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Riforma sanitaria e produzione ospedaliera

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  • Fabbri Daniele

Abstract

The recent reform of hospital financing in Italy, which took place in 1995, increased the power of incentives producers respond to, making budget constraints harder and reducing resources devoted to their funding. In this paper we measure the evolution of technical and scale efficiency of public hospital across the reform. We look at a sample of 43 hospitals in Emilia-Romagna region, between 1994 and 1997. We conduct the analysis using DEA (Data Envelopment Analysis). In our sample we find evidence of rapidly decreasing return to scale in hospital production. We see that technical efficiency tend to increase in the early stage of the reform, while it decreases in the last year, basically due to a large reduction in output. We don't find evidence of any significant increase in scale efficiency. Interpretation of these results are provided and discussed.

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Bibliographic Info

Article provided by Società editrice il Mulino in its journal Politica economica.

Volume (Year): (2000)
Issue (Month): 1 ()
Pages: 131

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Handle: RePEc:mul:je8794:doi:10.1429/1493:y:2000:i:1:p:131

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  1. Newhouse, Joseph P., 1994. "Frontier estimation: How useful a tool for health economics?," Journal of Health Economics, Elsevier, vol. 13(3), pages 317-322, October.
  2. Breyer, Friedrich, 1987. "The specification of a hospital cost function : A comment on the recent literature," Journal of Health Economics, Elsevier, vol. 6(2), pages 147-157, June.
  3. Grosskopf, S. & Valdmanis, V., 1987. "Measuring hospital performance : A non-parametric approach," Journal of Health Economics, Elsevier, vol. 6(2), pages 89-107, June.
  4. Valdmanis, Vivian, 1992. "Sensitivity analysis for DEA models : An empirical example using public vs. NFP hospitals," Journal of Public Economics, Elsevier, vol. 48(2), pages 185-205, July.
  5. Keeler, Theodore E & Ying, John S, 1996. "Hospital Costs and Excess Bed Capacity: A Statistical Analysis," The Review of Economics and Statistics, MIT Press, vol. 78(3), pages 470-81, August.
  6. Ellis, Randall P., 1998. "Creaming, skimping and dumping: provider competition on the intensive and extensive margins1," Journal of Health Economics, Elsevier, vol. 17(5), pages 537-555, October.
  7. Nyman, John A & Bricker, Dennis L, 1989. "Profit Incentives and Technical Efficiency in the Production of Nursing Home Care," The Review of Economics and Statistics, MIT Press, vol. 71(4), pages 586-94, November.
  8. 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.
  9. Cutler, D.M., 1992. "The Incidence of Adverse Medical Outcome Under Prospective Payment," Harvard Institute of Economic Research Working Papers 1603, Harvard - Institute of Economic Research.
  10. Rajiv D. Banker & Robert F. Conrad & Robert P. Strauss, 1986. "A Comparative Application of Data Envelopment Analysis and Translog Methods: An Illustrative Study of Hospital Production," Management Science, INFORMS, vol. 32(1), pages 30-44, January.
  11. Randall P. Ellis & Thomas G. McGuire, 1994. "Hospital Response to Prospective Payment: Moral Hazard, Selection, and Practice-Style Effects," Papers 0050, Boston University - Industry Studies Programme.
  12. Rajiv D. Banker, 1993. "Maximum Likelihood, Consistency and Data Envelopment Analysis: A Statistical Foundation," Management Science, INFORMS, vol. 39(10), pages 1265-1273, October.
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Cited by:
  1. Elisabetta Mafrolla & Eugenio D’Amico, 2013. "Patients’ mobility as an indicator for (in)efficiency:a panel data analysis on Italian health care authorities," Health Economics Review, Springer, vol. 3(1), pages 1-13, December.

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