Open AccessHow efficient are New Zealand's District Health Boards at producing life expectancy gains for Māori and Europeans?
Author(s) -
Sandiford Peter,
Consuelo David Juan José Vivas,
Rouse Paul
Publication year - 2017
Publication title -
australian and new zealand journal of public health
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.946
H-Index - 76
eISSN - 1753-6405
pISSN - 1326-0200
DOI - 10.1111/1753-6405.12618
Subject(s) - life expectancy , data envelopment analysis , population , replicate , equity (law) , health equity , demography , actuarial science , economics , econometrics , medicine , statistics , environmental health , mathematics , political science , sociology , economic growth , health care , law
Abstract Objective: Use data envelopment analysis (DEA) to measure the efficiency of New Zealand's District Health Boards (DHBs) at achieving gains in Māori and European life expectancy (LE). Methods: Using life tables for 2006 and 2013, a two‐output DEA model established the production possibility frontier for Māori and European LE gain. Confidence limits were generated from a 10,000 replicate Monte Carlo simulation. Results: Results support the use of LE change as an indicator of DHB efficiency. DHB mean income and education were related to initial LE but not to its rate of change. LE gains were unrelated to either the initial level of life expectancy or to the proportion of Māori in the population. DHB efficiency ranged from 79% to 100%. Efficiency was significantly correlated with DHB financial performance. Conclusion: Changes in LE did not depend on the social characteristics of the DHB. The statistically significant association between efficiency and financial performance supports its use as an indicator of managerial effectiveness. Implications for public health: Efficient health systems achieve better population health outcomes. DEA can be used to measure the relative efficiency of sub‐national health authorities at achieving health gain and equity outcomes.