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The purpose of this paper is to use stochastic frontier analysis (SFA) to estimate the efficiency of public investments and their impact on economic growth in the USA using panel data. Results of the study show highly significant and positive relationships between gross state product (GSP) and expenditures on education, transportation, health, welfare, and public safety (police and fire), and negative but significant relationships between output and employment in health care and public safety services. Inefficiencies in the study are measured using per capita tax revenue and time. Tax revenue has a very minimal positive and significant effect on efficiency, while time inversely relates to efficiency.

The present study uses SFA to investigate the efficiency of government expenditures in five service sectors – education, transportation, health, welfare, and public safety (police and fire), using recent data and economic trends. The study hypothesizes that changes in the current levels of expenditures in the public sector have a significant impact on the aggregate economy, as measured by GSP. The study uses GSP as the dependent (output) variable, and government expenditure on the five service sectors as the independent (input) variables.

Analysis of efficiency for individual states for all 21 years produced interesting results. Overall, the technical efficiency of the public sector was quite high. The average TE score across all years and all states was 0.878. This suggests that public sector operates at a relatively high efficiency level.

The current SFA model followed Battese and Coelli approach of estimating efficiency of public sectors in each state of the USA. It allowed estimation of policy impact on the overall efficiency. It was applied to macroeconomic panel data.

The purpose of this paper is to design and validate a reliable and comprehensive instrument to assess the influence of sustainable supply chain management (SSCM) practices on sustainable performance in hospitals.

A systematic and mixed-method approach was used to create and validate an instrument for assessing the level of implementation of hospital SSCM practices and the perceived extent of environmental, social and economic performance. This includes the development of preliminary items and the evaluation of content and construct validity. Data from Colombian hospitals was collected. Structural equation modeling was used to test the structural model.

During the content validity phase, an initial version of the questionnaire consisting of 88 items was generated. This version was qualitatively and quantitatively reviewed and assessed by six academicians and two hospital practitioners, based on criteria of sufficiency, clarity, relevance and coherence. The computation of both individual and scale content validity indices, along with the qualitative feedback, led to the refinement of the questionnaire. The subsequent phase of construct validity involved the implementation of a pilot test with 55 responses gathered from Colombian hospitals. By considering the metrics of convergent validity and discriminant validity derived from the analysis of structural equation modeling, the final instrument was composed of 59 items. The results reveal that hospital SSCM practices can be conceptualized and measured through two dimensions: environmental and social. The former includes the underlying constructs of internal environmental management, green purchasing and green operations. The latter encompasses the constructs of working conditions and employee well-being, equity management, social purchasing and community development and participation. Sustainable performance is defined by its environmental, social and economic dimensions.

This study is intended to provide useful insights for hospitals, researchers and policymakers to measure and develop strategies to enhance the implementation of SSCM practices, thereby improving sustainable performance. As a matter of fact, the instrument has already been applied in a recent empirical study conducted in Colombia, aimed at addressing the influence of SSCM practices on sustainable performance in hospitals.

To the best of the authors’ knowledge, this is the first study to develop and empirically test an instrument for measuring the influence of SSCM on sustainable performance, both in the hospital setting and in an emerging country.