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Economies of Scale and Efficiency Measurement in Switzerland's Nursing Homes

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  • Mehdi Farsi
  • Massimo Filippini
  • Diego Lunati

Abstract

This paper examines the cost efficiency in the nursing home industry, an issue of concern to Swiss policy makers because of the explosive growth of national expenditure on elderly care and the aging of the population. A stochastic cost frontier model has been applied to a panel of 1780 observations from 356 nursing homes operating over 1998-2002 in Switzerland. We compare the estimation results from different econometric techniques focusing on the specification of unobserved heterogeneity across firms. The potential effects of such unobserved factors on the estimation results and their interpretation have been discussed. The findings suggest that the economies of scale are an important potential source of cost reduction in a majority of Swiss nursing homes. Moreover the average performance of a representative nursing home is very close to the estimated best practice.

Suggested Citation

  • Mehdi Farsi & Massimo Filippini & Diego Lunati, 2008. "Economies of Scale and Efficiency Measurement in Switzerland's Nursing Homes," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 144(III), pages 359-378, September.
    • Handle: RePEc:ses:arsjes:2008-iii-5
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    Cited by:

    1. Di Giorgio, L. & Filippini, M. & Masiero, G., 2015. "Structural and managerial cost differences in nonprofit nursing homes," Economic Modelling, Elsevier, vol. 51(C), pages 289-298.
    2. L. Di Giorgio & M. Filippini & G. Masiero, 2016. "Is higher nursing home quality more costly?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 17(8), pages 1011-1026, November.
    3. Alice Tran & Kim-Huong Nguyen & Len Gray & Tracy Comans, 2019. "A Systematic Literature Review of Efficiency Measurement in Nursing Homes," IJERPH, MDPI, vol. 16(12), pages 1-18, June.
    4. Iparraguirre, José Luis & Ma, Ruosi, 2015. "Efficiency in the provision of social care for older people. A three-stage Data Envelopment Analysis using self-reported quality of life," Socio-Economic Planning Sciences, Elsevier, vol. 49(C), pages 33-46.
    5. INUI Tomohiko & KAWASAKI Kazuyasu & ITO Yukiko & MIYAGAWA Tsutomu & MANO Toshiki, 2019. "Management Practices and Labor Productivity in Intensive Care Homes for the Elderly (Japanese)," Discussion Papers (Japanese) 19049, Research Institute of Economy, Trade and Industry (RIETI).
    6. Laura Di Giorgio & Massimo Filippini & Giuliano Masiero, 2012. "The impact of the institutional form on the cost efficiency of nursing homes," Quaderni della facoltà di Scienze economiche dell'Università di Lugano 1203, USI Università della Svizzera italiana.
    7. Shiovan Ni Luasa & Declan Dineen & Marta Zieba, 2018. "Technical and scale efficiency in public and private Irish nursing homes – a bootstrap DEA approach," Health Care Management Science, Springer, vol. 21(3), pages 326-347, September.

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    More about this item

    Keywords

    cost efficiency; economies of scale; nursing homes; stochastic frontier; panel data;
    All these keywords.

    JEL classification:

    • C13 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Estimation: General
    • C21 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Cross-Sectional Models; Spatial Models; Treatment Effect Models
    • D24 - Microeconomics - - Production and Organizations - - - Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity
    • H70 - Public Economics - - State and Local Government; Intergovernmental Relations - - - General
    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L30 - Industrial Organization - - Nonprofit Organizations and Public Enterprise - - - General

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