IDEAS home Printed from
MyIDEAS: Log in (now much improved!) to save this article

Measuring Hospital Efficiency through Data Envelopment Analysis when Policy-makers' Preferences Matter. An Application to a Sample of Italian NHS Hospitals

  • Rebba Vincenzo
  • Rizzi Dino

In this paper we show how both the choice of specific constraints on output weights (in accordance with health care policy-makers' preferences) and the consideration of exogenous variables outside the control of hospital management (and linked to past policy-makers' decisions) can affect the measurement of hospital technical efficiency using the "Data Envelopment Analysis" (DEA). Considering these issues, the DEA method is applied to measure the efficiency of 85 (public and private) hospitals in Veneto, a Northern region of Italy. The empirical analysis allows us to verify the role of weight restrictions and of demand in measuring the efficiency of hospitals operating within a National Health Service (NHS). We find that the imposition of a lower bound on the virtual weight of acute care discharges weighted by case-mix (in order to consider policy-maker objectives) reduces average hospital efficiency. Moreover, we show that, in many cases, low efficiency scores are attributable to external factors, which are not fully controlled by the hospital management. Finally, we show that accredited private hospitals exhibit a higher level of total inefficiency than public ones: for-profit hospitals are mostly characterised by scale inefficiency, while non-profit hospitals are affected by different sources of inefficiency. Most of the hospitals in Veneto are too small in relation to their output levels (i.e. are characterised by IRS) and this problem of scale inefficiency characterises mainly the accredited private hospitals. This result indicates that private hospitals are considered important within regional health care planning as providers of supplementary services integrating public supply, even though they operate at a sub-optimal scale.

If you experience problems downloading a file, check if you have the proper application to view it first. In case of further problems read the IDEAS help page. Note that these files are not on the IDEAS site. Please be patient as the files may be large.

File URL:
Download Restriction: Access to full text is restricted to subscribers

File URL:
Download Restriction: no

As the access to this document is restricted, you may want to look for a different version under "Related research" (further below) or search for a different version of it.

Article provided by Società editrice il Mulino in its journal Politica economica.

Volume (Year): (2007)
Issue (Month): 3 ()
Pages: 233-258

in new window

Handle: RePEc:mul:je8794:doi:10.1429/25710:y:2007:i:3:p:233-258
Contact details of provider: Web page:

No references listed on IDEAS
You can help add them by filling out this form.

This item is not listed on Wikipedia, on a reading list or among the top items on IDEAS.

When requesting a correction, please mention this item's handle: RePEc:mul:je8794:doi:10.1429/25710:y:2007:i:3:p:233-258. See general information about how to correct material in RePEc.

For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: ()

If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

If references are entirely missing, you can add them using this form.

If the full references list an item that is present in RePEc, but the system did not link to it, you can help with this form.

If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your profile, as there may be some citations waiting for confirmation.

Please note that corrections may take a couple of weeks to filter through the various RePEc services.

This information is provided to you by IDEAS at the Research Division of the Federal Reserve Bank of St. Louis using RePEc data.