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Efficienza tecnica e produzione ospedaliera: una valutazione con Data Envelopment Analysis delle prestazioni ospedaliere nel periodo della riforma

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  • D. Fabbri

Abstract

In questi ultimi anni il Sistema Sanitario Nazionale stato sottoposto ad un sostanziale processo di tra-sformazione e di riforma. Uno fra gli ambiti pi investiti dalle trasformazioni in atto certamente quello della produzione di servizi ospedalieri. Nel quadro istituzionale che si va delineando i produttori vengono sempre pi responsabilizzati a perseguire strategie di razionalizzazione nell uso delle risorse e di raziona-mento della domanda. E in questo contesto che il miglioramento dell efficienza produttiva assume il valo-re di obiettivo prioritario. In questo studio ci concentriamo sulla componente tecnica dell efficienza nella produzione ospedaliera al fine di valutare se e in quale misura le recenti riforme abbiano contribuito ad accrescerla. L analisi viene condotta, impiegando la tecnica di Data Envelopment Analysis (DEA), sugli ospedali pubblici della regione Emilia-Romagna, i cui dati d attivit sono stati rilevati per il periodo fra il 1994 e il 1995. I risultati confermano la presenza di un significativo miglioramento delle prestazioni in ter-mini di efficienza tecnica che si realizza in assenza di progresso tecnologico. Il miglioramento pronunciato e statisticamente significativo nell ambito della produzione di ricoveri , mentre risulta statisticamente non significativo nella produzione di giornate di degenza . L inefficienza si concentra nell utilizzo del per-sonale amministrativo e di quello infermieristico. L utilizzo dei letti e del personale medico risulta presso-ch pienamente efficiente. Sul versante degli output si riscontra il permanere di una rilevante capacit inutilizzata nella produzione di ricoveri di elevata complessit . Questo porta a concludere che nel periodo esaminato gli incentivi introdotti dalla riforma hanno raggiunto l obiettivo di migliorare l efficienza nell uso delle risorse tuttavia sono stati insufficienti rispetto al contenimento della produzione sanitaria e al razio-namento della domanda.

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  • D. Fabbri, 1998. "Efficienza tecnica e produzione ospedaliera: una valutazione con Data Envelopment Analysis delle prestazioni ospedaliere nel periodo della riforma," Working Papers 318, Dipartimento Scienze Economiche, Universita' di Bologna.
    • Handle: RePEc:bol:bodewp:318
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