Does prospective payment increase hospital (in)efficiency? Evidence from the Swiss hospital sector
Several European countries have followed the United States in introducing prospective payment for hospitals with the expectation of achieving cost efficiency gains. This article examines whether theoretical expectations of cost efficiency gains can be empirically confirmed. In contrast to previous studies, the analysis of Switzerland provides a comparison of a retrospective per diem payment system with a prospective global budget and a payment per patient case system. Using a sample of approximately 90 public financed Swiss hospitals during the years 2004 to 2009 and Bayesian inference of a standard and a random parameter frontier model, cost efficiency gains are found, particularly with a payment per patient case system. Payment systems designed to put hospitals at operating risk are more effective than retrospective payment systems. However, hospitals are heterogeneous with respect to their production technologies, making a random parameter frontier model the superior specification for Switzerland.
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- Koop, G. & Osiewalski, J. & Steel, M. F. J., .
"Bayesian efficiency analysis through individual effects: Hospital cost frontiers,"
CORE Discussion Papers RP
1245, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
- Koop, Gary & Osiewalski, Jacek & Steel, Mark F. J., 1997. "Bayesian efficiency analysis through individual effects: Hospital cost frontiers," Journal of Econometrics, Elsevier, vol. 76(1-2), pages 77-105.
- KOOPÂ , Gary & OSIEWALSKIÂ , Jacek & STEELÂ , Mark, 1995. "Bayesian Efficiency Analysis through Individual Effects : Hospital Cost Frontiers," CORE Discussion Papers 1995036, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
- Joseph P. Newhouse, 1996. "Reimbursing Health Plans and Health Providers: Efficiency in Production versus Selection," Journal of Economic Literature, American Economic Association, vol. 34(3), pages 1236-1263, September.
- Efthymios G. Tsionas, 2002.
"Stochastic frontier models with random coefficients,"
Journal of Applied Econometrics,
John Wiley & Sons, Ltd., vol. 17(2), pages 127-147.
- Tsionas, E.G., 2001. "Stochastic Frontier Models with Random Coefficients," DEOS Working Papers 130, Athens University of Economics and Business.
- Tsionas, E.G., 2001. "Stochastic Frontier Models with Random Coefficients," Athens University of Economics and Business 130, Athens University of Economics and Business, Department of International and European Economic Studies.
- Mehdi Farsi & Massimo Filippini, 2006. "An Analysis of Efficiency and Productivity in Swiss Hospitals," Swiss Journal of Economics and Statistics (SJES), Swiss Society of Economics and Statistics (SSES), vol. 142(I), pages 1-37, March.
- Mehdi Farsi & Massimo Filippini & William Greene, 2006.
"Application Of Panel Data Models In Benchmarking Analysis Of The Electricity Distribution Sector ,"
Annals of Public and Cooperative Economics,
Wiley Blackwell, vol. 77(3), pages 271-290, 09.
- Mehdi Farsi & Massimo Filippini & William Greene, 2005. "Application of Panel Data Models in Benchmarking Analysis of the Electrivity Distribution Sector," CEPE Working paper series 05-39, CEPE Center for Energy Policy and Economics, ETH Zurich.
- Chalkley, M. & Malcomson, J.M., 1995.
"Contracting for health services when patient demand does not reflect quality,"
Discussion Paper Series In Economics And Econometrics
9514, Economics Division, School of Social Sciences, University of Southampton.
- 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.
- Simar, L. & Wilson, P.W., 1999.
"Statistical Inference in Nonparametric Frontier Models: the State of the Art,"
9904, Catholique de Louvain - Institut de statistique.
- Léopold Simar & Paul Wilson, 2000. "Statistical Inference in Nonparametric Frontier Models: The State of the Art," Journal of Productivity Analysis, Springer, vol. 13(1), pages 49-78, January.
- 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 On line Working Paper Series
2006:9, Oslo University, Health Economics Research Programme.
- Biorn, Erik & Hagen, Terje P. & Iversen, Tor & Magnussen, Jon, 2006. "Heterogeneity in Hospitals' Responses to a Financial Reform: A Random Coefficient Analysis of The Impact of Activity-Based Financing on Efficiency," MPRA Paper 8169, University Library of Munich, Germany.
- 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.
- Biørn, Erik & Hagen, Terje P. & Iversen, Tor & Magnussen, Jon, 2009.
"The effect of activity-based financing on hospital efficiency: A panel data analysis of DEA efficiency scores 1992-2000,"
HERO On line Working Paper Series
2002:8, Oslo University, Health Economics Research Programme.
- 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.
- Chalkley, Martin & Malcomson, James M., 2000.
"Government purchasing of health services,"
Handbook of Health Economics,
in: A. J. Culyer & J. P. Newhouse (ed.), Handbook of Health Economics, edition 1, volume 1, chapter 15, pages 847-890
- Chalkley, M. & Malcomson, J.M., 1998. "Government purchasing of health services," Discussion Paper Series In Economics And Econometrics 9821, Economics Division, School of Social Sciences, University of Southampton.
- Luis Orea & Subal C. Kumbhakar, 2004. "Efficiency measurement using a latent class stochastic frontier model," Empirical Economics, Springer, vol. 29(1), pages 169-183, January.
- Philippe K Widmer & Peter Zweifel & Mehdi Farsi, 2010.
"Accounting For Heterogeneity In The Measurement of Hospital Performance,"
Economics Discussion / Working Papers
10-21, The University of Western Australia, Department of Economics.
- Philippe K. Widmer & Peter Zweifel & Mehdi Farsi, 2011. "Accounting for heterogeneity in the measurement of hospital performance," ECON - Working Papers 052, Department of Economics - University of Zurich.
- repec:pra:mprapa:8100 is not listed on IDEAS
- Jim Griffin & Mark Steel, 2007.
"Bayesian stochastic frontier analysis using WinBUGS,"
Journal of Productivity Analysis,
Springer, vol. 27(3), pages 163-176, June.
- Jim Griffin & Mark Steel, 2005. "Bayesian Stochastic Frontier Analysis Using WinBUGS," Econometrics 0509004, EconWPA.
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