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East-west: does it make a difference to hospital efficiencies in Ukraine?


  • Anatoly I. Pilyavsky
  • William E. Aaronson

    (Temple University, Philadelphia, PA, USA)

  • Patrick M. Bernet

    (Florida Atlantic University, USA)

  • Michael D. Rosko

    (Widener University, Chester, PA, USA)

  • Vivian G. Valdmanis

    (University of the Sciences in Philadelphia, USA)

  • Mikhail V. Golubchikov

    (Ministry of Health, Kyiv, Ukraine)


Ukraine's history has given it a split personality (e.g. divergent cultural influences on economic and managerial behavior), as was observed in the recent political developments both prior to and following the December 2004 elections. Eastern regions were heavily influenced by Russo-Soviet rule, while western regions have more of a European outlook. This study, which is largely exploratory, compares recent trends in hospital efficiency in Ukraine to see if this split personality manifests itself in differential rates of improvement. Given the inflexibility of Soviet-style planned economies, it is hypothesized that western regions will show greater improvement in economic efficiency that can be attributed to higher levels of managerial and medical entrepreneurship. Data for this study comes from three oblasts (i.e. geopolitical regions), one in the west and two in the east, spanning from 1997 to 2001. Data envelopment analysis (DEA) was used to estimate technical efficiency for the hospitals. After correcting for bias, a second-stage Tobit regression was estimated. Results indicate that hospitals in the west improved efficiencies, while those in the east stayed constant. These western areas of the nation, being more amenable to western management and medical 'business' practice, may be quicker to pick up on new techniques to increase healthcare delivery efficiencies. This may stem from the more limited effects of a shorter history of incorporation into a Soviet-style planned and controlled economy in which individual decision-making and entrepreneurship was suppressed in favor of central decision-making by the state. Copyright © 2006 John Wiley & Sons, Ltd.

Suggested Citation

  • Anatoly I. Pilyavsky & William E. Aaronson & Patrick M. Bernet & Michael D. Rosko & Vivian G. Valdmanis & Mikhail V. Golubchikov, 2006. "East-west: does it make a difference to hospital efficiencies in Ukraine?," Health Economics, John Wiley & Sons, Ltd., vol. 15(11), pages 1173-1186.
  • Handle: RePEc:wly:hlthec:v:15:y:2006:i:11:p:1173-1186
    DOI: 10.1002/hec.1120

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    References listed on IDEAS

    1. Bruce Hollingsworth & P.J. Dawson & N. Maniadakis, 1999. "Efficiency measurement of health care: a review of non‐parametric methods and applications," Health Care Management Science, Springer, vol. 2(3), pages 161-172, July.
    2. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
    3. Simar, Leopold & Wilson, Paul W., 2007. "Estimation and inference in two-stage, semi-parametric models of production processes," Journal of Econometrics, Elsevier, vol. 136(1), pages 31-64, January.
    4. John E Tedstrom, 1995. "Ukraine: A Crash Course in Economic Transition," Comparative Economic Studies, Palgrave Macmillan;Association for Comparative Economic Studies, vol. 37(4), pages 49-67, December.
    5. King Banaian, 1999. "The Ukrainian Economy since Independence," Books, Edward Elgar Publishing, number 1676.
    6. John Tomer, 2002. "Intangible Factors in the Eastern European Transition: A Socio-Economic Analysis," Post-Communist Economies, Taylor & Francis Journals, vol. 14(4), pages 421-444.
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    Cited by:

    1. Patrick Bernet & Michael Rosko & Vivian Valdmanis & Anatoly Pilyavsky & William Aaronson, 2008. "Productivity efficiencies in Ukrainian polyclinics: lessons for health system transitions from differential responses to market changes," Journal of Productivity Analysis, Springer, vol. 29(2), pages 103-111, April.
    2. Adriana Castelli & Andrew Street & Rossella Verzulli & Padraic Ward, 2015. "Examining variations in hospital productivity in the English NHS," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(3), pages 243-254, April.
    3. Oliver Tiemann & Jonas Schreyögg, 2012. "Changes in hospital efficiency after privatization," Health Care Management Science, Springer, vol. 15(4), pages 310-326, December.
    4. Cristian Nedelea, I. & Matthew Fannin, J., 2013. "Analyzing cost efficiency of Critical Access Hospitals," Journal of Policy Modeling, Elsevier, vol. 35(1), pages 183-195.
    5. Chew Lian Chua & Alfons Palangkaraya & Jongsay Yong, 2011. "Hospital Competition, Technical Efficiency and Quality," The Economic Record, The Economic Society of Australia, vol. 87(277), pages 252-268, June.
    6. Ng, Ying Chu, 2011. "The productive efficiency of Chinese hospitals," China Economic Review, Elsevier, vol. 22(3), pages 428-439, September.
    7. Barros, Carlos Pestana & Menezes, Antonio & Vieira, José António Cabral & Peypoch, Nicolas & Solonandrasana, Bernardin, 2007. "An Analysis of Hospital Efficiency and Productivity Growth Using the Luenberger Productivity Indicator," IZA Discussion Papers 2689, Institute for the Study of Labor (IZA).
    8. Ng, Ying Chu, 2008. "The Productive Efficiency of the Health Care Sector of China," The Review of Regional Studies, Southern Regional Science Association, vol. 38(3), pages 381-393.
    9. Panagiotis Mitropoulos & Ioannis Mitropoulos & Aris Sissouras, 2013. "Managing for efficiency in health care: the case of Greek public hospitals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(6), pages 929-938, December.
    10. Jos Blank & Vivian Valdmanis, 2010. "Environmental factors and productivity on Dutch hospitals: a semi-parametric approach," Health Care Management Science, Springer, vol. 13(1), pages 27-34, March.
    11. De Nicola, Arianna & Mancuso, Paolo & Valdmanis, Vivian, 2013. "Quality and health care performance in the Italian regions," MPRA Paper 50495, University Library of Munich, Germany.

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