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Competition and Efficiencyin health care: an analysis of the Italian case

  • R. Cellini
  • G. Pignataro
  • I. Rizzo

In this paper, we look at the Italian National Health System as a case study, in order to investigate whether competition exerts positive effect on the efficiency of the system. Using the DEA technique we measure the efficiency of accredited hospital production at the regional level; secondly, we take a cross-section regression analysis approach to analyse the determinants of efficiency. A general conclusion stemming out of the analysis is that competition is not a value per se and that its effects on the performance of the system are affected by the rules governing it.

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Paper provided by Dipartimento Scienze Economiche, Universita' di Bologna in its series Working Papers with number 354.

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Date of creation: Jul 1999
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Handle: RePEc:bol:bodewp:354
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  1. R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, vol. 30(9), pages 1078-1092, September.
  2. Nazrul Islam, 1995. "Growth Empirics: A Panel Data Approach," The Quarterly Journal of Economics, Oxford University Press, vol. 110(4), pages 1127-1170.
  3. Gerdtham, Ulf-G. & Löthgren, Mickael & Tambour, Magnus & Rehnberg, Clas, 1998. "Internal Markets and Health Care Efficiency: A Multiple-Output Stochastic Frontier Analysis," SSE/EFI Working Paper Series in Economics and Finance 222, Stockholm School of Economics.
  4. James F. Burgess, Jr. & Paul W. Wilson, 1996. "Hospital Ownership and Technical Inefficiency," Management Science, INFORMS, vol. 42(1), pages 110-123, January.
  5. David W. Kalisch & Tetsuya Aman & Libbie A. Buchele, 1998. "Social and Health Policies in OECD Countries: A Survey of Current Programmes and Recent Developments," OECD Labour Market and Social Policy Occasional Papers 33, OECD Publishing.
  6. Zwanziger, Jack & Melnick, Glenn A., 1988. "The effects of hospital competition and the Medicare PPS program on hospital cost behavior in California," Journal of Health Economics, Elsevier, vol. 7(4), pages 301-320, December.
  7. Eulália Dalmau-Atarrodona & Jaume Puig-Junoy, 1998. "Market Structure and Hospital Efficiency: Evaluating Potential Effects of Deregulation in a National Health Service," Review of Industrial Organization, Springer, vol. 13(4), pages 447-466, August.
  8. Gerdtham, Ulf-G. & Löthgren, Mickael, 1998. "Health Care System Effects on Cost Efficiency in the OECD Countries," SSE/EFI Working Paper Series in Economics and Finance 247, Stockholm School of Economics.
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