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Assessing physician productivity following Norwegian hospital reform: A panel and data envelopment analysis

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  • Johannessen, Karl Arne
  • Kittelsen, Sverre A.C.
  • Hagen, Terje P.

Abstract

Although health care reforms may improve efficiency at the macro level, less is known regarding their effects on the utilization of health care personnel. Following the 2002 Norwegian hospital reform, we studied the productivity of the physician workforce and the effect of personnel mix on this measure in all nineteen Norwegian hospitals from 2001 to 2013.

Suggested Citation

  • Johannessen, Karl Arne & Kittelsen, Sverre A.C. & Hagen, Terje P., 2017. "Assessing physician productivity following Norwegian hospital reform: A panel and data envelopment analysis," Social Science & Medicine, Elsevier, vol. 175(C), pages 117-126.
  • Handle: RePEc:eee:socmed:v:175:y:2017:i:c:p:117-126
    DOI: 10.1016/j.socscimed.2017.01.008
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    1. 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.
    2. Jonas Schreyögg, 2008. "A micro‐costing approach to estimating hospital costs for appendectomy in a Cross‐European context," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages 59-69, January.
    3. Rossella Verzulli & Rowena Jacobs & Maria Goddard, 2011. "Do hospitals respond to greater autonomy? Evidence from the English NHS," Working Papers 064cherp, Centre for Health Economics, University of York.
    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. Kirsi Vitikainen & Miika Linna & Andrew Street, 2010. "Substituting inpatient for outpatient care: what is the impact on hospital costs and efficiency?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(4), pages 395-404, August.
    6. Steven Simoens & Jeremy Hurst, 2006. "The Supply of Physician Services in OECD Countries," OECD Health Working Papers 21, OECD Publishing.
    7. María Jose Aragon Aragon & Adriana Castelli & James Gaughan, 2017. "Hospital Trusts productivity in the English NHS: Uncovering possible drivers of productivity variations," PLOS ONE, Public Library of Science, vol. 12(8), pages 1-14, August.
    8. Franco, Lynne Miller & Bennett, Sara & Kanfer, Ruth, 2002. "Health sector reform and public sector health worker motivation: a conceptual framework," Social Science & Medicine, Elsevier, vol. 54(8), pages 1255-1266, April.
    9. Laudicella, Mauro & Olsen, Kim Rose & Street, Andrew, 2010. "Examining cost variation across hospital departments-a two-stage multi-level approach using patient-level data," Social Science & Medicine, Elsevier, vol. 71(10), pages 1872-1881, November.
    10. Nicholas Bloom & Carol Propper & Stephan Seiler & John Van Reenen, 2015. "The Impact of Competition on Management Quality: Evidence from Public Hospitals," Review of Economic Studies, Oxford University Press, vol. 82(2), pages 457-489.
    11. Wilsford, David, 1994. "Path Dependency, or Why History Makes It Difficult but Not Impossible to Reform Health Care Systems in a Big Way," Journal of Public Policy, Cambridge University Press, vol. 14(3), pages 251-283, July.
    12. Emma Medin & Kjartan Anthun & Unto Häkkinen & Sverre Kittelsen & Miika Linna & Jon Magnussen & Kim Olsen & Clas Rehnberg, 2011. "Cost efficiency of university hospitals in the Nordic countries: a cross-country analysis," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(6), pages 509-519, December.
    13. Oliver Tiemann & Jonas Schreyögg, 2012. "Changes in hospital efficiency after privatization," Health Care Management Science, Springer, vol. 15(4), pages 310-326, December.
    14. Hvenegaard, Anne & Street, Andrew & Sørensen, Torben Højmark & Gyrd-Hansen, Dorte, 2009. "Comparing hospital costs: What is gained by accounting for more than a case-mix index?," Social Science & Medicine, Elsevier, vol. 69(4), pages 640-647, August.
    15. Adriana Castelli & Andrew Street & Rossella Verzulli & Padraic Ward, 2015. "Examining variations in hospital productivity in the English NHS," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(3), pages 243-254, April.
    16. 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.
    17. Neil Rickman & Alistair McGuire, 1999. "Regulating Providers’ Reimbursement in a Mixed Market for Health Care," Scottish Journal of Political Economy, Scottish Economic Society, vol. 46(1), pages 53-71, February.
    18. Reinhard Busse & Jonas Schreyögg & Peter C. Smith, 2008. "Variability in healthcare treatment costs amongst nine EU countries – results from the HealthBASKET project," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages 1-8, January.
    19. Erik Biørn & Terje Hagen & Tor Iversen & Jon Magnussen, 2010. "How different are hospitals’ responses to a financial reform? The impact on efficiency of activity-based financing," Health Care Management Science, Springer, vol. 13(1), pages 1-16, March.
    20. Léopold Simar & Paul W. Wilson, 1998. "Sensitivity Analysis of Efficiency Scores: How to Bootstrap in Nonparametric Frontier Models," Management Science, INFORMS, vol. 44(1), pages 49-61, January.
    21. Julia Bonastre & Marc le Vaillant & Gerard de Pouvourville, 2011. "The impact of research on hospital costs of care: an empirical study," Health Economics, John Wiley & Sons, Ltd., vol. 20(1), pages 73-84, January.
    22. Rumbold, Benedict E. & Smith, Judith A. & Hurst, Jeremy & Charlesworth, Anita & Clarke, Aileen, 2015. "Improving productive efficiency in hospitals: findings from a review of the international evidence," Health Economics, Policy and Law, Cambridge University Press, vol. 10(1), pages 21-43, January.
    23. Richard Heijink & Peter Engelfriet & Clas Rehnberg & Sverre A. C. Kittelsen & Unto Häkkinen & on behalf of the EuroHOPE study group, 2015. "A Window on Geographic Variation in Health Care: Insights from EuroHOPE," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 164-177, December.
    24. Sverre A. C. Kittelsen & Kjartan S. Anthun & Fanny Goude & Ingrid M. S. Huitfeldt & Unto Häkkinen & Marie Kruse & Emma Medin & Clas Rehnberg & Hanna Rättö & on behalf of the EuroHOPE study group, 2015. "Costs and Quality at the Hospital Level in the Nordic Countries," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 140-163, December.
    25. 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.
    26. Hagen, Terje P. & Kaarboe, Oddvar M., 2006. "The Norwegian hospital reform of 2002: Central government takes over ownership of public hospitals," Health Policy, Elsevier, vol. 76(3), pages 320-333, May.
    27. Jan Erik Askildsen & Tor Helge Holmås, 2013. "Wages and work conditions as determinants for physicians’ work decisions," Applied Economics, Taylor & Francis Journals, vol. 45(3), pages 397-406, January.
    28. 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.
    29. Miriam M. Wiley, 2005. "The Irish health system: developments in strategy, structure, funding and delivery since 1980," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages 169-186, September.
    30. Miika Linna & Unto Häkkinen & Eero Linnakko, 1998. "An econometric study of costs of teaching and research in Finnish hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 7(4), pages 291-305, June.
    31. Oliver Tiemann, 2008. "Variations in hospitalisation costs for acute myocardial infarction – a comparison across Europe," Health Economics, John Wiley & Sons, Ltd., vol. 17(S1), pages 33-45, January.
    32. Devlin, Rose Anne & Sarma, Sisira, 2008. "Do physician remuneration schemes matter? The case of Canadian family physicians," Journal of Health Economics, Elsevier, vol. 27(5), pages 1168-1181, September.
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