IDEAS home Printed from https://ideas.repec.org/p/hhs/oslohe/2006_009.html
   My bibliography  Save this paper

Heterogenety in hospitals responses to a financial reform: A random coefficient analysis of the impact of activity-based financing on efficiency

Author

Listed:
  • Eric, Biørn

    () (Department of Economics, University of Oslo)

  • Hagen, Terje P.

    () (Institute of Health Management and Health Economics)

  • Iversen, Tor

    () (Institute of Health Management and Health Economics)

  • Magnussen, Jon

    () (Department of Public Health and General Practice)

Abstract

The paper examines the heterogeneity with respect to the impact of a financial reform - Activity Based Financing (ABF) - on hospital efficiency in Norway. Measures of technical efficiency and of cost-efficiency are considered. The data set is from a contiguous ten-year panel of 47 hospitals covering both pre-ABF years and years after its imposition. Substantial heterogeneity in the responses, as measured by both estimated and predicted coefficients, is found. Rank correlations between the estimated/predicted coefficients of the ABF dummy and the pre-ABF/post-ABF efficiencies are examined. Overall, improvement seems to be more pronounced in technical efficiency than in cost-efficiency.

Suggested Citation

  • Eric, Biørn & Hagen, Terje P. & Iversen, Tor & Magnussen, Jon, 2009. "Heterogenety in hospitals responses to a financial reform: A random coefficient analysis of the impact of activity-based financing on efficiency," HERO Online Working Paper Series 2006:9, University of Oslo, Health Economics Research Programme.
  • Handle: RePEc:hhs:oslohe:2006_009
    as

    Download full text from publisher

    File URL: http://www.hero.uio.no/publicat/2006/HERO2006_9.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Chalkley, Martin & Malcomson, James M., 1998. "Contracting for health services when patient demand does not reflect quality," Journal of Health Economics, Elsevier, vol. 17(1), pages 1-19, January.
    2. Brigitte Dormont & Carine Milcent, 2002. "Quelle régulation pour les hôpitaux publics français ?," Revue Française d'Économie, Programme National Persée, vol. 17(2), pages 117-142.
    3. Erik Biørn & Kjersti-Gro Lindquist & Terje Skjerpen, 2002. "Heterogeneity in Returns to Scale: A Random Coefficient Analysis with Unbalanced Panel Data," Journal of Productivity Analysis, Springer, vol. 18(1), pages 39-57, July.
    4. repec:adr:anecst:y:2003:i:69:p:03 is not listed on IDEAS
    5. Ole Olesen & Niels Petersen, 2002. "The Use of Data Envelopment Analysis with Probabilistic Assurance Regions for Measuring Hospital Efficiency," Journal of Productivity Analysis, Springer, vol. 17(1), pages 83-109, January.
    6. Biorn, Erik & Hagen, Terje P. & Iversen, Tor & Magnussen, Jon, 2002. "The Effect of Activity-Based Financing on Hospital Efficiency: A Panel Data Analysis of DEA Efficiency Scores 1992-2000," MPRA Paper 8099, University Library of Munich, Germany.
    7. Tulkens, Henry & Vanden Eeckaut, Philippe, 1995. "Non-parametric efficiency, progress and regress measures for panel data: Methodological aspects," European Journal of Operational Research, Elsevier, vol. 80(3), pages 474-499, February.
    8. Erik Biorn & Kjerti-Gro Lindquist & Terje Skjerpen, 2003. "Random Coefficients in Unbalanced Panels: An Application on Data from Chemical Plants," Annals of Economics and Statistics, GENES, issue 69, pages 55-83.
    9. 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.
    10. Newhouse, Joseph P. & Byrne, Daniel J., 1988. "Did Medicare's Prospective Payment System cause length of stay to fall?," Journal of Health Economics, Elsevier, vol. 7(4), pages 413-416, December.
    11. 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.
    12. Guillem López‐Casasnovas & Marc Saez, 1999. "The impact of teaching status on average costs in Spanish hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 8(7), pages 641-651, November.
    13. Fare, Rolf & Knox Lovell, C. A., 1978. "Measuring the technical efficiency of production," Journal of Economic Theory, Elsevier, vol. 19(1), pages 150-162, October.
    14. Mark Duggan, 2002. "Hospital Market Structure and the Behavior of Not-For-Profit Hospitals," RAND Journal of Economics, The RAND Corporation, vol. 33(3), pages 433-446, Autumn.
    15. Lancaster, Tony, 2000. "The incidental parameter problem since 1948," Journal of Econometrics, Elsevier, vol. 95(2), pages 391-413, April.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Philippe Widmer, 2015. "Does prospective payment increase hospital (in)efficiency? Evidence from the Swiss hospital sector," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(4), pages 407-419, May.
    2. Di Giorgio, Laura & Filippini, Massimo & Masiero, Giuliano, 2014. "Implications of global budget payment system on nursing home costs," Health Policy, Elsevier, vol. 115(2), pages 237-248.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Erik Biørn & Terje Hagen & Tor Iversen & Jon Magnussen, 2010. "How different are hospitals’ responses to a financial reform? The impact on efficiency of activity-based financing," Health Care Management Science, Springer, vol. 13(1), pages 1-16, March.
    2. Martinussen, Pal E. & Midttun, Linda, 2004. "Day surgery and hospital efficiency: empirical analysis of Norwegian hospitals, 1999-2001," Health Policy, Elsevier, vol. 68(2), pages 183-196, May.
    3. Biorn, Erik & Hagen, Terje P. & Iversen, Tor & Magnussen, Jon, 2002. "The Effect of Activity-Based Financing on Hospital Efficiency: A Panel Data Analysis of DEA Efficiency Scores 1992-2000," MPRA Paper 8099, University Library of Munich, Germany.
    4. R. Amy Puenpatom & Robert Rosenman, 2006. "Efficiency of Thai provincial public hospitals after the introduction of National Health Insurance Program," Working Papers 2006-2, School of Economic Sciences, Washington State University.
    5. Briec, W., 2000. "An extended Fare-Lovell technical efficiency measure," International Journal of Production Economics, Elsevier, vol. 65(2), pages 191-199, April.
    6. Lorenzo Castelli & Raffaele Pesenti & Walter Ukovich, 2010. "A classification of DEA models when the internal structure of the Decision Making Units is considered," Annals of Operations Research, Springer, vol. 173(1), pages 207-235, January.
    7. C. Lovell & Shawna Grosskopf & Eduardo Ley & Jesús Pastor & Diego Prior & Philippe Eeckaut, 1994. "Linear programming approaches to the measurement and analysis of productive efficiency," TOP: An Official Journal of the Spanish Society of Statistics and Operations Research, Springer;Sociedad de Estadística e Investigación Operativa, vol. 2(2), pages 175-248, December.
    8. W. Briec, 1999. "Hölder Distance Function and Measurement of Technical Efficiency," Journal of Productivity Analysis, Springer, vol. 11(2), pages 111-131, April.
    9. Andrew Johnson & John Ruggiero, 2014. "Nonparametric measurement of productivity and efficiency in education," Annals of Operations Research, Springer, vol. 221(1), pages 197-210, October.
    10. Ashrafi, Ali & Seow, Hsin-Vonn & Lee, Lai Soon & Lee, Chew Ging, 2013. "The efficiency of the hotel industry in Singapore," Tourism Management, Elsevier, vol. 37(C), pages 31-34.
    11. Huang, Chin-wei & Chiu, Yung-ho & Fang, Wei-ta & Shen, Neng, 2014. "Assessing the performance of Taiwan’s environmental protection system with a non-radial network DEA approach," Energy Policy, Elsevier, vol. 74(C), pages 547-556.
    12. Ravelojaona, Paola, 2019. "On constant elasticity of substitution – Constant elasticity of transformation Directional Distance Functions," European Journal of Operational Research, Elsevier, vol. 272(2), pages 780-791.
    13. Cherchye, L. & Post, G.T., 2001. "Methodological Advances in Dea," ERIM Report Series Research in Management ERS-2001-53-F&A, Erasmus Research Institute of Management (ERIM), ERIM is the joint research institute of the Rotterdam School of Management, Erasmus University and the Erasmus School of Economics (ESE) at Erasmus University Rotterdam.
    14. Wang, Zhaohua & Feng, Chao, 2015. "Sources of production inefficiency and productivity growth in China: A global data envelopment analysis," Energy Economics, Elsevier, vol. 49(C), pages 380-389.
    15. Jin XU & Panagiotis ZERVOPOULOS & Zhenhua QIAN & Gang CHENG, 2012. "A Universal Solution For Units Invariance In Data Envelopment Analysis," Theoretical and Practical Research in the Economic Fields, ASERS Publishing, vol. 3(2), pages 121-128.
    16. Isabelle Piot-Lepetit & Dominique Vermersch & Robert D. Weaver & . American Agricultural Economics Association, 1995. "Subvector Technical EffÏciency : An Application to French Agriculture," Post-Print hal-02403487, HAL.
    17. Chen Lin & Sanford Berg, 2008. "Incorporating Service Quality into Yardstick Regulation: An Application to the Peru Water Sector," Review of Industrial Organization, Springer;The Industrial Organization Society, vol. 32(1), pages 53-75, February.
    18. Alexander Cotte Poveda, 2012. "Estimating Effectiveness of the Control of Violence and Socioeconomic Development in Colombia: An Application of Dynamic Data Envelopment Analysis and Data Panel Approach," Social Indicators Research: An International and Interdisciplinary Journal for Quality-of-Life Measurement, Springer, vol. 105(3), pages 343-366, February.
    19. Ruiz, Jose L. & Sirvent, Inmaculada, 2001. "Techniques for the assessment of influence in DEA," European Journal of Operational Research, Elsevier, vol. 132(2), pages 390-399, July.
    20. Fazıl Gökgöz & Mustafa Taylan Güvercin, 2018. "Investigating the total factor productivity changes in the top ICT companies worldwide," Electronic Commerce Research, Springer, vol. 18(4), pages 791-811, December.

    More about this item

    Keywords

    Health econometrics; Panel data; Hospital efficiency; Activity-based financing; Random coefficients; Heterogeneity; Rank Correlation;
    All these keywords.

    JEL classification:

    • C23 - Mathematical and Quantitative Methods - - Single Equation Models; Single Variables - - - Models with Panel Data; Spatio-temporal Models
    • C33 - Mathematical and Quantitative Methods - - Multiple or Simultaneous Equation Models; Multiple Variables - - - Models with Panel Data; Spatio-temporal Models
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:hhs:oslohe:2006_009. See general information about how to correct material in RePEc.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: (Kristi Brinkmann Lenander). General contact details of provider: https://edirc.repec.org/data/heuiono.html .

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service hosted by the Research Division of the Federal Reserve Bank of St. Louis . RePEc uses bibliographic data supplied by the respective publishers.