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Riforme del Servizio Sanitario Nazionale e dinamica dell’efficienza ospedaliera in Piemonte

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Abstract

In this paper we estimate cost efficiency and technological characteristics of public hospitals in Piemonte over the period from 2000 to 2004. During the Nineties, different regulatory reforms aiming at controlling health expenditure affected the Italian National Health Service, ranging from the introduction of a new reimbursement scheme for hospitals (DRG-based) at the micro level, to the implementation of fiscal federalism at the macro level. We argue that all these legislative interventions rendered producers more prone to control costs, in order to be able to meet financial constraints. Our empirical findings support this hypothesis: average cost inefficiency, computed after estimating a Translog stochastic cost frontier by the Battese and Coelli (1992) approach, reduced remarkably during the observed years, while the adoption of more effective technologies shifted upward the minimum-cost frontier. We also find evidence of relevant scale economies not exploited by producers, which decrease with ospital size (number of beds) and output complexity (average DRG weight).

Suggested Citation

  • Chiara Canta & Massimiliano Piacenza & Turati Gilberto, 2005. "Riforme del Servizio Sanitario Nazionale e dinamica dell’efficienza ospedaliera in Piemonte," CERIS Working Paper 200515, Institute for Economic Research on Firms and Growth - Moncalieri (TO) ITALY -NOW- Research Institute on Sustainable Economic Growth - Moncalieri (TO) ITALY.
  • Handle: RePEc:csc:cerisp:200515
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    References listed on IDEAS

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    1. Alessandro Sembenelli & Laura Rondi & Fabio Schiantarelli & Brian Sack, 1993. "Firms' Financial And Real Responses To Business Cycle Shocks And Monetary Tightening: Evidence For Large And Small Italian Companies," CERIS Working Paper 199305, Institute for Economic Research on Firms and Growth - Moncalieri (TO) ITALY -NOW- Research Institute on Sustainable Economic Growth - Moncalieri (TO) ITALY.
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    Cited by:

    1. Cinzia Di Novi & Dino Rizzi & Michele Zanette, 2016. "Larger is Better: the Scale Effects of the Italian Local Healthcare Authorities Amalgamation Program," Working Papers 2016:04, Department of Economics, University of Venice "Ca' Foscari".
    2. repec:spr:eujhec:v:19:y:2018:i:2:d:10.1007_s10198-017-0884-8 is not listed on IDEAS
    3. Cinzia Di Novi & Anna Marenzi & Dino Rizzi, 2018. "Do healthcare tax credits help poor-health individuals on low incomes?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 19(2), pages 293-307, March.
    4. Antonio Affuso & Cataldo Ferrarese & Guido Nannariello, 2013. "Spending Review: un’analisi di efficienza delle Capitanerie di porto," SCIENZE REGIONALI, FrancoAngeli Editore, vol. 2013(3), pages 111-143.

    More about this item

    Keywords

    riforme del SSN; ospedali pubblici; efficienza produttiva; frontiera di costo stocastica;

    JEL classification:

    • D21 - Microeconomics - - Production and Organizations - - - Firm Behavior: Theory
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L32 - Industrial Organization - - Nonprofit Organizations and Public Enterprise - - - Public Enterprises; Public-Private Enterprises

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