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Competition and Efficiency in Health Care: An Analysis of the Italian Case

  • Roberto Cellini
  • Giacomo Pignataro
  • Ilde Rizzo

In this paper we look at the Italian NationalHealth System as a case study, in order to investigate whethercompetition exerts positive effects on the efficiency of hospitals.Using the DEA technique we measure the efficiency of Italianhospital production; secondly, we take a regression analysisapproach to analyse its determinants. A general conclusion stemmingout of the analysis is that competition is not a value per seand that its effects on hospitals' performance are affected bythe rules governing the health system. Copyright Kluwer Academic Publishers 2000

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File URL: http://hdl.handle.net/10.1023/A:1008737506560
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Article provided by Springer in its journal International Tax and Public Finance.

Volume (Year): 7 (2000)
Issue (Month): 4 (August)
Pages: 503-519

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Handle: RePEc:kap:itaxpf:v:7:y:2000:i:4:p:503-519
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  1. Zwanziger, Jack & Melnick, Glenn A., 1988. "The effects of hospital competition and the Medicare PPS program on hospital cost behavior in California," Journal of Health Economics, Elsevier, vol. 7(4), pages 301-320, December.
  2. David W. Kalisch & Tetsuya Aman & Libbie A. Buchele, 1998. "Social and Health Policies in OECD Countries: A Survey of Current Programmes and Recent Developments," OECD Labour Market and Social Policy Occasional Papers 33, OECD Publishing.
  3. Eulália Dalmau-Atarrodona & Jaume Puig-Junoy, 1998. "Market Structure and Hospital Efficiency: Evaluating Potential Effects of Deregulation in a National Health Service," Review of Industrial Organization, Springer, vol. 13(4), pages 447-466, August.
  4. U.-G. Gerdtham & M. Löthgren & M. Tambour & C. Rehnberg, 1999. "Internal markets and health care efficiency: a multiple-output stochastic frontier analysis," Health Economics, John Wiley & Sons, Ltd., vol. 8(2), pages 151-164.
  5. Gerdtham, Ulf-G. & Löthgren, Mickael, 1998. "Health Care System Effects on Cost Efficiency in the OECD Countries," SSE/EFI Working Paper Series in Economics and Finance 247, Stockholm School of Economics.
  6. Islam, Nazrul, 1995. "Growth Empirics: A Panel Data Approach," The Quarterly Journal of Economics, MIT Press, vol. 110(4), pages 1127-70, November.
  7. 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.
  8. James F. Burgess, Jr. & Paul W. Wilson, 1996. "Hospital Ownership and Technical Inefficiency," Management Science, INFORMS, vol. 42(1), pages 110-123, January.
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