Non-parametric frontier estimation of health care efficiency among US states, 2002–2008

Valuating the efficiency of social security and healthcare in OECD countries from a sustainable development

Under the goal of sustainable development, coping with the increase in social security and healthcare expenses caused by population aging is becoming increasingly important, but it is rare in the literature to evaluate the impact of social security efficiency on healthcare efficiency. This research uses the dynamic SBM two-stage model to observe the efficiencies of social security and healthcare in OECD countries. There are two findings as follows. First, the higher social security efficiency is, the better is the healthcare efficiency of countries with lower per capita GDP. Second, higher social security efficiency of National Health Service (NHS) countries denote better healthcare efficiency. When the financial source of the social security system is taxation, then it is more likely to bring higher efficiency to healthcare.

Discrete-Event Simulation Modeling in Healthcare: A Comprehensive Review

Discrete-event simulation (DES) is a stochastic modeling approach widely used to address dynamic and complex systems, such as healthcare. In this review, academic databases were systematically searched to identify 231 papers focused on DES modeling in healthcare. These studies were sorted by year, approach, healthcare setting, outcome, provenance, and software use. Among the surveys, conceptual/theoretical studies, reviews, and case studies, it was found that almost two-thirds of the theoretical articles discuss models that include DES along with other analytical techniques, such as optimization and lean/six sigma, and one-third of the applications were carried out in more than one healthcare setting, with emergency departments being the most popular. Moreover, half of the applications seek to improve time- and efficiency-related metrics, and one-third of all papers use hybrid models. Finally, the most popular DES software is Arena and Simul8. Overall, there is an increasing trend towards using DES in healthcare to address issues at an operational level, yet less than 10% of DES applications present actual implementations following the modeling stage. Thus, future research should focus on the implementation of the models to assess their impact on healthcare processes, patients, and, possibly, their clinical value. Other areas are DES studies that emphasize their methodological formulation, as well as the development of frameworks for hybrid models.

Environmental Assessment and Sustainable Development in the United States

This study aims to overview the U.S. sustainable development by measuring the environmental performance of 50 states over the period of 2009–2018. To attain the objective, we employ data envelopment analysis for environmental assessment where we prioritize the minimization of CO2 emissions first and the maximization of gross state product later under the concept of managerial disposability (i.e., an environment-based performance measure). Then, we examine how the state-level environmental performance measures are associated with their political and spatial contexts. For the purpose, we conduct the Kruskal-Wallis rank sum test across groups of states characterized by their political transitions in the presidential and gubernatorial elections and defined by the regions of the U.S. Economic Development Administration and Environmental Protection Agency. Based on our empirical results, we find that (a) overall environmental performance has gradually enhanced over time, (b) there are statistically significant differences in the environmental performance measures along with the political transitions, and (c) states on both coasts have outperformed those of the middle in the measurement.