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Competition and Efficiency in Health Care: An Analysis of the Italian Case

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  • Roberto Cellini
  • Giacomo Pignataro
  • Ilde Rizzo

Abstract

In this paper we look at the Italian NationalHealth System as a case study, in order to investigate whethercompetition exerts positive effects on the efficiency of hospitals.Using the DEA technique we measure the efficiency of Italianhospital production; secondly, we take a regression analysisapproach to analyse its determinants. A general conclusion stemmingout of the analysis is that competition is not a value per seand that its effects on hospitals' performance are affected bythe rules governing the health system. Copyright Kluwer Academic Publishers 2000

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File URL: http://hdl.handle.net/10.1023/A:1008737506560
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Bibliographic Info

Article provided by Springer in its journal International Tax and Public Finance.

Volume (Year): 7 (2000)
Issue (Month): 4 (August)
Pages: 503-519

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Handle: RePEc:kap:itaxpf:v:7:y:2000:i:4:p:503-519

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Web page: http://www.springerlink.com/link.asp?id=102915

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References

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  1. Eulália Dalmau-Atarrodona & Jaume Puig-Junoy, 1998. "Market Structure and Hospital Efficiency: Evaluating Potential Effects of Deregulation in a National Health Service," Review of Industrial Organization, Springer, vol. 13(4), pages 447-466, August.
  2. Gerdtham, Ulf-G. & Löthgren, Mickael, 1998. "Health Care System Effects on Cost Efficiency in the OECD Countries," Working Paper Series in Economics and Finance 247, Stockholm School of Economics.
  3. Zwanziger, Jack & Melnick, Glenn A., 1988. "The effects of hospital competition and the Medicare PPS program on hospital cost behavior in California," Journal of Health Economics, Elsevier, vol. 7(4), pages 301-320, December.
  4. David W. Kalisch & Tetsuya Aman & Libbie A. Buchele, 1998. "Social and Health Policies in OECD Countries: A Survey of Current Programmes and Recent Developments," OECD Labour Market and Social Policy Occasional Papers 33, OECD Publishing.
  5. U.-G. Gerdtham & M. Löthgren & M. Tambour & C. Rehnberg, 1999. "Internal markets and health care efficiency: a multiple-output stochastic frontier analysis," Health Economics, John Wiley & Sons, Ltd., vol. 8(2), pages 151-164.
  6. Islam, Nazrul, 1995. "Growth Empirics: A Panel Data Approach," The Quarterly Journal of Economics, MIT Press, vol. 110(4), pages 1127-70, November.
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Cited by:
  1. Gian Paolo Barbetta & Gilberto Turati & Angelo M. Zago, 2007. "Behavioral differences between public and private not-for-profit hospitals in the Italian national health service," Health Economics, John Wiley & Sons, Ltd., vol. 16(1), pages 75-96.
  2. Bordignon, Massimo & Turati, Gilberto, 2009. "Bailing out expectations and public health expenditure," Journal of Health Economics, Elsevier, vol. 28(2), pages 305-321, March.
  3. Massimo Bordignon & Gilberto Turati, 2003. "Bailing Out Expectations and Health Expenditure in Italy," CESifo Working Paper Series 1026, CESifo Group Munich.
  4. Ancarani, A. & Di Mauro, C. & Giammanco, M.D., 2009. "The impact of managerial and organizational aspects on hospital wards' efficiency: Evidence from a case study," European Journal of Operational Research, Elsevier, vol. 194(1), pages 280-293, April.
  5. C. L. Chua & Alfons Palangkaraya & Jongsay Yong, 2009. "Hospital Competition, Technical Efficiency, and Quality," Melbourne Institute Working Paper Series wp2009n16, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne.
  6. Gianni De Fraja & Paola Valbonesi, 2009. "Mixed Oligopoly: Old and New," Discussion Papers in Economics 09/20, Department of Economics, University of Leicester.
  7. Silvana Robone & Alberto Zanardi, 2006. "Market structure and technology: evidence from the Italian National Health Service," International Journal of Health Care Finance and Economics, Springer, vol. 6(3), pages 215-236, September.
  8. PINTO, Claudio, 2013. "Complexity of Treatment, and Changes in Efficiency and Productivity for Directly Managed Italian Hospitals," CELPE Discussion Papers 124, CELPE - Centre of Labour Economics and Economic Policy, University of Salerno, Italy.
  9. Padovano, Fabio, 2012. "The drivers of interregional policy choices: Evidence from Italy," European Journal of Political Economy, Elsevier, vol. 28(3), pages 324-340.
  10. Elenka Brenna & Federico Spandonaro, 2014. "Does federalism induce patients’ mobility across regions? Evidence from the Italian experience," DISCE - Working Papers del Dipartimento di Economia e Finanza def9, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).

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