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Competition and Efficiencyin health care: an analysis of the Italian case

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  • R. Cellini
  • G. Pignataro
  • I. 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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Bibliographic Info

Paper provided by Dipartimento Scienze Economiche, Universita' di Bologna in its series Working Papers with number 354.

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Date of creation: Jul 1999
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Handle: RePEc:bol:bodewp:354

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References

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  1. 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, Elsevier, vol. 7(4), pages 301-320, December.
  2. Islam, Nazrul, 1995. "Growth Empirics: A Panel Data Approach," The Quarterly Journal of Economics, MIT Press, MIT Press, vol. 110(4), pages 1127-70, November.
  3. 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., John Wiley & Sons, Ltd., vol. 8(2), pages 151-164.
  4. R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, INFORMS, vol. 30(9), pages 1078-1092, September.
  5. 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, OECD Publishing 33, OECD Publishing.
  6. 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, Springer, vol. 13(4), pages 447-466, August.
  7. James F. Burgess, Jr. & Paul W. Wilson, 1996. "Hospital Ownership and Technical Inefficiency," Management Science, INFORMS, INFORMS, vol. 42(1), pages 110-123, January.
  8. Gerdtham, Ulf-G. & Löthgren, Mickael, 1998. "Health Care System Effects on Cost Efficiency in the OECD Countries," Working Paper Series in Economics and Finance, Stockholm School of Economics 247, Stockholm School of Economics.
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Citations

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Cited by:
  1. 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, Elsevier, vol. 194(1), pages 280-293, April.
  2. Bordignon, Massimo & Turati, Gilberto, 2009. "Bailing out expectations and public health expenditure," Journal of Health Economics, Elsevier, Elsevier, vol. 28(2), pages 305-321, March.
  3. 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).
  4. Chew Lian Chua & Alfons Palangkaraya & Jongsay Yong, 2011. "Hospital Competition, Technical Efficiency and Quality," The Economic Record, The Economic Society of Australia, The Economic Society of Australia, vol. 87(277), pages 252-268, 06.
  5. Massimo Bordignon & Gilberto Turati, 2003. "Bailing Out Expectations and Health Expenditure in Italy," CESifo Working Paper Series, CESifo Group Munich 1026, CESifo Group Munich.
  6. Padovano, Fabio, 2012. "The drivers of interregional policy choices: Evidence from Italy," European Journal of Political Economy, Elsevier, Elsevier, vol. 28(3), pages 324-340.
  7. Gian Paolo Barbetta & Gilberto Turati & Angelo Zago, 2004. "Behavioral Differences Between Public and Private Not-For-Profit Hospitals in the Italian National Health Service," Working Papers, University of Verona, Department of Economics 12, University of Verona, Department of Economics.
  8. 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, Springer, vol. 6(3), pages 215-236, September.
  9. PINTO, Claudio, 2013. "Complexity of Treatment, and Changes in Efficiency and Productivity for Directly Managed Italian Hospitals," CELPE Discussion Papers, CELPE - Centre of Labour Economics and Economic Policy, University of Salerno, Italy 124, CELPE - Centre of Labour Economics and Economic Policy, University of Salerno, Italy.
  10. Gianni De Fraja & Paola Valbonesi, 2009. "Mixed Oligopoly: Old and New," Discussion Papers in Economics, Department of Economics, University of Leicester 09/20, Department of Economics, University of Leicester.

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