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The impact of New Public Management on efficiency: An analysis of Madrid's hospitals

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  • Alonso, José M.
  • Clifton, Judith
  • Díaz-Fuentes, Daniel

Abstract

Madrid has recently become the site of one of the most controversial cases of public healthcare reform in the European Union. Despite the fact that the introduction of New Public Management (NPM) into Madrid hospitals has been vigorous, little scholarship has been done to test whether NPM actually led to technical efficiency. This paper is one of the first attempts to do so. We deploy a bootstrapped data envelopment analysis to compare efficiency scores in traditionally managed hospitals and those operating with new management formulas. We do not find evidence that NPM hospitals are more efficient than traditionally managed ones. Moreover, our results suggest that what actually matters may be the management itself, rather than the management model.

Suggested Citation

  • Alonso, José M. & Clifton, Judith & Díaz-Fuentes, Daniel, 2015. "The impact of New Public Management on efficiency: An analysis of Madrid's hospitals," Health Policy, Elsevier, vol. 119(3), pages 333-340.
    • Handle: RePEc:eee:hepoli:v:119:y:2015:i:3:p:333-340
    DOI: 10.1016/j.healthpol.2014.12.001
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    1. Jean-Jacques Laffont & Jean Tirole, 1991. "The Politics of Government Decision-Making: A Theory of Regulatory Capture," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 106(4), pages 1089-1127.
    2. Jacobs,Rowena & Smith,Peter C. & Street,Andrew, 2006. "Measuring Efficiency in Health Care," Cambridge Books, Cambridge University Press, number 9780521851442.
    3. O'Neill, Liam & Rauner, Marion & Heidenberger, Kurt & Kraus, Markus, 2008. "A cross-national comparison and taxonomy of DEA-based hospital efficiency studies," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 158-189, September.
    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, October.
    5. Gallo, Pedro & Gené-Badia, Joan, 2013. "Cuts drive health system reforms in Spain," Health Policy, Elsevier, vol. 113(1), pages 1-7.
    6. Acerete, Basilio & Stafford, Anne & Stapleton, Pamela, 2011. "Spanish healthcare public private partnerships: The ‘Alzira model’," CRITICAL PERSPECTIVES ON ACCOUNTING, Elsevier, vol. 22(6), pages 533-549.
    7. Varabyova, Yauheniya & Schreyögg, Jonas, 2013. "International comparisons of the technical efficiency of the hospital sector: Panel data analysis of OECD countries using parametric and non-parametric approaches," Health Policy, Elsevier, vol. 112(1), pages 70-79.
    8. Murat Bilsel & Nurhan Davutyan, 2014. "Hospital efficiency with risk adjusted mortality as undesirable output: the Turkish case," Annals of Operations Research, Springer, vol. 221(1), pages 73-88, October.
    9. Banker, Rajiv D., 1984. "Estimating most productive scale size using data envelopment analysis," European Journal of Operational Research, Elsevier, vol. 17(1), pages 35-44, July.
    10. 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.
    11. Basilio Acerete & Anne Stafford & Pamela Stapleton, 2012. "New development: New global health care PPP developments—a critique of the success story," Public Money & Management, Taylor & Francis Journals, vol. 32(4), pages 311-314, July.
    12. Andrei Shleifer & Robert W. Vishny, 1994. "The Politics of Market Socialism," Journal of Economic Perspectives, American Economic Association, vol. 8(2), pages 165-176, Spring.
    13. Mark Hellowell & Allyson M. Pollock, 2009. "The Private Financing Of Nhs Hospitals: Politics, Policy And Practice," Economic Affairs, Wiley Blackwell, vol. 29(1), pages 13-19, March.
    14. 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, July.
    15. 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.
    16. Oliver Hart & Andrei Shleifer & Robert W. Vishny, 1997. "The Proper Scope of Government: Theory and an Application to Prisons," The Quarterly Journal of Economics, President and Fellows of Harvard College, vol. 112(4), pages 1127-1161.
    17. Paul H. Jensen & Robin E. Stonecash, 2005. "Incentives and the Efficiency of Public Sector‐outsourcing Contracts," Journal of Economic Surveys, Wiley Blackwell, vol. 19(5), pages 767-787, December.
    18. Alessandra Ferrari, 2006. "The internal market and hospital efficiency: a stochastic distance function approach," Applied Economics, Taylor & Francis Journals, vol. 38(18), pages 2121-2130.
    19. William W. Cooper & Lawrence M. Seiford & Kaoru Tone, 2007. "Data Envelopment Analysis," Springer Books, Springer, edition 0, number 978-0-387-45283-8, January.
    20. Léopold Simar & Paul Wilson, 2000. "Statistical Inference in Nonparametric Frontier Models: The State of the Art," Journal of Productivity Analysis, Springer, vol. 13(1), pages 49-78, January.
    21. Wilson, Paul W., 2008. "FEAR: A software package for frontier efficiency analysis with R," Socio-Economic Planning Sciences, Elsevier, vol. 42(4), pages 247-254, December.
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