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

Listed author(s):
  • 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.

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Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 15 (2006)
Issue (Month): 11 ()
Pages: 1173-1186

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Handle: RePEc:wly:hlthec:v:15:y:2006:i:11:p:1173-1186
DOI: 10.1002/hec.1120
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  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. King Banaian, 1999. "The Ukrainian Economy since Independence," Books, Edward Elgar Publishing, number 1676.
  4. 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.
  5. 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.
  6. 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.
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