The offshoring of services has steadily expanded in recent years and acquired growing importance in certain tourism subsectors. The present study analyses for the first time the offshoring indices and the trend seen in tourism services, based on input–output data (Spanish National Accounts) during the 2000–2007 expansive period. A distinction is made between offshoring associated with international fragmentation of production and offshoring due to a shift from domestic to foreign suppliers. The results point to a relocation of intermediate services to foreign countries in certain tourism subsectors (including travel agencies and air and maritime transport), involving both the international fragmentation of production and a substitution of the source of supply.
Aim: To evaluate the level of efficiency of public acute hospitals situated in the region of Murcia (Spain). Materials & methods: Data from nine acute general hospitals of Murcia’s Health Service (SMS by its Spanish acronym) were analyzed over the 2012–2014 period. The data were extracted from the In-patient Health Establishment Statistics of the Ministry of Health, Social Services and Equality, from the National Health Service (SNS) portal and the SMS portal. To this end, the data envelopment analysis (DEA)-window method was used, since this extension of the basic DEA model allows to compare the efficiency of a small number of units over different years and analyze changes in efficiency over time. In addition, the model was complemented by smooth bootstrapping and a superefficiency analysis to improve the quality of the data interpretation. Four inputs were used (number of beds, number of operating rooms, personnel costs and operating costs), two undesirable outputs (average stay and rate of return) and three desirable outputs (weighted discharges, emergencies and surgical interventions). Results: The average level of inefficiency was 1.58% over the study period, with a good evolution between 2012 (3.53%) and 2014 (0.20%). This improvement was also reflected in the number of efficient hospitals that rose from two in 2012 to eight in 2014. Moreover, the slack levels detected were small. Conclusion: The management of the public hospitals analyzed was favorable, both regarding average level of efficiency and the number of hospitals qualified as efficient. However, the analysis revealed several ways to increase efficiency by reducing specific inputs and nondesirable outputs (mainly operating and personnel costs as well as average length of stay) while increasing desirable outputs (mostly the number of surgical interventions). To finish, specific policy measures are suggested to improve the performance of these hospitals.
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