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The impact of managerial and organizational aspects on hospital wards' efficiency: Evidence from a case study

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  • Ancarani, A.
  • Di Mauro, C.
  • Giammanco, M.D.

Abstract

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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  • 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, vol. 194(1), pages 280-293, April.
    • Handle: RePEc:eee:ejores:v:194:y:2009:i:1:p:280-293
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    2. Kao, Ling-Jing & Lu, Chi-Jie & Chiu, Chih-Chou, 2011. "Efficiency measurement using independent component analysis and data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 210(2), pages 310-317, April.
    3. Nan Jiang & Antony Andrews, 2020. "Efficiency of New Zealand’s District Health Boards at Providing Hospital Services: A stochastic frontier analysis," Journal of Productivity Analysis, Springer, vol. 53(1), pages 53-68, February.
    4. L-J Kao & C-C Lu & C-C Chiu, 2011. "The training institution efficiency of the semiconductor institute programme in Taiwan—application of spatiotemporal ICA with DEA approach," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 62(12), pages 2162-2172, December.
    5. Ancarani, Alessandro & Di Mauro, Carmela & Gitto, Simone & Mancuso, Paolo & Ayach, Ali, 2016. "Technology acquisition and efficiency in Dubai hospitals," Technological Forecasting and Social Change, Elsevier, vol. 113(PB), pages 475-485.
    6. 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.
    7. Sabina Nuti & Guido Noto & Tommaso Grillo Ruggieri & Milena Vainieri, 2021. "The Challenges of Hospitals’ Planning & Control Systems: The Path toward Public Value Management," IJERPH, MDPI, vol. 18(5), pages 1-14, March.
    8. Valdmanis, Vivian & Bernet, Patrick & Moises, James, 2010. "Hospital capacity, capability, and emergency preparedness," European Journal of Operational Research, Elsevier, vol. 207(3), pages 1628-1634, December.
    9. Sepideh Abolghasem & Mehdi Toloo & Santiago Amézquita, 2019. "Cross-efficiency evaluation in the presence of flexible measures with an application to healthcare systems," Health Care Management Science, Springer, vol. 22(3), pages 512-533, September.
    10. Monica Giancotti & Annamaria Guglielmo & Marianna Mauro, 2017. "Efficiency and optimal size of hospitals: Results of a systematic search," PLOS ONE, Public Library of Science, vol. 12(3), pages 1-40, March.
    11. Deng, Zhongqi & Jiang, Nan & Pang, Ruizhi, 2021. "Factor-analysis-based directional distance function: The case of New Zealand hospitals," Omega, Elsevier, vol. 98(C).
    12. Hong Ngoc Nguyen & Christopher O’Donnell, 2022. "Estimating the Revenue Efficiency of Public Service Providersin the Presence of Demand Constraints," CEPA Working Papers Series WP032022, School of Economics, University of Queensland, Australia.
    13. Nieswand, Maria & Seifert, Stefan, 2018. "Environmental factors in frontier estimation – A Monte Carlo analysis," European Journal of Operational Research, Elsevier, vol. 265(1), pages 133-148.
    14. Cláudia Araújo & Carlos Barros & Peter Wanke, 2014. "Efficiency determinants and capacity issues in Brazilian for-profit hospitals," Health Care Management Science, Springer, vol. 17(2), pages 126-138, June.
    15. Mehmet Gok & Erkut Altındağ, 2015. "Analysis of the cost and efficiency relationship: experience in the Turkish pay for performance system," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(5), pages 459-469, June.
    16. Habib Zare & Madjid Tavana & Abbas Mardani & Sepideh Masoudian & Mahyar Kamali Saraji, 2019. "A hybrid data envelopment analysis and game theory model for performance measurement in healthcare," Health Care Management Science, Springer, vol. 22(3), pages 475-488, September.
    17. Pınar Kaya Samut & Reyhan Cafrı, 2016. "Analysis of the Efficiency Determinants of Health Systems in OECD Countries by DEA and Panel Tobit," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 129(1), pages 113-132, October.
    18. Yang, Xiaopeng & Zheng, Danheng & Sieminowski, Tammy & Paradi, Joseph C., 2015. "A dynamic benchmarking system for assessing the recovery of inpatients: Evidence from the neurorehabilitation process," European Journal of Operational Research, Elsevier, vol. 240(2), pages 582-591.
    19. Androutsou, Lorena & Metaxas, Theodore, 2018. "Measuring the effeciency of medical tourism industry in EU members states," MPRA Paper 92461, University Library of Munich, Germany.

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