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Behavioral differences between public and private not-for-profit hospitals in the Italian national health service

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  • Gian Paolo Barbetta

    (Istituto di Economia e Finanza, Universit� Cattolica di Milano, Italy)

  • Gilberto Turati

    (Dipartimento di Scienze Economiche e Finanziarie, Universit� di Torino, Italy)

  • Angelo M. Zago

    (Dipartimento di Scienze Economiche, Universit� di Verona, Italy)

Abstract

In this paper we attempt to identify behavioral differences between public and private not-for-profit hospitals, by exploiting the introduction of the DRG-based payment system in the Italian NHS during the second half of the 1990s. We estimate the technical efficiency of a sample of hospitals for the period 1995-2000 considering an output distance function, and adopting both parametric (COLS and SF) and nonparametric (DEA) approaches. Our results show a convergence of mean efficiency scores between not-for-profit and public hospitals, and seem to suggest that differences in economic performances between competing ownership forms are more the result of the institutional settings in which they operate than the effect of the incentive structures embedded in the different proprietary forms. We also observe a decline in technical efficiency, probably due to policies aimed at reducing hospitalization rates. Copyright © 2006 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.1143
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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 16 (2007)
Issue (Month): 1 ()
Pages: 75-96

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Handle: RePEc:wly:hlthec:v:16:y:2007:i:1:p:75-96

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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Cited by:
  1. Martine Audibert & Xiao Xian Huang & Jacky Mathonnat & Aurore Pelissier & Anning Ma, 2012. "Health Insurance Reform and Efficiency of Township Hospitals in Rural China: An Analysis from Survey Data," Working Papers, HAL halshs-00587799, HAL.
  2. De Nicola, Arianna & Gitto, Simone & Mancuso, Paolo, 2011. "A two-stage DEA model to evaluate the efficiency of the Italian health system," MPRA Paper 39126, University Library of Munich, Germany.
  3. Helmut Herwartz & Christoph Strumann, 2014. "Hospital efficiency under prospective reimbursement schemes: an empirical assessment for the case of Germany," The European Journal of Health Economics, Springer, Springer, vol. 15(2), pages 175-186, March.
  4. Silvio Daidone & Francesco D’Amico, 2009. "Technical efficiency, specialization and ownership form: evidences from a pooling of Italian hospitals," Journal of Productivity Analysis, Springer, Springer, vol. 32(3), pages 203-216, December.
  5. Ng, Ying Chu, 2011. "The productive efficiency of Chinese hospitals," China Economic Review, Elsevier, Elsevier, vol. 22(3), pages 428-439, September.
  6. Piacenza, Massimiliano & Turati, Gilberto & Vannoni, Davide, 2010. "Restructuring hospital industry to control public health care expenditure: The role of input substitutability," Economic Modelling, Elsevier, Elsevier, vol. 27(4), pages 881-890, July.
  7. Federico Belotti & Giuseppe Ilardi, 2012. "Consistent Estimation of the “True” Fixed-effects Stochastic Frontier Model," CEIS Research Paper, Tor Vergata University, CEIS 231, Tor Vergata University, CEIS, revised 18 Apr 2012.
  8. Berta, P & Callea, G & Martini, G & Vittadini, G, 2009. "The effects of upcoding, cream skimming and readmissions on the Italian hospitals efficiency: a population–based investigation," MPRA Paper 17671, University Library of Munich, Germany.
  9. Abbas, Touqeer & Awan, Masood Sarwar & Aslam, Muhammad Amir & Waqas, Muhammad, 2011. "Analyzing the efficiency differences among basic health units in Sargodha District," MPRA Paper 32244, University Library of Munich, Germany.
  10. Claudio Pinto, 2014. "Efficiency comparison for directly managed public hospitals for different geographical area in Italy," Working papers, Società Italiana di Economia Pubblica 5, Società Italiana di Economia Pubblica.
  11. Lagravinese, Raffaele & Paradiso, Massimo, 2012. "Corruption and health expenditure in Italy," MPRA Paper 43215, University Library of Munich, Germany.
  12. Helmut Herwartz & Christoph Strumann, 2012. "On the effect of prospective payment on local hospital competition in Germany," Health Care Management Science, Springer, Springer, vol. 15(1), pages 48-62, March.
  13. Street, Andrew & Sivey, Peter & Mason, Anne & Miraldo, Marisa & Siciliani, Luigi, 2010. "Are English treatment centres treating less complex patients?," Health Policy, Elsevier, Elsevier, vol. 94(2), pages 150-157, February.
  14. 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, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE) def9, Università Cattolica del Sacro Cuore, Dipartimenti e Istituti di Scienze Economiche (DISCE).
  15. Vincenzo Atella & Federico Belotti & Silvio Daidone & Giuseppe Ilardi & Giorgia Marini, 2012. "Cost-containment policies and hospital efficiency: evidence from a panel of Italian hospitals," CEIS Research Paper, Tor Vergata University, CEIS 228, Tor Vergata University, CEIS, revised 13 Apr 2012.

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