Accounting for quality in the measurement of hospital performance: evidence from Costa Rica
This paper provides insights into how Costa Rican public hospitals responded to the pressure for increased efficiency and quality introduced by the reforms carried out over the period 1997-2001. To that purpose we compute a generalized output distance function by means of non-parametric mathematical programming to construct a productivity index, which accounts for productivity changes while controlling for quality of care. Our results show an improvement in hospital performance mainly driven by quality increases. The adoption of management contracts seems to have contributed to such enhancement, more notably for small hospitals. Further, productivity growth is primarily due to technical and scale efficiency change rather than technological change. A number of policy implications are drawn from these results. Copyright © 2006 John Wiley & Sons, Ltd.
Volume (Year): 16 (2007)
Issue (Month): 7 ()
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- Rodriguez-Alvarez, Ana & Fernandez-Blanco, Victor & Lovell, C. A. Knox, 2004. "Allocative inefficiency and its cost:: The case of Spanish public hospitals," International Journal of Production Economics, Elsevier, vol. 92(2), pages 99-111, November.
- Arocena, Pablo & Waddams Price, Catherine, 2002. "Generating efficiency: economic and environmental regulation of public and private electricity generators in Spain," International Journal of Industrial Organization, Elsevier, vol. 20(1), pages 41-69, January.
- Fare, R. & Grosskopf, S. & Hernandez-Sancho, F., 2004. "Environmental performance: an index number approach," Resource and Energy Economics, Elsevier, vol. 26(4), pages 343-352, December.
- Dranove, David & Satterthwaite, Mark A., 2000. "The industrial organization of health care markets," Handbook of Health Economics,in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 20, pages 1093-1139 Elsevier.
- Jean-Paul Chavas & Thomas L. Cox, 1999.
"A Generalized Distance Function and the Analysis of Production Efficiency,"
Southern Economic Journal,
Southern Economic Association, vol. 66(2), pages 294-318, October.
- Jean-Paul Chavas & Thomas L. Cox, 1999. "A Generalized Distance Function and the Analysis of Production Efficiency," Wisconsin-Madison Agricultural and Applied Economics Staff Papers 422, Wisconsin-Madison Agricultural and Applied Economics Department.
- Miika Linna & Unto Häkkinen & Eero Linnakko, 1998. "An econometric study of costs of teaching and research in Finnish hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 7(4), pages 291-305.
- Fare, Rolf, et al, 1989. "Multilateral Productivity Comparisons When Some Outputs Are Undesirable: A Nonparametric Approach," The Review of Economics and Statistics, MIT Press, vol. 71(1), pages 90-98, February.
- Filmer, Deon & Hammer, Jeffrey S & Pritchett, Lant H, 2000. "Weak Links in the Chain: A Diagnosis of Health Policy in Poor Countries," World Bank Research Observer, World Bank Group, vol. 15(2), pages 199-224, August.
- repec:ccp:journl:v:20:y:2002:i:1:p:41-69 is not listed on IDEAS
- Jose Zofio & C. A. Knox Lovell, 2001. "Graph efficiency and productivity measures: an application to US agriculture," Applied Economics, Taylor & Francis Journals, vol. 33(11), pages 1433-1442.
- Juan Ventura & Eduardo GonzáLez & Ana Cárcaba, 2004. "Efficiency and Program-Contract Bargaining in Spanish Public Hospitals," Annals of Public and Cooperative Economics, Wiley Blackwell, vol. 75(4), pages 549-573, December. Full references (including those not matched with items on IDEAS)