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Assessing Hospital Efficiency: Non-parametric Evidence for Portugal

  • António Afonso
  • Sónia Fernandes

We compute DEA efficiency scores and Malmquist indexes for a panel data set comprising 68 Portuguese public hospitals belonging to the National Health System (NHS) in the period 2000-2005, when several units started being run in an entrepreneurial framework. With data on hospital services’ and resource quantities we construct an output distance function, we assess by how much can output quantities be proportionally expanded without changing input quantities Our results show that, on average, the NHS hospital sector revealed positive but small productivity growth between 2000 and 2004. The mean TFP indices vary between 0.917 and 1.109, implying some differences in the Malmquist indices across specifications. Furthermore, there are significant fluctuations among NHS hospitals in terms of individual efficiency scores from one year to the other.

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File URL: http://pascal.iseg.utl.pt/~depeco/wp/wp072008.pdf
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Paper provided by ISEG - School of Economics and Management, Department of Economics, University of Lisbon in its series Working Papers Department of Economics with number 2008/07.

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Date of creation: Feb 2008
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Handle: RePEc:ise:isegwp:wp72008
Contact details of provider: Postal: Department of Economics, ISEG - School of Economics and Management, University of Lisbon, Rua do Quelhas 6, 1200-781 LISBON, PORTUGAL
Web page: https://aquila1.iseg.ulisboa.pt/aquila/departamentos/EC

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  1. Valdmanis, Vivian, 1992. "Sensitivity analysis for DEA models : An empirical example using public vs. NFP hospitals," Journal of Public Economics, Elsevier, vol. 48(2), pages 185-205, July.
  2. Afonso, Antonio & St. Aubyn, Miguel, 2006. "Cross-country efficiency of secondary education provision: A semi-parametric analysis with non-discretionary inputs," Economic Modelling, Elsevier, vol. 23(3), pages 476-491, May.
  3. António Afonso & Ludger Schuknecht & Vito Tanzi, 2005. "Public sector efficiency: An international comparison," Public Choice, Springer, vol. 123(3), pages 321-347, June.
  4. Seiford, Lawrence M. & Thrall, Robert M., 1990. "Recent developments in DEA : The mathematical programming approach to frontier analysis," Journal of Econometrics, Elsevier, vol. 46(1-2), pages 7-38.
  5. Aigner, Dennis & Lovell, C. A. Knox & Schmidt, Peter, 1977. "Formulation and estimation of stochastic frontier production function models," Journal of Econometrics, Elsevier, vol. 6(1), pages 21-37, July.
  6. Margit Sommersguter-Reichmann, 2000. "The impact of the Austrian hospital financing reform on hospital productivity: empirical evidence on efficiency and technology changes using a non-parametric input-based Malmquist approach," Health Care Management Science, Springer, vol. 3(4), pages 309-321, September.
  7. Mónica Duarte Oliveira & Carlos Gouveia Pinto, 2005. "Health care reform in Portugal: an evaluation of the NHS experience," Health Economics, John Wiley & Sons, Ltd., vol. 14(S1), pages S203-S220.
  8. Bruce Hollingsworth & P.J. Dawson & N. Maniadakis, 1999. "Efficiency measurement of health care: a review of non‐parametric methods and applications," Health Care Management Science, Springer, vol. 2(3), pages 161-172, July.
  9. Miika Linna, 1998. "Measuring hospital cost efficiency with panel data models," Health Economics, John Wiley & Sons, Ltd., vol. 7(5), pages 415-427.
  10. Breyer, Friedrich, 1987. "The specification of a hospital cost function : A comment on the recent literature," Journal of Health Economics, Elsevier, vol. 6(2), pages 147-157, June.
  11. repec:cup:cbooks:9780521851442 is not listed on IDEAS
  12. Elvira Lima & David K. Whynes, 2003. "Finance and performance of Portuguese hospitals," NIMA Working Papers 20, Núcleo de Investigação em Microeconomia Aplicada (NIMA), Universidade do Minho.
  13. António Afonso & Miguel St. Aubyn, 2005. "Non-parametric approaches to education and health efficiency in OECD countries," Journal of Applied Economics, Universidad del CEMA, vol. 0, pages 227-246, November.
  14. Antonio Afonso & Sonia Fernandes, 2006. "Measuring local government spending efficiency: Evidence for the Lisbon region," Regional Studies, Taylor & Francis Journals, vol. 40(1), pages 39-53.
  15. Elizabeth Docteur & Howard Oxley, 2003. "Health-Care Systems: Lessons from the Reform Experience," OECD Health Working Papers 9, OECD Publishing.
  16. 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.
  17. Zere, E., 2000. "Hospital Efficiency in Sub-Saharan Africa. Evidence from South Africa," Research Paper 187, World Institute for Development Economics Research.
  18. E Zere & Diane Mcintyre & T Addison, 2001. "Technical Efficiency And Productivity Of Public Sector Hospitals In Three South African Provinces," South African Journal of Economics, Economic Society of South Africa, vol. 69(2), pages 336-358, 06.
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