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Optimal productive size of hospital’s intensive care units


  • Hervé Leleu

    () (CNRS-LEM (UMR 8179), IESEG School of Management)

  • James Moises

    () (Tulane University)

  • Vivian Valdmanis

    () (University of the Sciences in Philadelphia)


Authors of past studies focusing on returns to scale in hospitals proffered mixed results. These seemingly contradictory findings have probably arisen due to different methodological approaches (parametric or non parametric), different aggregation levels of analysis (hospital/department/units), nature of data (quantity data or economic values) and also due to technological improvements operating in hospitals and case mix adjustment to account for the severity of patients' conditions.
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  • Hervé Leleu & James Moises & Vivian Valdmanis, 2011. "Optimal productive size of hospital’s intensive care units," Working Papers 2011-ECO-01, IESEG School of Management.
  • Handle: RePEc:ies:wpaper:e201101

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    References listed on IDEAS

    1. Dranove, David, 1998. "Economies of scale in non-revenue producing cost centers: Implications for hospital mergers," Journal of Health Economics, Elsevier, vol. 17(1), pages 69-83, January.
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    3. Tsekouras, Kostas & Papathanassopoulos, Fotis & Kounetas, Kostas & Pappous, Giorgos, 2010. "Does the adoption of new technology boost productive efficiency in the public sector? The case of ICUs system," International Journal of Production Economics, Elsevier, vol. 128(1), pages 427-433, November.
    4. Paul W. Wilson & Kathleen Carey, 2004. "Nonparametric analysis of returns to scale in the US hospital industry," Journal of Applied Econometrics, John Wiley & Sons, Ltd., vol. 19(4), pages 505-524.
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    7. 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.
    8. Boussemart, Jean-Philippe & Briec, Walter & Peypoch, Nicolas & Tavéra, Christophe, 2009. "[alpha]-Returns to scale and multi-output production technologies," European Journal of Operational Research, Elsevier, vol. 197(1), pages 332-339, August.
    9. J-P Boussemart & W Briec & H Leleu, 2009. "Linear programming solutions and distance functions under a constant returns to scale technology," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 60(1), pages 72-78, January.
    10. Lindrooth, Richard C. & Lo Sasso, Anthony T. & Bazzoli, Gloria J., 2003. "The effect of urban hospital closure on markets," Journal of Health Economics, Elsevier, vol. 22(5), pages 691-712, September.
    11. 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.
    12. Preyra, Colin & Pink, George, 2006. "Scale and scope efficiencies through hospital consolidations," Journal of Health Economics, Elsevier, vol. 25(6), pages 1049-1068, November.
    13. Lau, Lawrence J., 1978. "Applications of Profit Functions," Histoy of Economic Thought Chapters,in: Fuss, Melvyn & McFadden, Daniel (ed.), Production Economics: A Dual Approach to Theory and Applications, volume 1, chapter 3 McMaster University Archive for the History of Economic Thought.
    14. Vita, Michael G., 1990. "Exploring hospital production relationships with flexible functional forms," Journal of Health Economics, Elsevier, vol. 9(1), pages 1-21, June.
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    Cited by:

    1. Miningou, Élisé Wendlassida & Vierstraete, Valérie, 2013. "Households' living situation and the efficient provision of primary education in Burkina Faso," Economic Modelling, Elsevier, vol. 35(C), pages 910-917.
    2. repec:lrk:eeaart:31_2_8 is not listed on IDEAS
    3. repec:eee:ejores:v:266:y:2018:i:2:p:716-735 is not listed on IDEAS
    4. repec:kap:jproda:v:48:y:2017:i:1:d:10.1007_s11123-017-0501-y is not listed on IDEAS
    5. George Fragkiadakis & Michael Doumpos & Constantin Zopounidis & Christophe Germain, 2016. "Operational and economic efficiency analysis of public hospitals in Greece," Post-Print hal-01414677, HAL.
    6. repec:spr:annopr:v:247:y:2016:i:2:d:10.1007_s10479-014-1710-7 is not listed on IDEAS
    7. De Nicola, Arianna & Mancuso, Paolo & Valdmanis, Vivian, 2013. "Quality and health care performance in the Italian regions," MPRA Paper 50495, University Library of Munich, Germany.
    8. Buzzacchi, Luigi & Scellato, Giuseppe & Ughetto, Elisa, 2016. "Frequency of medical malpractice claims: The effects of volumes and specialties," Social Science & Medicine, Elsevier, vol. 170(C), pages 152-160.
    9. Silva, Elvira & Lansink, Alfons Oude & Stefanou, Spiro E., 2015. "The adjustment-cost model of the firm: Duality and productive efficiency," International Journal of Production Economics, Elsevier, vol. 168(C), pages 245-256.
    10. Chowdhury, Hedayet & Zelenyuk, Valentin & Laporte, Audrey & Wodchis, Walter P., 2014. "Analysis of productivity, efficiency and technological changes in hospital services in Ontario: How does case-mix matter?," International Journal of Production Economics, Elsevier, vol. 150(C), pages 74-82.

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    Hospital; Intensive Care Units; Returns to Scale; Optimal Size;

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