Measuring inefficiency in long-term care commissioning: evidence from english local authorities

Using a stochastic frontier approach, this paper explores efficiency in the commissioning of publicly funded social services among 148 English Councils through a six-year panel database (2002-2007), covering institutional and community care. Our estimates provide key policy evidence in a context in which optimization is critical both for social and financial purposes. Results suggest a slight decrease in the average inefficiency score, moving from 1.080 in the first year to 1.076 in the last year. Cost-output elasticity of institutional care is greater than those of community care services. Greater savings are obtained when the market is open to independent providers.