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A Strategic Financial Management Evaluation of Private Hospitals’ Effectiveness and Efficiency for Sustainable Financing: A Research Study

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  • Michael Kourtis
  • Panayiotis Curtis
  • Michael Hanias
  • Eleftherios Kourtis

Abstract

Purpose: The purpose of the study is to evaluate the performance οf private hospitals and identify conditions that secure sustainable financing οf the sector. Design/Methodology/Approach: The Data Envelopment Analysis (DEA) was used as the main tool to measure efficiency and effectiveness among fifteen (15) major private hospitals in Greece. Audited financial statement data were analyzed as a basis for the assessment of their performance. Αn input oriented model was applied due to the fact that assets and employee expenses are more likely to be under the control of management in private hospitals, compared to revenues and CFFO. The latter were used as outputs that represent measures of effectiveness and efficiency respectively which secure sustainability. We opted for the Variable Return to Scale (VRS) version of DEA (in connection with the CRS one), since hospital are systems extremely depended on the human capital and the knowledge management, as a means of creating value and are characterized by non-linear dynamics. Findings: The great majority of the hospitals in the sample exhibit increasing and decreasing returns scale. Inefficiencies found to emanate from a non-optimal scale of the hospitals rather, than from management’s lack of capability to transform inputs to outputs. Practical Implications: The study aspires to frame options and help management to make informed choices that promote sustainable development of the private sector, which are also applicable to the public one. It is essential for public authorities to judge the meaningful performance of the private hospitals, to administer accordingly the level of its subsidies through public insurance funds, the claw back and rebate policies in a period of fiscal austerity and act accordingly to attract or deter the inflow of scalable private funds in healthcare to promote human wellbeing. Originality/Value: Performance differences, can be leveraged to guide improvements in the operation of the private hospitals and reforms in the health care system.

Suggested Citation

  • Michael Kourtis & Panayiotis Curtis & Michael Hanias & Eleftherios Kourtis, 2021. "A Strategic Financial Management Evaluation of Private Hospitals’ Effectiveness and Efficiency for Sustainable Financing: A Research Study," European Research Studies Journal, European Research Studies Journal, vol. 0(1), pages 1025-1054.
    • Handle: RePEc:ers:journl:v:xxiv:y:2021:i:1:p:1025-1054
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    1. Guan, Jian Cheng & Yam, Richard C.M. & Mok, Chiu Kam & Ma, Ning, 2006. "A study of the relationship between competitiveness and technological innovation capability based on DEA models," European Journal of Operational Research, Elsevier, vol. 170(3), pages 971-986, May.
    2. Gloria J. Bazzoli & Hsueh‐Fen Chen & Mei Zhao & Richard C. Lindrooth, 2008. "Hospital financial condition and the quality of patient care," Health Economics, John Wiley & Sons, Ltd., vol. 17(8), pages 977-995, August.
    3. Waldemar Tarczynski & Malgorzata Tarczynska-Luniewska & Kinga Flaga-Gieruszynska, 2020. "The Problem of Bankruptcy in Listed Companies," European Research Studies Journal, European Research Studies Journal, vol. 0(Special 2), pages 3-15.
    4. Coelli, Tim J., 1995. "Recent Developments In Frontier Modelling And Efficiency Measurement," Australian Journal of Agricultural Economics, Australian Agricultural and Resource Economics Society, vol. 39(3), pages 1-27, December.
    5. Siskou, Olga & Kaitelidou, Daphne & Papakonstantinou, Vasiliki & Liaropoulos, Lycourgos, 2008. "Private health expenditure in the Greek health care system: Where truth ends and the myth begins," Health Policy, Elsevier, vol. 88(2-3), pages 282-293, December.
    6. Yasemin Y. Kor & Huseyin Leblebici, 2005. "How do interdependencies among human‐capital deployment, development, and diversification strategies affect firms' financial performance?," Strategic Management Journal, Wiley Blackwell, vol. 26(10), pages 967-985, October.
    7. Avkiran, Necmi K., 2011. "Association of DEA super-efficiency estimates with financial ratios: Investigating the case for Chinese banks," Omega, Elsevier, vol. 39(3), pages 323-334, June.
    8. Panayiotis Curtis & Jonh Thalassinos, 2005. "Equity fund raising and “creative” accounting practices: Indications from Athens Stock Exchange for the 1999-2000 period," European Research Studies Journal, European Research Studies Journal, vol. 0(1-2), pages 127-127.
    9. G.P. Kourtis & L.P. Κourtis & M.P. Kourtis & P. Curtis, 2017. "Fundamental Analysis, Stock Returns and High B/M Companies," International Journal of Economics & Business Administration (IJEBA), International Journal of Economics & Business Administration (IJEBA), vol. 0(4), pages 3-18.
    10. Victor Podinovski & Emmanuel Thanassoulis, 2007. "Improving discrimination in data envelopment analysis: some practical suggestions," Journal of Productivity Analysis, Springer, vol. 28(1), pages 117-126, October.
    11. Yasemin Y. Kor & Joseph T. Mahoney, 2000. "Penrose’s Resource‐Based Approach: The Process and Product of Research Creativity," Journal of Management Studies, Wiley Blackwell, vol. 37(1), pages 1-1, January.
    12. Sunil Kumar & Rachita Gulati, 2010. "Measuring efficiency, effectiveness and performance of Indian public sector banks," International Journal of Productivity and Performance Management, Emerald Group Publishing Limited, vol. 59(1), pages 51-74, January.
    13. Panayiotis Courtis, 2003. "DU PONT Ratio: A comprehensive measure of business performance," European Research Studies Journal, European Research Studies Journal, vol. 0(1-2), pages 21-34, January -.
    14. William Greene & Dan Segal, 2004. "Profitability and Efficiency in the U.S. Life Insurance Industry," Journal of Productivity Analysis, Springer, vol. 21(3), pages 229-247, May.
    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. Gabriel Hawawini & Venkat Subramanian & Paul Verdin, 2003. "Is performance driven by industry‐or firm‐specific factors? A new look at the evidence," Strategic Management Journal, Wiley Blackwell, vol. 24(1), pages 1-16, January.
    17. Malgorzata Pawlowska, 2015. "The impact of market structure and the business cycle on bank profitability: the role of foreign ownership. The case of Poland," NBP Working Papers 229, Narodowy Bank Polski.
    18. William W. Cooper & Lawrence M. Seiford & Joe Zhu, 2011. "Data Envelopment Analysis: History, Models, and Interpretations," International Series in Operations Research & Management Science, in: William W. Cooper & Lawrence M. Seiford & Joe Zhu (ed.), Handbook on Data Envelopment Analysis, chapter 0, pages 1-39, Springer.
    19. Sebastian Kohl & Jan Schoenfelder & Andreas Fügener & Jens O. Brunner, 2020. "Correction to: The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals," Health Care Management Science, Springer, vol. 23(1), pages 170-170, March.
    20. Joe Zhu, 2014. "Data Envelopment Analysis," International Series in Operations Research & Management Science, in: Quantitative Models for Performance Evaluation and Benchmarking, edition 3, chapter 1, pages 1-9, Springer.
    21. Panayiotis G. Curtis & Michael Hanias & Eleftherios Kourtis & Mixalis Kourtis, 2020. "Data Envelopment Analysis (DEA) and Financial Ratios: Α Pro-Stakeholders’ View of Performance Measurement for Sustainable Value Creation of the Wind Energy," International Journal of Economics & Business Administration (IJEBA), International Journal of Economics & Business Administration (IJEBA), vol. 0(2), pages 326-350.
    22. Jacobs,Rowena & Smith,Peter C. & Street,Andrew, 2006. "Measuring Efficiency in Health Care," Cambridge Books, Cambridge University Press, number 9780521851442.
    23. Barbara Casu & Claudia Girardone, 2004. "Financial conglomeration: efficiency, productivity and strategic drive," Applied Financial Economics, Taylor & Francis Journals, vol. 14(10), pages 687-696.
    24. Robert Stefko & Beata Gavurova & Kristina Kocisova, 2018. "Healthcare efficiency assessment using DEA analysis in the Slovak Republic," Health Economics Review, Springer, vol. 8(1), pages 1-12, December.
    25. Michael Rosko & Mona Al-Amin & Manouchehr Tavakoli, 2020. "Efficiency and profitability in US not-for-profit hospitals," International Journal of Health Economics and Management, Springer, vol. 20(4), pages 359-379, December.
    26. Jamal Ouenniche & Skarleth Carrales, 2018. "Assessing efficiency profiles of UK commercial banks: a DEA analysis with regression-based feedback," Annals of Operations Research, Springer, vol. 266(1), pages 551-587, July.
    27. Panayiotis Curtis & Theodore A. Roupas, 2009. "Health Care Finance, the Performance of Public Hospitals and Financial Statement Analysis," European Research Studies Journal, European Research Studies Journal, vol. 0(4), pages 199-212.
    28. Cook, Wade D. & Tone, Kaoru & Zhu, Joe, 2014. "Data envelopment analysis: Prior to choosing a model," Omega, Elsevier, vol. 44(C), pages 1-4.
    29. Birger Wernerfelt, 1984. "A resource‐based view of the firm," Strategic Management Journal, Wiley Blackwell, vol. 5(2), pages 171-180, April.
    30. Anna Cwiakala- Malys & Pawel Lagowski & Malgorzata Durbajlo-Mrowiec & Lukasz Kuzminski & Tomasz Rolczynski, 2020. "Efficiency Evaluation of Using Resources by Hospital Units," European Research Studies Journal, European Research Studies Journal, vol. 0(4), pages 1177-1196.
    31. 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.
    32. repec:ers:journl:v:v:y:2017:i:4:p:3-18 is not listed on IDEAS
    33. Chang, Hsi-Hui, 1998. "Determinants of Hospital Efficiency: the Case of Central Government-owned Hospitals in Taiwan," Omega, Elsevier, vol. 26(2), pages 307-317, April.
    34. Seiford, Lawrence M. & Zhu, Joe, 1999. "An investigation of returns to scale in data envelopment analysis," Omega, Elsevier, vol. 27(1), pages 1-11, February.
    35. William W. Cooper & Lawrence M. Seiford & Kaoru Tone, 2006. "Introduction to Data Envelopment Analysis and Its Uses," Springer Books, Springer, number 978-0-387-29122-2, September.
    Full references (including those not matched with items on IDEAS)

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    Cited by:

    1. Eleftherios Kourtis & Michael Kourtis & Panayiotis Curtis & Michael Hanias, 2022. "Sustainable Business Growth, Value Creation and Dynamic Competitive Advantage: The Greek Pharmaceutical Industry," European Research Studies Journal, European Research Studies Journal, vol. 0(2), pages 46-79.
    2. Panayiotis Curtis & Michael Hanias & Eleftherios Kourtis & Michael Kourtis, 2021. "Financial Performance Assessment οf Strategy for Building Resilience and Readiness in the Hotel Sector of Greece," International Journal of Finance, Insurance and Risk Management, International Journal of Finance, Insurance and Risk Management, vol. 11(2), pages 3-27.
    3. Elzbieta Izabela Szczepankiewicz & Beata Zaleska & Anna Bartoszewicz, 2021. "Assessment of the Level of Implementation of Internal Audits in Polish Public Hospitals," European Research Studies Journal, European Research Studies Journal, vol. 0(2), pages 78-95.

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    More about this item

    Keywords

    Hospitals; efficiency; effectiveness; financial data; DEA; sustainable strategy.;
    All these keywords.

    JEL classification:

    • C14 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Semiparametric and Nonparametric Methods: General
    • D21 - Microeconomics - - Production and Organizations - - - Firm Behavior: Theory
    • D24 - Microeconomics - - Production and Organizations - - - Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity
    • C61 - Mathematical and Quantitative Methods - - Mathematical Methods; Programming Models; Mathematical and Simulation Modeling - - - Optimization Techniques; Programming Models; Dynamic Analysis
    • H41 - Public Economics - - Publicly Provided Goods - - - Public Goods
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health

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