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Technical efficiency, specialization and ownership form: evidences from a pooling of Italian hospitals

  • Silvio Daidone

    ()

  • Francesco D’Amico

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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File URL: http://hdl.handle.net/10.1007/s11123-009-0137-7
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Article provided by Springer in its journal Journal of Productivity Analysis.

Volume (Year): 32 (2009)
Issue (Month): 3 (December)
Pages: 203-216

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Handle: RePEc:kap:jproda:v:32:y:2009:i:3:p:203-216
Contact details of provider: Web page: http://www.springerlink.com/link.asp?id=100296

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  1. 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.
  2. Wang, Hung-jen & Schmidt, Peter, 2001. "One-step and two-step estimation of the effects of exogenous variables on technical efficiency levels," MPRA Paper 31075, University Library of Munich, Germany, revised Mar 2002.
  3. Catherine J. Morrison Paul & Warren E. Johnston & Gerald A. G. Frengley, 2000. "Efficiency in New Zealand Sheep and Beef Farming: The Impacts of Regulatory Reform," The Review of Economics and Statistics, MIT Press, vol. 82(2), pages 325-337, May.
  4. 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.
  5. 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.
  6. 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.
  7. repec:ver:wpaper:12 is not listed on IDEAS
  8. 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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