本文採用一階段隨機邊界分析方法，建立一多投入多產出之投入距離函數模型，衡量民國81~91年間台灣66家國際觀光旅館經營之相對技術效率，同時探討造成不效率之因素。並利用投入導向Malmquist生產力指數進一步分析國際觀光旅館產業生產力改變的原因與幅度。 整體而言，台灣國際觀光旅館產業之經營效率大致呈現緩慢進步之趨勢。造成整體產業生產力提升之原因，主要為業者對於投入產出配置使用之效率改善，而非生產技術進步。除了整體經濟景氣因素當然影響觀光產業之興衰外，個別國際觀光旅館業者之效率表現仍受到許多因素影響。諸如規模、國際化程度等內部原因，及旅館是否位處風景區、所在地縣市政府對觀光發展投注之資源預算和該地市場競爭程度等外在因素。 從政府政策方面來分析，若以整體國際觀光旅館產業經營效率來衡量我國觀光產業興衰，民國87年隔週休二日政策及民國90年實施之全面週休二日政策，的確有效帶動國人休閒旅遊之風潮，促進國內觀光發展。而各縣市政府觀光相關支出與國際觀光旅館生產力變動之關係，呈現正向相關，則表示政府支出增加有助於觀光產業蓬勃發展，並增加國際觀光旅館之經營效率。由於觀光產業生產具外部性，政府積極利用觀光產業以帶動經濟景氣繁榮成長的政策應當可行。 / In this paper a multi-output, multi-input and input oriented distance function is built by one-stage stochastic frontier approach (Battese and Coelli, 1995) to estimate the relative efficiency of the 66 international tourist hotels in Taiwan in 1992~2002 and to explore the determinants of technical efficiency. In addition, the Malmquist productivity index model is used to analyze the range and the causes of the productivity changed. The results reveal that managerial efficiency of international tourist hotel industry improves gradually. The productivity growth can be attributed to efficiency gains, but not the effects of technical progress. There are significant differences in efficiency due to difference not only in the macroeconomic situation, but also in many other individual factors, such as scale, joining an international chain, located in scenic area, local government other economic service expenditure and competitiveness. Analyzing the government policy, the implementations of two-day-off twice a month policy in 1998 and two-day-off per week policy in 2001 have fostered domestic traveling and expanded tourist hotel industry. The local government other economic service expenditure has positive effect on efficiency of international tourist hotels. That is to say, increasing in local government tourist expenditure will promote tourism market and improve efficiency of a hotel. Because of the production externality in tourism industry the idea that government tries to promote tourism to benefit economic development would be workable.

BARROSO, Juarez Coelho. Avaliação da Pesca da Lagosta Vermelha (Panulirus argus) e da Lagosta verde (Panulirus laevicauda) na Plataforma Continental do Brasil. 2012. 109 f. : Dissertação (mestrado) - Universidade Federal do Ceará, Centro de Ciências Agrárias, Departamento de Engenharia de Pesca, Fortaleza-CE, 2012 / Submitted by Nádja Goes (nmoraissoares@gmail.com) on 2016-07-18T13:17:31Z No. of bitstreams: 1 2012_dis_jcbarroso.pdf: 2594115 bytes, checksum: ce2b67584a13e444ae16d1c1c08898f1 (MD5) / Approved for entry into archive by Nádja Goes (nmoraissoares@gmail.com) on 2016-07-18T13:17:44Z (GMT) No. of bitstreams: 1 2012_dis_jcbarroso.pdf: 2594115 bytes, checksum: ce2b67584a13e444ae16d1c1c08898f1 (MD5) / Made available in DSpace on 2016-07-18T13:17:44Z (GMT). No. of bitstreams: 1 2012_dis_jcbarroso.pdf: 2594115 bytes, checksum: ce2b67584a13e444ae16d1c1c08898f1 (MD5) Previous issue date: 2012 / Extractive fishing lobster in Brazil is an important economic activity which includes different social sectors in the coastal region and provides an average annual income of USD$ 84 million. The great demand for the product, the high value in international market, expansion of the artisanal fleet, failure in enforce of conservation measures, the fishing impact on ecosystems and perhaps climate variability, have led to a high exploitation or overexploitation of the crustacean stocks. The evaluation and fishery prediction depends of biological and fisheries data collection, in the last two decades the absence of these data and the lack in the life cycle study generated a high level of uncertainty in the management of the fishery. In the present study, a comprehensive analysis is done of biological and fishery information generated by the thesis project and the data that precedes. The areas of the stock aggregation were distributed into 31 strata covering an area of 356.610 km², divided into two regions: shallow < 50 m (160.510 km²) and depth between 50 and 100 m (196.100 km²). The medium productivity index (1999-2006) between species was 29,75 kg/km² in Panulirus argus and 8,39 kg/km² in P. laevicauda; in different strata varied between 0.02 and 217.0 kg/km² (both species). Catchability coefficients ranged between 0.10 and 0.14, showing that the fishing gears (caçoeira, manzuá and cangalha) have a low efficiency in the lobster fishery. The sampling of landings between different fishing periods (1970-1979, 1980-1988 and 1989-1993) showed a progressive decrease in the small lobsters and as a result the mean length showed an increasing trend. The random samples on boats that fished between 20 and 35 m (1999), revealed that lobsters recruited (50 and 75 mm, Lc) accounted for 91% (P. argus) and 96% (P. laevicauda) of the total catch, which with the expansion of fishing (increased effort) was accompanied by a decreasing of the CPUE by fishing grids (between 1974 and 1991), showed a growth overfishing which are probably influencing in the high variations of the annual catches and its negative trend observed in the last fifteen years (1995-2009). The analysis between CPUE and abundance (N), revealed a lack of proportionality (hyperstability) between both parameters, which could be affecting the relationship between CPUE and effort and overestimating yield maximum sustainable (YMS). We estimated a yield maximum sustainable per unit area of 14 kg/km² and a yield maximum sustainable preliminary between 5,000 and 5,604 t. This empirical result should be confirmed through the development of stratified random sampling is proposed in this study. There is not evidence of recruitment overfishing in the stocks, but high rates of exploitation in the deep stock (50 to 100 m) of P. argus, composed mainly of older specimens and high reproductive power, could be accentuating the risk of low recruitment and collapse. This high level of uncertainty which takes the lobster fishery on the continental shelf of Brazil must be addressed by new ways of thinking, by a long-term and acquiring new skills and knowledge to develop fisheries sustainable. / A pesca extrativa de lagosta no Brasil é uma atividade econômica importante que engloba diferentes setores sociais na região costeira e que aporta um ingresso médio anual de 84 milhões de dólares. A grande demanda do produto, o elevado valor no mercado internacional, a expansão da frota artesanal, o não cumprimento das medidas de conservação, o impacto da pesca no ecossistema e possivelmente a variabilidade do clima, tem propiciado uma elevada explotação ou sobre-explotação dos estoques destes crustáceos. A avaliação e previsão da pescaria dependem da coleta de informação biológica e pesqueira, em que nas duas últimas décadas a ausência destes dados e a falta de estudo do ciclo de vida gerou um elevado nível de incerteza na administração da pescaria. No presente estudo, foi realizada uma análise integral da informação biológico-pesqueira gerada pelo projeto de mestrado e pelos dados que o precedem. As zonas de agregação dos estoques pesqueiros se distribuíram em 31 estratos que cobrem uma área de 356.610 km², divididos em duas regiões: rasa < 50 m (160.510 km²) e profunda entre 50 e 100 m (196.100 km²). O índice de produtividade médio (1999-2006) entre espécies foi de 29,75 kg/km² em Panulirus argus e de 8,39 kg/km² em P. laevicauda; nos diferentes estratos variou entre 0,02 e 217,0 kg/km² (ambas as espécies). Os coeficientes de capturabilidade variaram entre 0,10 e 0,14, demonstrando-se que os aparelhos de pesca (caçoeira, manzuá e cangalha) apresentam uma baixa eficiência na pescaria de lagosta. A amostragem dos desembarques entre diferentes períodos de pesca (1970-1979, 1980-1988 e 1989-1993) mostrou uma diminuição progressiva das lagostas pequenas e, como resultado, o comprimento médio mostrou uma tendência crescente. As amostragens aleatórias nas embarcações que pescaram entre 20 e 35 m (1999) revelaram que as lagostas recrutadas (50 e 75 mm, CC) representaram 91% (P. argus) e 96% (P. laevicauda) do total capturado, que conjuntamente com a expansão da área de pesca (aumento do esforço) e a diminuição da CPUE por quadrículas de pesca (entre 1974 e 1991), evidenciaram uma sobrepesca de crescimento que provavelmente esteja influenciando nas elevadas variações das capturas anuais e em sua tendência negativa observada nos últimos 15 anos (1995-2009). A análise realizada entre a CPUE e a abundância (N), revelou uma falta de proporcionalidade (hiperestabilidade) entre ambos os parâmetros, que poderia estar afetando a relação entre a CPUE e o esforço, e sobre-estimando as estimativas do rendimento máximo sustentável (RMS). Foi estimado um rendimento máximo sustentável por unidade de área de 14 kg/km² e um rendimento máximo sustentável preliminar entre 5.000 e 5.604 t. Este resultado empírico deve ser corroborado a partir do desenvolvimento da amostragem aleatória estratificada que foi proposto no presente estudo. Não existem evidências de uma sobrepesca de recrutamento nos estoques, mas as altas taxas de explotação no estoque do setor profundo (50 e 100 m) de P. argus, composto principalmente por exemplares mais velhos e de elevado poder reprodutor, poderia estar acentuando o risco dos recrutamentos baixos e dos colapsos. Este grande nível de incerteza pelo que transcorre a pescaria de lagosta na plataforma continental do Brasil deve ser abordado por formas de pensar novas e diferentes, por uma visão em longo prazo e pela obtenção de novos conhecimentos científicos que permitam desenvolver uma pesca sustentável.

CoordenaÃÃo de AperfeiÃoamento de NÃvel Superior / A pesca extrativa de lagosta no Brasil à uma atividade econÃmica importante que engloba diferentes setores sociais na regiÃo costeira e que aporta um ingresso mÃdio anual de 84 milhÃes de dÃlares. A grande demanda do produto, o elevado valor no mercado internacional, a expansÃo da frota artesanal, o nÃo cumprimento das medidas de conservaÃÃo, o impacto da pesca no ecossistema e possivelmente a variabilidade do clima, tem propiciado uma elevada explotaÃÃo ou sobre-explotaÃÃo dos estoques destes crustÃceos. A avaliaÃÃo e previsÃo da pescaria dependem da coleta de informaÃÃo biolÃgica e pesqueira, em que nas duas Ãltimas dÃcadas a ausÃncia destes dados e a falta de estudo do ciclo de vida gerou um elevado nÃvel de incerteza na administraÃÃo da pescaria. No presente estudo, foi realizada uma anÃlise integral da informaÃÃo biolÃgico-pesqueira gerada pelo projeto de mestrado e pelos dados que o precedem. As zonas de agregaÃÃo dos estoques pesqueiros se distribuÃram em 31 estratos que cobrem uma Ãrea de 356.610 kmÂ, divididos em duas regiÃes: rasa < 50 m (160.510 kmÂ) e profunda entre 50 e 100 m (196.100 kmÂ). O Ãndice de produtividade mÃdio (1999-2006) entre espÃcies foi de 29,75 kg/km em Panulirus argus e de 8,39 kg/km em P. laevicauda; nos diferentes estratos variou entre 0,02 e 217,0 kg/km (ambas as espÃcies). Os coeficientes de capturabilidade variaram entre 0,10 e 0,14, demonstrando-se que os aparelhos de pesca (caÃoeira, manzuà e cangalha) apresentam uma baixa eficiÃncia na pescaria de lagosta. A amostragem dos desembarques entre diferentes perÃodos de pesca (1970-1979, 1980-1988 e 1989-1993) mostrou uma diminuiÃÃo progressiva das lagostas pequenas e, como resultado, o comprimento mÃdio mostrou uma tendÃncia crescente. As amostragens aleatÃrias nas embarcaÃÃes que pescaram entre 20 e 35 m (1999) revelaram que as lagostas recrutadas (50 e 75 mm, CC) representaram 91% (P. argus) e 96% (P. laevicauda) do total capturado, que conjuntamente com a expansÃo da Ãrea de pesca (aumento do esforÃo) e a diminuiÃÃo da CPUE por quadrÃculas de pesca (entre 1974 e 1991), evidenciaram uma sobrepesca de crescimento que provavelmente esteja influenciando nas elevadas variaÃÃes das capturas anuais e em sua tendÃncia negativa observada nos Ãltimos 15 anos (1995-2009). A anÃlise realizada entre a CPUE e a abundÃncia (N), revelou uma falta de proporcionalidade (hiperestabilidade) entre ambos os parÃmetros, que poderia estar afetando a relaÃÃo entre a CPUE e o esforÃo, e sobre-estimando as estimativas do rendimento mÃximo sustentÃvel (RMS). Foi estimado um rendimento mÃximo sustentÃvel por unidade de Ãrea de 14 kg/km e um rendimento mÃximo sustentÃvel preliminar entre 5.000 e 5.604 t. Este resultado empÃrico deve ser corroborado a partir do desenvolvimento da amostragem aleatÃria estratificada que foi proposto no presente estudo. NÃo existem evidÃncias de uma sobrepesca de recrutamento nos estoques, mas as altas taxas de explotaÃÃo no estoque do setor profundo (50 e 100 m) de P. argus, composto principalmente por exemplares mais velhos e de elevado poder reprodutor, poderia estar acentuando o risco dos recrutamentos baixos e dos colapsos. Este grande nÃvel de incerteza pelo que transcorre a pescaria de lagosta na plataforma continental do Brasil deve ser abordado por formas de pensar novas e diferentes, por uma visÃo em longo prazo e pela obtenÃÃo de novos conhecimentos cientÃficos que permitam desenvolver uma pesca sustentÃvel. / Extractive fishing lobster in Brazil is an important economic activity which includes different social sectors in the coastal region and provides an average annual income of USD$ 84 million. The great demand for the product, the high value in international market, expansion of the artisanal fleet, failure in enforce of conservation measures, the fishing impact on ecosystems and perhaps climate variability, have led to a high exploitation or overexploitation of the crustacean stocks. The evaluation and fishery prediction depends of biological and fisheries data collection, in the last two decades the absence of these data and the lack in the life cycle study generated a high level of uncertainty in the management of the fishery. In the present study, a comprehensive analysis is done of biological and fishery information generated by the thesis project and the data that precedes. The areas of the stock aggregation were distributed into 31 strata covering an area of 356.610 kmÂ, divided into two regions: shallow < 50 m (160.510 kmÂ) and depth between 50 and 100 m (196.100 kmÂ). The medium productivity index (1999-2006) between species was 29,75 kg/km in Panulirus argus and 8,39 kg/km in P. laevicauda; in different strata varied between 0.02 and 217.0 kg/km (both species). Catchability coefficients ranged between 0.10 and 0.14, showing that the fishing gears (caÃoeira, manzuà and cangalha) have a low efficiency in the lobster fishery. The sampling of landings between different fishing periods (1970-1979, 1980-1988 and 1989-1993) showed a progressive decrease in the small lobsters and as a result the mean length showed an increasing trend. The random samples on boats that fished between 20 and 35 m (1999), revealed that lobsters recruited (50 and 75 mm, Lc) accounted for 91% (P. argus) and 96% (P. laevicauda) of the total catch, which with the expansion of fishing (increased effort) was accompanied by a decreasing of the CPUE by fishing grids (between 1974 and 1991), showed a growth overfishing which are probably influencing in the high variations of the annual catches and its negative trend observed in the last fifteen years (1995-2009). The analysis between CPUE and abundance (N), revealed a lack of proportionality (hyperstability) between both parameters, which could be affecting the relationship between CPUE and effort and overestimating yield maximum sustainable (YMS). We estimated a yield maximum sustainable per unit area of 14 kg/km and a yield maximum sustainable preliminary between 5,000 and 5,604 t. This empirical result should be confirmed through the development of stratified random sampling is proposed in this study. There is not evidence of recruitment overfishing in the stocks, but high rates of exploitation in the deep stock (50 to 100 m) of P. argus, composed mainly of older specimens and high reproductive power, could be accentuating the risk of low recruitment and collapse. This high level of uncertainty which takes the lobster fishery on the continental shelf of Brazil must be addressed by new ways of thinking, by a long-term and acquiring new skills and knowledge to develop fisheries sustainable.

Submitted by Willians Gaspar (willians.gaspar@fgv.br) on 2018-01-22T16:33:59Z No. of bitstreams: 1 A Correlação entre Jornada de Trabalho e Produtividade - Uma Perspectiva Macroeconômica entre Países.pdf: 1651221 bytes, checksum: 10a95ba6074b04f5e4e0f6d88a9bf7b6 (MD5) / Approved for entry into archive by Janete de Oliveira Feitosa (janete.feitosa@fgv.br) on 2018-01-24T12:00:40Z (GMT) No. of bitstreams: 1 A Correlação entre Jornada de Trabalho e Produtividade - Uma Perspectiva Macroeconômica entre Países.pdf: 1651221 bytes, checksum: 10a95ba6074b04f5e4e0f6d88a9bf7b6 (MD5) / Made available in DSpace on 2018-01-29T18:55:15Z (GMT). No. of bitstreams: 1 A Correlação entre Jornada de Trabalho e Produtividade - Uma Perspectiva Macroeconômica entre Países.pdf: 1651221 bytes, checksum: 10a95ba6074b04f5e4e0f6d88a9bf7b6 (MD5) Previous issue date: 2017-12-19 / This research has as general objective to identify the variables or contributing factors to subsidize the discussion about reduction of the Working Day. As a specific objective, what is proposed is to verify how these same variables affect Productivity. For both objectives the macroeconomic aspects of the countries analyzed are considered. The criterion for selecting these countries is based on the "ranking" of the OECD and World Bank database for the year 2013, considering all the major world economies, which together represent 65.22% of global GDP. The data extracted refer to the "Gross Domestic Product - GDP at (PPP) - Purchasing Power Parity", which consists of the Gross Domestic Product, in international dollars, with a view to the comparative possibility of these economies by purchasing power parity (PPP). Other sources of information were considered as objects of analysis and observations, including the statistical series of secondary data from the International Labor Office (ILO), the International Monetary Fund (IMF), the United Nations (UNDP), the Brazilian Institute of Geography and Economics (IBGE), the Department of Statistics and Socioeconomic Studies (DIEESE) and the Institute of Economic and Applied Research (IPEA). The research was conducted at the macroeconomic level of the countries, with a longitudinal temporal cut between the years 2007 and 2013, in order to observe the behavior of these economies, including during the period of the 2008 global crisis. evolution of the historical series of GDP, revealing the size of the economy, GDP per capita, which captures wealth in relation to the population. Finally, we consider the labor productivity factor itself, which deals with the relationship between GDP, the number of people and the number of hours worked in the period. This research has as general objective to identify the variables or contributing factors to subsidize the discussion about reduction of the Working Day. As a specific objective, what is proposed is to verify how these same variables affect Productivity. For both objectives the macroeconomic aspects of the countries analyzed are considered. The criterion for selecting these countries is based on the "ranking" of the OECD and World Bank database for the year 2013, considering all the major world economies, which together represent 65.22% of global GDP. The data extracted refer to the "Gross Domestic Product - GDP at (PPP) - Purchasing Power Parity", which consists of the Gross Domestic Product, in international dollars, with a view to the comparative possibility of these economies by purchasing power parity (PPP). Other sources of information were considered as objects of analysis and observations, including the statistical series of secondary data from the International Labor Office (ILO), the International Monetary Fund (IMF), the United Nations (UNDP), the Brazilian Institute of Geography and Economics (IBGE), the Department of Statistics and Socioeconomic Studies (DIEESE) and the Institute of Economic and Applied Research (IPEA). The research was conducted at the macroeconomic level of the countries, with a longitudinal temporal cut between the years 2007 and 2013, in order to observe the behavior of these economies, including during the period of the 2008 global crisis. evolution of the historical series of GDP, revealing the size of the economy, GDP per capita, which captures wealth relative to the population. Finally, we consider the labor productivity factor itself, which deals with the relationship between GDP, the number of people and the number of hours worked in the period. Design/Methodology/ approach – The method is a qualitative research of the exploratory type, subsidized by quantitative correlation analysis, and the statistical design is directed to the verification of the degree of association between the variables: Working day and Labor productivity; that is, calculation and interpretation of the degree of correlation between these two variables. Findings – In the final conclusion of the study, it is inferred based on the theoretical reference and the analysis of the statistical data, if the reduction in the working day contributes to changes in productivity indexes, and just as other variables are considered in this discussion. Research limitations – No aspects of the national culture, climatic conditions and segregation of nations by percentage of participation in agriculture, industry, and services were considered in the composition of their economies, with a view to performing comparative analysis by subgroups. In addition, the sample set is restricted both in number of countries and in relation to the relatively short period between 2007 and 2013, in addition to being marked by an atypical event such as the global economic crisis of 2008. Practical contributions – To governments, organizations and workers to rethink the possible economic and social benefits, through public policies that allow greater flexibility in working hours, focusing on the competitive advantages and the balance of the relation between labor and capital, observing the legal aspects, productivity, quality of life, unit costs and the generation of jobs / Esta pesquisa tem como objetivo geral identificar as variáveis ou fatores contribuintes para subsidiar a discussão sobre redução da Jornada de Trabalho. Como objetivo específico, o que se propõe é verificar como essas mesmas variáveis afetam a Produtividade. Para ambos os objetivos são considerados os aspectos macroeconômicos dos países analisados. O critério para seleção desses países se fundamenta no “ranking” da base de dados da Organização para a Cooperação e Desenvolvimento Econômico – OCDE e do Banco Mundial, ano base 2013, considerando-se o conjunto das maiores economias mundiais, que, juntas, representam 65,22% do PIB global. Os dados extraídos são referentes ao “Gross Domestic Product – GDP at (PPP) - Purchasing Power Parity”, que consiste no Produto Interno Bruto, em dólares internacionais, com vistas à possibilidade comparativa destas economias pela paridade do poder de compra (PPC). Outras fontes de informações foram consideradas como objetos de análise e observações, incluindo-se as séries estatísticas de dados secundários do Instituto Internacional do Trabalho (OIT), do Fundo Monetário Internacional (FMI), das Nações Unidas (UNDP), do Instituto Brasileiro de Geografia e Economia (IBGE), do Departamento Intersindical de Estatística e Estudos Socioeconômicos (DIEESE) e do Instituto de Pesquisa Econômica e Aplicada (IPEA). A pesquisa foi conduzida no nível macroeconômico dos países, com corte temporal longitudinal entre os anos de 2007 a 2013, com o objetivo de observar-se o comportamento dessas economias, inclusive durante o período da crise mundial de 2008. Nesse sentido, foi avaliada a evolução da série histórica do PIB, como reveladora do tamanho da economia, o PIB per capita, que captura a riqueza em relação à população. Por último, considera-se o fator produtividade do trabalho propriamente dito, que trata da relação entre o PIB, o número de pessoas e o número de horas trabalhadas no período. Quanto ao método, trata-se de pesquisa qualitativa do tipo exploratória, subsidiada por análise quantitativa correlacional, sendo o delineamento estatístico direcionado para a verificação do grau de associação entre as varáveis: Jornada de trabalho e Produtividade do trabalho; ou seja, cálculo e interpretação do grau de correlação entre essas duas variáveis. Na conclusão final do trabalho, infere-se com base no referencial teórico e na análise dos dados estatísticos, se a redução na jornada de trabalho contribui para alterações nos índices de produtividade, e assim como outras variáveis são consideradas nesta discussão. Não foram considerados aspectos da cultura nacional, condições climáticas e segregação das nações por percentual de participação respectivamente em agricultura, indústria, e serviços, na composição de suas economias, visando realizar análise comparativa por subgrupos. Além disto o conjunto amostral é restrito, tanto em número de países, quanto em relação ao período, relativamente curto, entre 2007 e 2013, além de ter sido marcado por fato atípico como a crise econômica mundial de 2008. Á governos, organizações e trabalhadores para repensarem os eventuais benefícios econômicos e sociais, através de políticas públicas que permitam maior flexibilização das jornadas de trabalho, com foco nas vantagens competitivas e no equilíbrio da relação entre mão de obra e capital, observando os aspectos legais, a produtividade, a qualidade de vida, os custos unitários e a geração de empregos

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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.