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Hospital ownership and efficiency: A review of studies with particular focus on Germany

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  • Tiemann, Oliver
  • Schreyögg, Jonas
  • Busse, Reinhard

Abstract

The German hospital market has been subject over the past two decades to a variety of healthcare reforms. Particularly the introduction of diagnosis-related groups (DRGs) in 2004 aimed to increase efficiency of hospitals. The objective of the paper is to review recent studies comparing the efficiency of German public, private non-profit and private for-profit hospitals. The results of the studies are quite mixed. However, in line with the evidence found in studies from other countries, especially the US, the evidence from Germany suggests that private ownership (i.e., private non-profit and private for-profit) is not necessarily associated with higher efficiency compared to public ownership. This may be a surprising result to many policy makers as private for-profit hospitals are often perceived the most efficient ownership type by the public.

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  • Tiemann, Oliver & Schreyögg, Jonas & Busse, Reinhard, 2012. "Hospital ownership and efficiency: A review of studies with particular focus on Germany," Health Policy, Elsevier, vol. 104(2), pages 163-171.
    • Handle: RePEc:eee:hepoli:v:104:y:2012:i:2:p:163-171
    DOI: 10.1016/j.healthpol.2011.11.010
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    21. García-Cornejo, Beatriz & Pérez-Méndez, José A., 2018. "Assessing the effect of standardized cost systems on financial performance. A difference-in-differences approach for hospitals according to their technological level," Health Policy, Elsevier, vol. 122(4), pages 396-403.
    22. Cristian A Herrera & Gabriel Rada & Lucy Kuhn-Barrientos & Ximena Barrios, 2014. "Does Ownership Matter? An Overview of Systematic Reviews of the Performance of Private For-Profit, Private Not-For-Profit and Public Healthcare Providers," PLOS ONE, Public Library of Science, vol. 9(12), pages 1-18, December.
    23. Guccio, C.; & Pignataro, G.; & Romeo, D.; & Vidoli, F.;, 2022. "Is austerity good for efficiency, at least? A counterfactual assessment for the Italian NHS," Health, Econometrics and Data Group (HEDG) Working Papers 22/28, HEDG, c/o Department of Economics, University of York.
    24. Färe, Rolf & Karagiannis, Giannis, 2022. "Aggregating Farrell efficiencies without value data: The case of hospitals," Socio-Economic Planning Sciences, Elsevier, vol. 84(C).

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