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Efficiency and Program-Contract Bargaining in Spanish Public Hospitals

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  • Juan Ventura
  • Eduardo GonzáLez
  • Ana Cárcaba

Abstract

This paper analyses the evolution of productivity in Spanish public hospitals during the period characterised by the use of program-contracts. The results demonstrate that a significant improvement has occurred. The decomposition of the Malmquist productivity index shows that efficiency change has been the main contributor to productivity improvement. We also analyse the dynamic implications of program-contract bargaining. In particular, the data support the hypothesis that the bargaining process has been subject to a ratchet effect, i.e., the more a hospital does today, the more the hospital is asked to do in the future. This result threatens the credibility of the program-contract as an incentive system. Copyright CIRIEC, 2004.

Suggested Citation

  • Juan Ventura & Eduardo GonzáLez & Ana Cárcaba, 2004. "Efficiency and Program-Contract Bargaining in Spanish Public Hospitals," Annals of Public and Cooperative Economics, Wiley Blackwell, vol. 75(4), pages 549-573, December.
  • Handle: RePEc:bla:annpce:v:75:y:2004:i:4:p:549-573
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    Cited by:

    1. Worthington, Andrew C. & Lee, Boon L., 2008. "Efficiency, technology and productivity change in Australian universities, 1998-2003," Economics of Education Review, Elsevier, vol. 27(3), pages 285-298, June.
    2. Pablo Arocena & Ariadna García-Prado, 2007. "Accounting for quality in the measurement of hospital performance: evidence from Costa Rica," Health Economics, John Wiley & Sons, Ltd., vol. 16(7), pages 667-685.
    3. Dino Rizzi & Vincenzo Rebba, 2006. "Measuring Hospital Efficiency through Data Envelopment Analysis when Policy-makers� Preferences Matter. An Application to a sample of Italian NHS hospitals," Working Papers 2006_13, Department of Economics, University of Venice "Ca' Foscari".
    4. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128.

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