T.K. Niaounakis
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12 records found
1
Economies of scale and sustainability in local government
A complex issue
Economies of scale: a multi-level perspective
Applications in Dutch local public services
BACKGROUND: The development of labour productivity is relevant for accurately planning future staffing requirements, especially in sectors where technological developments may drive labour substitution. The present study investigates how labour productivity has developed across Dutch medical specialists (2007-2017) and discusses its implications for workforce planning, also in relation to the existing literature. METHODS: A regression model is developed in which the number of full-time equivalents is related to production (admissions), hospital characteristics and a trend parameter. The trend parameter captures the average annual change in the number of full-time equivalents per production output and is a measure for labour productivity. The model is applied to a micro-data set of Dutch hospitals in the period 2007-2017 across 24 different specialties using regression methods. RESULTS: The results indicate an increase in the number of full-time equivalents per admission has increased for most specialisms and that labour productivity has thus decreased. However, there is considerable heterogeneity and uncertainty across different specialisms. CONCLUSIONS: The results amplify the issue of medical personnel shortages driven by the growing demand for health care. The research outcomes are linked to the existing literature regarding physicians' productivity. Changes in accountability such as using relative value units, incentive payments, use of staff and mid-level providers, and technology have been discussed, and some consensus has been reached.
Managing size of public schools and school boards
A multi-level cost approach applied to dutch primary education
In many countries, the provision of primary education is among the core responsibilities of local governments. One of the main questions local governments face concerns the optimal configuration of school boards and size of schools. In this paper we analyse the relation between cost and scale in school boards and in schools. The influence of both the governing layer (board) and the operational layer (school) on average cost are jointly modelled. Board cost is modelled as an aggregation of individual school cost functions so that individual school cost data are not required in order to estimate the model. The results indicate that small schools (<60) pupils are operating under sizable economies of scale. The optimum school size is estimated at roughly 450 pupils, but average cost remains roughly constant with regard to size. In contrast to school size, the effect of board size (in terms of the number of schools governed) on average cost is limited. The policy recommendation is that municipalities should create at least three schoolboards within their jurisdiction and take measures in case individual school size declines below 60 pupils.
Kosten van de lokale publieke gezondheidszorg in verband
Een kwantitatief onderzoek naar de kostenstructuur van de publieke gezondheidszorg in Nederlandse gemeenten 2008-2016
Inter-municipal cooperation, economies of scale and cost efficiency
An application of stochastic frontier analysis to Dutch municipal tax departments
Inter-municipal cooperation is increasingly popular in European countries. Saving cost is a key motivation. This paper analyses the relation between inter-municipal cooperation and cost efficiency among Dutch municipal tax departments between 2005 and 2012. Motivated by the notion that cost savings are ascribed to scale economies, the relation between cooperation and cost is modelled explicitly through scale. The size of the cooperation is incorporated as a determinant of cost efficiency. The results indicate that inter-municipal cooperation can contribute to reducing cost and that the relation can be explained by scale. Municipalities or cooperations sized around 10,000 inhabitants are estimated up to 30% inefficient. At 60,000 inhabitants, the benefits of scaling are largely exhausted. Other than through scale, municipalities that cooperate are not estimated to operate significantly more or less efficient.
Doelmatig huisvesten
Een empirisch onderzoek naar de relatie tussen krimp, schaal, rolverdelingen en de doelmatigheid van onderwijshuisvesting in het basisonderwijs
Wegen gewogen
Een empirisch onderzoek naar de kosten en doelmatigheid van het decentrale wegbeheer tussen 2008 en 2014
Doelmatig aanbesteden
Een empirisch onderzoek naar de relatie tussen aanbestedingskenmerken en de kostendoelmatigheid van concessies in het regionaal openbaar vervoer
Productiviteit van overheidsbeleid
Deel II, De Nederlandse zorg, 1980-2013
Lasten van (samen) belasten
Een empirisch onderzoek naar de doelmatigheid van de gemeentelijke belastingheffing en de uitvoering van de Wet WOZ tussen 2005 en 2012