Technical efficiency, specialization and ownership form: evidences from a pooling of Italian hospitals
We evaluate how the productive structure and level of specialization of a hospital affect technical efficiency by analyzing a six-year panel database (2000/2005) drawn from hospital discharge records and Ministry of Health data. We adopt a distance function approach, while measuring the technical efficiency level with stochastic frontier techniques. After controlling for environmental variables and hospital case-mix, inefficiency is negatively associated with specialization and positively associated with capitalization. Capitalization is typical of private structures which, on average, use resources less efficiently with respect to public and not-for-profit hospitals. Finally, by looking at scale elasticities, we find some evidence of unexploited economies of scale, leaving room for centralization.
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- Mehdi Farsi & Massimo Filippini, 2006. "An Analysis of Efficiency and Productivity in Swiss Hospitals," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 142(I), pages 1-37, March.
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"One-step and two-step estimation of the effects of exogenous variables on technical efficiency levels,"
31075, University Library of Munich, Germany, revised Mar 2002.
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- Gian Paolo Barbetta & Gilberto Turati & Angelo M. Zago, 2007. "Behavioral differences between public and private not-for-profit hospitals in the Italian national health service," Health Economics, John Wiley & Sons, Ltd., vol. 16(1), pages 75-96.
- Newhouse, Joseph P., 1994. "Frontier estimation: How useful a tool for health economics?," Journal of Health Economics, Elsevier, vol. 13(3), pages 317-322, October.
- Hung-Jen Wang, 2002.
"Heteroscedasticity and Non-Monotonic Efficiency Effects of a Stochastic Frontier Model,"
Journal of Productivity Analysis,
Springer, vol. 18(3), pages 241-253, November.
- Wang, Hung-Jen, 2002. "Heteroscedasticity and non-monotonic efficiency effects of a stochastic frontier model," MPRA Paper 31076, University Library of Munich, Germany.
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- Luca Grassetti & Enrico Gori & Simona Caterina Minotti, 2005. "Multilevel flexible specification of the production function in health economics," Working Papers 20050402, Università degli Studi di Milano-Bicocca, Dipartimento di Statistica.
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