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Decomposing the productivity differences between hospitals in the Nordic countries

  • Kittelsen, Sverre A.C.

    ()

    (Frisch Centre)

  • Persson, Benny Adam

    (Frisch Centre)

  • Rehnberg, Clas

    (Karolinska Institutet, Stockholm)

  • Anthun, Kjartan S.

    (SINTEF)

  • Goude, Fanny

    (Karolinska Institutet)

  • Rättö, Hanna

    (National Institute for Health and Welfare – THL, Helsinki)

  • Hope, Øyvind

    (SINTEF)

  • Häkkinen, Unto

    (National Institute for Health and Welfare – THL, Helsinki)

  • Medin, Emma

    (Karolinska Institutet, Stockholm)

  • Kalseth, Birgitte

    (SINTEF)

  • Kilsmark, Jannie

    (Danish Institute of health research, Copenhagen)

Previous studies indicate that Finnish hospitals have significantly higher productivity than in the other Nordic countries. We decompose the productivity levels into technical efficiency, scale efficiency and country specific possibility sets (technical frontiers). Data have been collected on operating costs and patient discharges in each DRG group for all hospitals in the Nordic countries. We find that there are small differences in scale and technical efficiency between countries, but large differences in production possibilities (frontier position). The results are robust to the choice of bootstrapped Data Envelopment Analysis (DEA) or Stochastic Frontier Analysis (SFA) as frontier estimation methodology.

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File URL: http://www.med.uio.no/helsam/forskning/nettverk/hero/publikasjoner/skriftserie/2013/hero2013-4.pdf
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Paper provided by Oslo University, Health Economics Research Programme in its series HERO On line Working Paper Series with number 2013:4.

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Length: 29 pages
Date of creation: 23 Jan 2014
Date of revision:
Handle: RePEc:hhs:oslohe:2013_004
Contact details of provider: Postal:
HERO / Institute of Health Management and Health Economics P.O. Box 1089 Blindern, N-0317 Oslo, Norway

Phone: 2307 5309
Fax: 2307 5310
Web page: http://www.hero.uio.no/eng.html
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  1. Kjell Salvanes & Sigve Tjøtta, 1998. "A Note on the Importance of Testing for Regularities for Estimated Flexible Functional Forms," Journal of Productivity Analysis, Springer, vol. 9(2), pages 133-143, March.
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  8. Halsteinli, Vidar & Kittelsen, Sverre A. & Magnussen, Jon, 2010. "Productivity growth in outpatient child and adolescent mental health services: The impact of case-mix adjustment," Social Science & Medicine, Elsevier, vol. 70(3), pages 439-446, February.
  9. Mette Asmild & Bruce Hollingsworth & Stephen Birch, 2012. "The scale of hospital production in different settings: One size does not fit all," MSAP Working Paper Series 04_2012, University of Copenhagen, Department of Food and Resource Economics.
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  11. Miika Linna & Unto Häkkinen & Mikko Peltola & Jon Magnussen & Kjartan Anthun & Sverre Kittelsen & Annette Roed & Kim Olsen & Emma Medin & Clas Rehnberg, 2010. "Measuring cost efficiency in the Nordic Hospitals—a cross-sectional comparison of public hospitals in 2002," Health Care Management Science, Springer, vol. 13(4), pages 346-357, December.
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  14. Simar, L. & Wilson, P.W., 1999. "Statistical Inference in Nonparametric Frontier Models: the State of the Art," Papers 9904, Catholique de Louvain - Institut de statistique.
  15. Medin, Emma & Häkkinen, Unto & Linna, Miika & Anthun, Kjartan S. & Kittelsen, Sverre A.C. & Rehnberg, Clas, 2013. "International hospital productivity comparison: Experiences from the Nordic countries," Health Policy, Elsevier, vol. 112(1), pages 80-87.
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  18. Battese, G E & Coelli, T J, 1995. "A Model for Technical Inefficiency Effects in a Stochastic Frontier Production Function for Panel Data," Empirical Economics, Springer, vol. 20(2), pages 325-32.
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