The impact of managerial and organizational aspects on hospital wards' efficiency: Evidence from a case study
In spite of its acknowledged relevance, the impact of managerial and organizational aspects on hospital wards' efficiency has been so far overlooked by the literature. In order to explore this issue, this paper presents a model of the relations between the decision making process of a hospital ward and its technical efficiency. In order to test the model, a two-step approach has been adopted. In the first step the technical efficiency of wards belonging to a large Italian Hospital Enterprise has been calculated using DEA. In the second step, efficiency scores have been regressed on a set of variables capturing managerial goals and actions internal to the ward, as well as re-organizations imposed by the hospital central management. Responses to a questionnaire administered to the heads of ward were used to build the independent variables. Results show that both decisions internal to the ward and exogenous re-organizations affect the ward's efficiency, and suggest that these variables are more significant in explaining efficiency than environmental ones.
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- R. Cellini & G. Pignataro & I. Rizzo, 1999.
"Competition and Efficiency in health care: an analysis of the Italian case,"
354, Dipartimento Scienze Economiche, Universita' di Bologna.
- Roberto Cellini & Giacomo Pignataro & Ilde Rizzo, 2000. "Competition and Efficiency in Health Care: An Analysis of the Italian Case," International Tax and Public Finance, Springer;International Institute of Public Finance, vol. 7(4), pages 503-519, August.
- Pauly, Mark V & Redisch, Michael, 1973. "The Not-For-Profit Hospital as a Physicians' Cooperative," American Economic Review, American Economic Association, vol. 63(1), pages 87-99, March.
- White, Halbert, 1980. "A Heteroskedasticity-Consistent Covariance Matrix Estimator and a Direct Test for Heteroskedasticity," Econometrica, Econometric Society, vol. 48(4), pages 817-38, May.
- Newhouse, Joseph P, 1970. "Toward a Theory of Nonprofit Institutions: An Economic Model of a Hospital," American Economic Review, American Economic Association, vol. 60(1), pages 64-74, March.
- Yu, Chunyan, 1998. "The effects of exogenous variables in efficiency measurement--A monte carlo study," European Journal of Operational Research, Elsevier, vol. 105(3), pages 569-580, March.
- Armen A. Alchian & Harold Demsetz, 1971.
"Production, Information Costs and Economic Organizations,"
UCLA Economics Working Papers
10A, UCLA Department of Economics.
- Alchian, Armen A & Demsetz, Harold, 1972. "Production , Information Costs, and Economic Organization," American Economic Review, American Economic Association, vol. 62(5), pages 777-95, December.
- Milgrom, Paul & Roberts, John, 1994. "Comparing Equilibria," American Economic Review, American Economic Association, vol. 84(3), pages 441-59, June.
- Chen, Andrew & Hwang, Yuhchang & Shao, Benjamin, 2005. "Measurement and sources of overall and input inefficiencies: Evidences and implications in hospital services," European Journal of Operational Research, Elsevier, vol. 161(2), pages 447-468, March.
- R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, vol. 30(9), pages 1078-1092, September.
- 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.
- Chilingerian, Jon A., 1995. "Evaluating physician efficiency in hospitals: A multivariate analysis of best practices," European Journal of Operational Research, Elsevier, vol. 80(3), pages 548-574, February.
- L. Steinmann & P. Zweifel, 2003. "On the (in)efficiency of Swiss hospitals," Applied Economics, Taylor & Francis Journals, vol. 35(3), pages 361-370.
- Li, Ling & Benton, W. C., 2003. "Hospital capacity management decisions: Emphasis on cost control and quality enhancement," European Journal of Operational Research, Elsevier, vol. 146(3), pages 596-614, May.
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