase of manpower and budget to the optimum scale for the best using of resources and to reduce inefficiency of excess capacity. 2. Enhancing horizontal communication among government agencies may improve the efficiency of Local Tax Bureaus. 3. If possible, it is recommended to evaluate Local Tax Bureaus without classification. If not, a mechanism of re-rating according to the scale change of Local Tax Bureaus may be needed. 4. It is proposed that Local Tax Bureaus of Group A can take lesson from those of Group B with better pure technical efficiency to learn from. 5. It is suggested that government authorities have to exclude the effect of external factors to improve the reliability and validity of performance evaluation. At the end of year 2010, several counties will be restructured in municipalities. The classification of Local Tax Bureaus for performance assessment must be changed. The reallocation of resources caused by restructuring may be used in future studies.

The present study is an attempt to analyze the impact of changing policy regime during the liberalization era on the behaviour of 81 sample firms in Indian electronics industry in terms of factor productivities. We categorise a period of 12 years (1993-2004) as the two phases of liberalisation: - Period/ Phase 1: 1993-1998 and Period/ Phase 2: 1999-2004. The 81 sample firms are segregated into four primary sub-sectors of electronics industry based on their use pattern: communication equipments, computer hardware, consumer electronics and other electronics. The objective is to trace the growth of output in the four sub-sectors in Indian electronics industry over two phases of liberalisation and to determine the relative contributions of Input Growth (IG) and Total Factor Productivity Growth (TFPG) to Output Growth (OG). Further, the study focuses on determining the relative contributions of Technological Progress (TP) and Technical Efficiency Change (TEC) to TFPG and establishes the influence of firm specific managerial decision making and management efficiency variables on TEC and TP. The methodology follows a three-step approach in order to achieve the above objectives. The first step is to determine a potential stochastic production function using stochastic frontier production function model and measure firm-wise technical inefficiency levels. The second step is to measure the growth of TFP over two phases and to derive the components TEC and TP. The third step measures the influence of management decision variables on TEC and TP using a frontier approach model on a panel data. The contribution of labour to output was found to be higher than the contribution of capital in all four sub-sectors. However, capital contribution improved in phase 2 relative to phase 1 for computer hardware and other electronics sub-sectors. Computer hardware was the only sub-sector that experienced an improvement in returns to scale from constant returns to scale in phase 1 to increasing returns to scale in phase 2 of liberalisation. The Technological Progress (TP) and Technical Efficiency Change (TEC) that contributed to TFPG exhibited a contrasting relationship for all the four sub-sectors in the electronics industry: TEC declined when there was high TP while it improved when there was a decline in TP. This could be because Indian electronics firms generally focus on either technology imports/ develop indigenous technology to achieve TP or to assimilate the imported/ indigenous technology for better use. The lag in assimilation of imported/ developed technology could be a reason for the negative relation between TEC and TP. The communication equipment sub-sector had a balanced growth in terms of TEC and TP among the four sub-sectors. The computer hardware and the other electronics sub-sectors were worse performers in terms of TEC in period 2 relative to period 1 and so had been the electronics industry as a whole. The computer hardware sub-sector had the highest average OG in period 2 relative to period 1 among all the sub-sectors due to relatively high contribution of IG. Other electronics sub-sector had the highest average TP that compensated for the negative average TEC. On an average, percentage contribution of TP to TFPG was high for the electronics industry and its sub-sectors in period 2 relative to period 1. This is an indication that the sub-sectors of Indian electronics industry have strived and achieved steady technological progress in the period of economic liberalisation to cope with the intensifying competition internally as well as externally. The sample firms in the electronics industry were in favour of towards external acquisition of sophisticated technology, which explains the relatively high contribution of TP to the TFPG of the industry. However, this was not followed up with adequate in-house R&D in order to develop indigenous technology or to absorb imported technology as a result of which TEC for the sub-sectors and the whole industry suffered. Growth in Operating Margin (OMG) and Growth in Returns on Capital Employed (ROCEG) generate additional revenue that could be ploughed back into the firm for improvement of its existing indigenous technology or absorption of imported technology thereby leading to improvement in TE and TP. The positive influence of OMG as well as ROCEG on TEC and TP for all the sub-sectors is an indication of efficient management in these sub-sectors in utilizing assets and profits to generate earnings. However, the trend of operating margin and returns on capital employed had been declining for all the sub-sectors. Inventory management proved to be costly for TP as financial resources diverted to maintain inventory had an undesirable effect on their indigenious technology. Most of the sample firms in the electronics industry were found to have incurred R&D expenditure to derive tax incentives. As a result the resources got diverted away from other creative operational or skill improvement efforts to unproductive and wasteful R&D activities. Thus, R&D did not have the desirable influence on the components of TFPG. The present study showed that unplanned and ad hoc technology imports or even raw material imports was not conducive to the growth of both the components of TFPG. Older firms need to develop their technology or adequately import better and more sophisticated technology. This would enable older (more experienced) electronic firms to overcome the negative influence of age, reflected in our analysis. This is, however, applicable to only those segments of the electronics industry where firms preferred to serve lower end of the market as well as lower end of the technological spectrum (eg. Computer hardware and other electronics sub-sectors). Electronics industry like any other capital goods industry offers scope for vertical integration. Management of the firms in electronics industry should emphasize on vertical integration, expansion of scale of operations and should initiate R&D investments to build up R&D base, among others to improve TEC and TP. This would also help to check the decline in operating margin and returns from invested capital among the firms. Thus, improved managerial effectiveness and decision making do help in the form of generating thereby surpluses facilitating to achieve higher TP and even TEC. Regional and State governments should provide adequate policy support and appropriate industrial infrastructure to electronic firms which would in turn improve their managerial effectiveness and TFPG.

海外華人人口，截至2004年底止，約為3,808萬人（不含香港、澳門），政府為照顧為眾多之海外僑胞，先於1926年於國民政府下設僑務委員會以推進僑務，復為擴大服務僑社並增進僑民福址，於1985年針對海外僑社需求，選擇華僑眾多之地區，設置華僑文教服務中心，自1985年起迄2004年底止，僑委會在海外各地前後共設置了十七個文教服務中心。為維持該等中心之運作，政府每年均編有巨額預算挹注，為瞭解相對於投入之資源，中心之產出是否符合經濟學上『投入』與『產出』之生產效率概念，本文之研究爰以產出導向之資料包絡分析法建立實證模型進行探討，同時以各文教服務中心為一決策單位，將2001年至2004年間各文教中心之投入及產出項目投入實證模型中，以計算各文教中心的經營績效。 實證結果顯示，海外文教中心整體的技術效率平均值介於2.4662與3.1605之間，同時規模效率平均值大於1，顯示造成各文教中心技術無效率的來源，大部份來自於純技術效率，另一部分則來自於規模無效率。 同時依實證結果資料可以發現，（一）僑委會截至2004年止之十七個文教中心，在各種不同的組合下，僅有4至9個中心之效率值為1，占全部文教中心的二成至五成，顯示整體經營績效有待加強與提升；（二）以僑委會關閉倫敦及墨爾本文教中心雖與實證分析結果相符，然績效較墨爾本中心為低之雪黎文教中心卻未關閉之情況而言，益顯數據性資料於決策過程中之重要性；（三）以全球華人人口分配來看，北美洲地區文教中心之技術效率值，無論在固定或變動規模下，就各種組合而言，均較其他地區文教中心之效率值為佳，顯示除應提高北美地區以外中心之效率外，似乎也反映了服務海外僑胞之資源分配是否過度集中，及與僑胞互動應予加強之問題。 最後，由於本研究係首次將DEA運用於駐外機構經營效率之評估，因此本文之相關實證模型將可作為評估我國其他部會所屬駐外機構效率衡量之基礎及參考。 / The overseas Chinese population, up till 2004, approximates 3.8 millions (not counting Hong Kong, Macao). To attend to their needs, the government has first established the Commission of Overseas Chinese Affairs under the Nationalist Government in 1926. To better and further serve this overseas Chinese community, the government has chosen among several populous areas to set up Chinese Culture and education service center later in 1985. Between 1985 and the end of 2004, 17 service centers have been set up. To keep these centers running requires a big budget support from the government each year. To examine if these centers provide values that conform to the economic concept of "the input" and "the output" production efficiency, this article has used the data envelopment analysis method to establish the real diagnosis model. This model has used various culture and education service centers as policy-making units from 2001 to 2004 to evaluate the efficacy of these service centers. Test results have shown that the mean value of central whole technical efficiency is between 2.4662 and 3.1605. Also, the mean value of scale efficiency is bigger than 1. This demonstrates the inefficient central technology rate of the service centers results mainly from pure technical inefficiency, and partly from diseconomy of scale. On the other hand, test results also show that, (1) up till 2004, among 17 culture and education centers, just only remain 4 to 9 with central efficiency value of 1 under different kinds of combinations. The fact that they account for two tenths to five tenths of the total number of service centers demonstrates the need for improvement in their operating performance (2) the closing of both London and Melbourne culture and education centers does not conform to the findings of the real diagnosis analysis, but Sydney center is not closed, which reveals the importance of data material in the decision-making process; (3) looking at the distribution of global overseas Chinese population, the technology efficiency values for culture and education centers in North America area are far higher than other areas, measured by all sorts of combinations regardless of fixed or variable scale. This has revealed issues of not only efficiency enhancements for local centers excepting this area, but also excessive concentration of service resources allocated within the region and augment the co-activity with compatriots. Finally, since this is the first time DEA has been utilized in a research to evaluate the management efficiencies for government agencies abroad, the real diagnosis model presented in this article might be used as a reference for similar studies in the future.

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本研究發展新的計量方法，運用隨機邊界法將單調性和曲度條件等性質納入迴歸模型，使用聯立迴歸模型進行估計，藉此讓係數估計值不易出現違反經濟理論的情況。 採用台灣2002年至2015年，51家商業銀行進行實證分析，發現本研究方法估計產出方向距離函數時，僅有5%以下的樣本點不符合單調和曲度等性質，用於估計產出面距離函數時，僅有2%以下的樣本點不符合。進一步探討台灣銀行業之非意欲產出--逾期放款--對估計技術效率的影響，顯示不考慮此非意欲產出造成整體銀行業、非金控本國銀行與外商銀行的技術效率被高估，而金控本國銀行的技術效率則被低估，此外，分析2007年金融風暴前後銀行業經營效率變化，顯示考慮非意欲產出銀行業經營效率顯著提升，然而，未考慮非意欲產出銀行業經營效率卻下降，兩者結果有著極大的差異。 / The aim of the paper is to develop a new approach, which is stochastic frontier analysis imposing monotonicity and curvature conditions, then using simultaneous regression model to estimate. By the approach, it can solve the problem of most of the coefficient estimates violating the economic theory. The study uses the data of 51 commercial banks in Taiwan from 2002 to 2015 to conduct the empirical analysis. It indicates that by output directional distance function, less than 5% sample points violate the monotonicity and curvature conditions; by output distance function, less than 2% sample points don’t obey the restricted conditions. Further, the paper discusses the effect of commercial banks’ undesirable output- non-performing loan- on estimating technical efficiency. The results show that ignoring the undesirable output cause the technical efficiency of overall banks, non-finance holding banks and foreign banks are overvalued, and the technical efficiency of finance holding banks are undervalued. Furthermore, analyze the change of business efficiency after financial crisis in 2007. It points out that using the model consider the undesirable output, the banks’ efficiency rises. However, using the model no consider the undesirable output, the banks’ efficiency decreases. There is an extremely conflict between two approach.

綜觀國內外探討金融產業經營效率之相關文獻，多數針對銀行、證券、保險中其一產業進行獨立實證研究，較無法將金融控股之綜效表現加以捕捉並體現在估計效率值中，也因此在本文中，將同時涵蓋銀行業務與證券業務，並以納入金控體制與否加以區分為不同子集合進行探討，透過數理方法聯結金控體制下銀行與證券業務部門兩者間因多角化經營所產生之綜效，以修正傳統方法上表現綜效法上之不足，使估計效率值具有更高的參考依據。 此外，研究產業效率所參考之研究方法，在相關文獻中無參數法乃以資料包絡分析法(Data envelopement analysis, DEA)為多數研究者所採用；參數法則以隨機邊界模型(stochastic frontier approach, SFA)為主要研究方法，進一步在不同群組技術效率之比較中，Battese et al. (2004) 與 O’Donnell et al. (2008)提出為多數研究者所接受之共同邊界模型(Metafrontier)，而Huang et al. (2013)所提出之修正模型使共同邊界模型在效率研究上更加完備，本文則希望以此修正模型作為主要研究模型，並同時引用Battese et al. (2004)傳統模型加以比較：(1)考慮綜效前後 (2)傳統模型與修正模型間效率值的差異，期待為後續相關研究者在方法論上提供參考依據。 關鍵字：經營效率、技術效率、共同邊界、計量方法、關聯結構法、金融控股銀行 / This study aims to discuss the evidence suggested that synergy improve the operating performance of Taiwan’s commerical banks and securites firms. Furthermore, efficiency comparisons amongst two basis metafrontier models, Haung et al.(2013) and Battese et al.(2004), and copula-adjusted metafrontier. The empirical results suggest that copula-adjusted metafrontier could significantly improve the efficiency of financial holding companies based on the data of sample period 2001-2012. On the framework of copula-adjusted metafrontier, the evidence also imply that financial holging companysubsidiary technical efficiency is better than non-financial holding company compared to the framework of Haung et al.(2013) and Battese et al.(2004), the conclusion emphasis that synergy is perhaps one crucial key factor influenced the efficiency estimation. Otherwise, this study appears to support the copula-adjusted metafrontier model is also well-adjusted compared to programming techniques because not only it enables the statistical inferences to be drawn, but also provides more efficiency estimations.

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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.