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Relative Efficiency, Scale Effect, and Scope Effect of Public Hospitals: Evidence from Australia

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Listed:
  • Wang, Jian

    (Shandong University)

  • Zhao, Zhong

    (Renmin University of China)

  • Mahmood, Amir

    (University of Newcastle, Australia)

Abstract

Using the 1997-1998 New South Wales public-hospitals comparison data, we investigate the hospital-level inefficiency by applying a stochastic-frontier multiproduct cost function. We use a flexible translog cost function to reduce the measurement errors of the outputs of the hospital. The main findings are: First, inefficiency accounts for 9.3% of total hospital costs in large hospitals and 11.3% in small hospitals, when including complexity indicators. Second, diseconomies of scale exist in very large hospitals, whereas scale economies appear in very small hospitals. Third, scope effects are found in both large and small hospitals. Fourth, small hospitals are more labor-intensive than large hospitals are.

Suggested Citation

  • Wang, Jian & Zhao, Zhong & Mahmood, Amir, 2006. "Relative Efficiency, Scale Effect, and Scope Effect of Public Hospitals: Evidence from Australia," IZA Discussion Papers 2520, Institute of Labor Economics (IZA).
  • Handle: RePEc:iza:izadps:dp2520
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    File URL: https://docs.iza.org/dp2520.pdf
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    References listed on IDEAS

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    3. Anthony Scott & David Parkin, 1995. "Investigating hospital efficiency in the new NHS: The role of the translog cost function," Health Economics, John Wiley & Sons, Ltd., vol. 4(6), pages 467-478, November.
    4. Wagstaff, Adam & Barnum, Howard, 1992. "Hospital cost functions for developing countries," Policy Research Working Paper Series 1044, The World Bank.
    5. Jondrow, James & Knox Lovell, C. A. & Materov, Ivan S. & Schmidt, Peter, 1982. "On the estimation of technical inefficiency in the stochastic frontier production function model," Journal of Econometrics, Elsevier, vol. 19(2-3), pages 233-238, August.
    6. Randall Randall P. Ellis, 1991. "Hospital Cost Function Estimation When Firms May Not Try to Minimize Total Costs," Papers 0029, Boston University - Industry Studies Programme.
    7. Dor, Avi & Farley, Dean E., 1996. "Payment source and the cost of hospital care: Evidence from a multiproduct cost function with multiple payers," Journal of Health Economics, Elsevier, vol. 15(1), pages 1-21, February.
    8. 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.
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    Cited by:

    1. Antony Andrews & Omphile Temoso & Sean Kimpton, 2021. "Persistent and Transient Inefficiency of Australian States and Territories in Providing Public Hospital Services: An Application of Bayesian Stochastic Finite Mixture Frontier Analysis," Economic Papers, The Economic Society of Australia, vol. 40(2), pages 104-115, June.
    2. Zhichao Wang & Valentin Zelenyuk, 2021. "Performance Analysis of Hospitals in Australia and its Peers: A Systematic Review," CEPA Working Papers Series WP012021, School of Economics, University of Queensland, Australia.
    3. Valentin Zelenyuk & Zhichao Wang, 2023. "Random vs. Explained Inefficiency in Stochastic Frontier Analysis: The Case of Queensland Hospitals," CEPA Working Papers Series WP052023, School of Economics, University of Queensland, Australia.
    4. Chew Lian Chua & Alfons Palangkaraya & Jongsay Yong, 2011. "Hospital Competition, Technical Efficiency and Quality," The Economic Record, The Economic Society of Australia, vol. 87(277), pages 252-268, June.
    5. Pedro Simões & Rui Marques, 2011. "Performance and congestion analysis of the portuguese hospital services," Central European Journal of Operations Research, Springer;Slovak Society for Operations Research;Hungarian Operational Research Society;Czech Society for Operations Research;Österr. Gesellschaft für Operations Research (ÖGOR);Slovenian Society Informatika - Section for Operational Research;Croatian Operational Research Society, vol. 19(1), pages 39-63, March.
    6. Sarah Young & Kevin Swarts & Sarah J. Prior & Douglass Doherty & Steven J. Campbell, 2022. "Vertical integration in the Australian community care setting: Can it work? A theoretical review of current literature," International Journal of Health Planning and Management, Wiley Blackwell, vol. 37(3), pages 1299-1310, May.

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    Keywords

    translog cost function; economies of scale and scope; efficiency; public hospital;
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