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Riforme del servizio sanitario nazionale e dinamica dell'efficienza ospedaliera in Piemonte

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  • Canta Chiara
  • Piacenza Massimiliano
  • Turati Gilberto

Abstract

In this paper we estimate cost efficiency and technological characteristics of public hospitals in Piedmont over the period from 2000 to 2004. During the Nineties, different regulatory reforms aiming at controlling health expenditure affected the Italian National Health Service, ranging from the introduction of a new reimbursement scheme for hospitals (DRG-based) at the micro level, to the implementation of fiscal federalism at the macro level. We argue that all these legislative interventions rendered producers more prone to control costs, in order to be able to meet financial constraints. Our empirical findings support this hypothesis: average cost inefficiency, computed after estimating a Translog stochastic cost frontier by the Battese and Coelli (1992) approach, reduced remarkably during the observed years, while the adoption of more effective technologies shifted upward the minimum-cost frontier. We also find evidence of relevant scale economies not exploited by producers, which decrease with hospital size (number of beds) and output complexity (average DRG weight).

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Bibliographic Info

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

Volume (Year): (2006)
Issue (Month): 2 ()
Pages: 157-192

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Handle: RePEc:mul:je8794:doi:10.1429/22411:y:2006:i:2:p:157-192

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Related research

Keywords: NHS reforms; public hospitals; productive efficiency; stochastic cost frontier.;

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References

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  1. Alessandro Sembenelli & Laura Rondi & Fabio Schiantarelli & Brian Sack, 1993. "Firms' Financial And Real Responses To Business Cycle Shocks And Monetary Tightening: Evidence For Large And Small Italian Companies," CERIS Working Paper 199305, Institute for Economic Research on Firms and Growth - Moncalieri (TO).
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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.
  2. Piacenza, Massimiliano & Turati, Gilberto & Vannoni, Davide, 2010. "Restructuring hospital industry to control public health care expenditure: The role of input substitutability," Economic Modelling, Elsevier, vol. 27(4), pages 881-890, July.
  3. Simona Sanguineti & Alessio Tei, 2012. "L’efficienza delle aziende di Trasporto Pubblico Locale: confronto tra le maggiori realtà italiane," ECONOMIA E DIRITTO DEL TERZIARIO, FrancoAngeli Editore, vol. 2012(3), pages 359-377.

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