Design/methodology/approach: This study uses multi-directional efficiency analysis to measure the technical inefficiency scores on a sample of 200 farm observations and single-bootstrap truncated regression model to define factors affecting technical inefficiency.
Findings: Managerial and program inefficiency scores are presented for intensive and semi-intensive production systems. The results reveal marked differences in the inefficiency scores across inputs and between production systems.
Practical implications: Intensive systems generally have lowest managerial and program inefficiency scores in the Malaysian dairy farming sector. Policy makers could use this information to advise dairy farmers to convert their farming system to the intensive system.
Social implications: The results suggest that the Malaysian Government should redefine its policy for providing farm finance and should target young farmers when designing training and extension programs in order to improve the performance of the dairy sector.
Originality/value: The existing literature on Southeast Asian dairy farming has neither focused on investigating input-specific efficiency nor on comparing managerial and program efficiency. This paper aims to fill this gap.
METHODS: The impact of omalizumab was estimated through a one-year static cohort model using the Work Productivity and Activity Impairment Allergy Specific (WPAI-AS) questionnaire derived from a clinical trial on omalizumab enrolling patients with severe and most severe JCP symptoms, which had been conducted in Japan. This effect was quantified using Japanese official statistics on employment and time use. The human capital approach and the proxy good approach were employed to monetize paid and unpaid work activities, respectively. A sensitivity analysis was implemented to account for modeling structural uncertainties.
RESULTS: Our results show that the use of omalizumab might reduce the paid and unpaid work productivity losses due to severe and most severe JCP by nearly one-third. In the severe symptom period of three weeks, 36.6 million hours of lost paid and unpaid work hours could be avoided, which sums up to a monetized productivity loss of 728.3 million USD.
CONCLUSIONS: Omalizumab could provide substantial benefits in terms of paid and unpaid work activities in patients with severe and most severe JCP. Our results also highlight the importance of considering unpaid work in estimating productivity costs due to poor health.
METHODS: The DEA was performed using countries as decision-making units, schizophrenia disease investment (cost of disease as a percentage of total health care expenditure) as the input, and disability-adjusted life years (DALYs) per patient due to schizophrenia as the output. Data were obtained from the Global Burden of Disease 2017 study, the World Bank Group, and a literature search of the PubMed database.
RESULTS: Data were obtained for 44 countries; of these, 34 had complete data and were included in the DEA. Disease investment (percentage of total health care expenditure) ranged from 1.11 in Switzerland to 6.73 in Thailand. DALYs per patient ranged from 0.621 in Lithuania to 0.651 in Malaysia. According to the DEA, countries with the most efficient schizophrenia health care were Lithuania, Norway, Switzerland and the US (all with efficiency score 1.000). The least efficient countries were Malaysia (0.955), China (0.959) and Thailand (0.965).
LIMITATIONS: DEA findings depend on the countries and variables that are included in the dataset.
CONCLUSIONS: In this international DEA, despite the difference in schizophrenia disease investment across countries, there was little difference in output as measured by DALYs per patient. Potentially, Lithuania, Norway, Switzerland and the US should be considered 'benchmark' countries by policy makers, thereby providing useful information to countries with less efficient systems.