The impact of managerial and organizational aspects on hospital wards' efficiency: Evidence from a case study
AbstractIn spite of its acknowledged relevance, the impact of managerial and organizational aspects on hospital wards' efficiency has been so far overlooked by the literature. In order to explore this issue, this paper presents a model of the relations between the decision making process of a hospital ward and its technical efficiency. In order to test the model, a two-step approach has been adopted. In the first step the technical efficiency of wards belonging to a large Italian Hospital Enterprise has been calculated using DEA. In the second step, efficiency scores have been regressed on a set of variables capturing managerial goals and actions internal to the ward, as well as re-organizations imposed by the hospital central management. Responses to a questionnaire administered to the heads of ward were used to build the independent variables. Results show that both decisions internal to the ward and exogenous re-organizations affect the ward's efficiency, and suggest that these variables are more significant in explaining efficiency than environmental ones.
Download InfoIf you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.
As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.
Bibliographic InfoArticle provided by Elsevier in its journal European Journal of Operational Research.
Volume (Year): 194 (2009)
Issue (Month): 1 (April)
Contact details of provider:
Web page: http://www.elsevier.com/locate/eor
OR in health services Organization Efficiency Data envelopment analysis Hospital;
Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
- Pauly, Mark V & Redisch, Michael, 1973. "The Not-For-Profit Hospital as a Physicians' Cooperative," American Economic Review, American Economic Association, vol. 63(1), pages 87-99, March.
- R. Cellini & G. Pignataro & I. Rizzo, 1999.
"Competition and Efficiencyin health care: an analysis of the Italian case,"
354, Dipartimento Scienze Economiche, Universita' di Bologna.
- Roberto Cellini & Giacomo Pignataro & Ilde Rizzo, 2000. "Competition and Efficiency in Health Care: An Analysis of the Italian Case," International Tax and Public Finance, Springer, vol. 7(4), pages 503-519, August.
- Milgrom, Paul & Roberts, John, 1994. "Comparing Equilibria," American Economic Review, American Economic Association, vol. 84(3), pages 441-59, June.
- Armen A. Alchian & Harold Demsetz, 1971.
"Production, Information Costs and Economic Organizations,"
UCLA Economics Working Papers
10A, UCLA Department of Economics.
- Alchian, Armen A & Demsetz, Harold, 1972. "Production , Information Costs, and Economic Organization," American Economic Review, American Economic Association, vol. 62(5), pages 777-95, December.
- Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
- Yu, Chunyan, 1998. "The effects of exogenous variables in efficiency measurement--A monte carlo study," European Journal of Operational Research, Elsevier, vol. 105(3), pages 569-580, March.
- Chen, Andrew & Hwang, Yuhchang & Shao, Benjamin, 2005. "Measurement and sources of overall and input inefficiencies: Evidences and implications in hospital services," European Journal of Operational Research, Elsevier, vol. 161(2), pages 447-468, March.
- R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, vol. 30(9), pages 1078-1092, September.
- Chilingerian, Jon A., 1995. "Evaluating physician efficiency in hospitals: A multivariate analysis of best practices," European Journal of Operational Research, Elsevier, vol. 80(3), pages 548-574, February.
- Li, Ling & Benton, W. C., 2003. "Hospital capacity management decisions: Emphasis on cost control and quality enhancement," European Journal of Operational Research, Elsevier, vol. 146(3), pages 596-614, May.
- L. Steinmann & P. Zweifel, 2003. "On the (in)efficiency of Swiss hospitals," Applied Economics, Taylor & Francis Journals, vol. 35(3), pages 361-370.
- White, Halbert, 1980. "A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity," Econometrica, Econometric Society, vol. 48(4), pages 817-38, May.
- Newhouse, Joseph P, 1970. "Toward a Theory of Nonprofit Institutions: An Economic Model of a Hospital," American Economic Review, American Economic Association, vol. 60(1), pages 64-74, March.
- Kao, Ling-Jing & Lu, Chi-Jie & Chiu, Chih-Chou, 2011. "Efficiency measurement using independent component analysis and data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 210(2), pages 310-317, April.
For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Zhang, Lei).
If references are entirely missing, you can add them using this form.