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A comparison of hospital scale effects in short‐run and long‐run cost functions

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  • Vassilis H. Aletras

Abstract

Numerous estimates of economies of scale in the hospital setting have been obtained since the early 1980s from both flexible long‐run and short‐run cost functions. Although the theoretical superiority of the latter approach is widely recognized, it has been previously suggested that the two cost specifications yield quite similar econometric findings regarding scale effects. This paper utilizes a new data set consisting of 91 Greek NHS hospitals in order to empirically examine this proposition by comparing economies of scale estimates derived from both translog total and variable cost functions. The results indicate that the use of long‐run equations might seriously mislead policy makers and that constant returns to scale prevail in Greek public hospitals. Copyright © 1999 John Wiley & Sons, Ltd.

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  • Vassilis H. Aletras, 1999. "A comparison of hospital scale effects in short‐run and long‐run cost functions," Health Economics, John Wiley & Sons, Ltd., vol. 8(6), pages 521-530, September.
  • Handle: RePEc:wly:hlthec:v:8:y:1999:i:6:p:521-530
    DOI: 10.1002/(SICI)1099-1050(199909)8:6<521::AID-HEC462>3.0.CO;2-G
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    5. Tountas, Yannis & Karnaki, Panagiota & Pavi, Elpida & Souliotis, Kyriakos, 2005. "The "unexpected" growth of the private health sector in Greece," Health Policy, Elsevier, vol. 74(2), pages 167-180, October.
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    8. Anne Mason & Marisa Miraldo & Luigi Siciliani & Peter Sivey & Andrew Street, 2008. "Establishing a Fair Playing Field for Payment by Results," Working Papers 039cherp, Centre for Health Economics, University of York.
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    11. Kontodimopoulos, Nick & Niakas, Dimitris, 2005. "Efficiency measurement of hemodialysis units in Greece with data envelopment analysis," Health Policy, Elsevier, vol. 71(2), pages 195-204, February.
    12. Kontodimopoulos, Nick & Nanos, Panagiotis & Niakas, Dimitris, 2006. "Balancing efficiency of health services and equity of access in remote areas in Greece," Health Policy, Elsevier, vol. 76(1), pages 49-57, March.
    13. Aletras, Vassilios & Kontodimopoulos, Nick & Zagouldoudis, Athanasios & Niakas, Dimitris, 2007. "The short-term effect on technical and scale efficiency of establishing regional health systems and general management in Greek NHS hospitals," Health Policy, Elsevier, vol. 83(2-3), pages 236-245, October.
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