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Technical efficiency of Portuguese public hospitals: A comparative analysis across the five regions of Portugal

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  • Diogo Cunha Ferreira
  • Alexandre Morais Nunes

Abstract

The present study aims to analyse the efficiency scores of hospital units, with reference to the five Portuguese health administrative regions (North, Centre, Lisbon and Tagus Valley, Alentejo, and Algarve). This paper contextualizes the process of decentralization of health in Portugal (started 1993) as well as the hospitals' corporatization and merging reforms (started 2002). These reforms aimed to meet health care needs by optimizing costs, improving efficiency, and broadening both access and quality in health services. Data envelopment analysis was used to quantify and compare the efficiencies of 27 hospitals heterogeneously distributed by five administrative regions. The results show a large average performance across the country. However, there are regions with scores larger than the national average and others with inferior results. This interregional diversity points towards disparities that deserve special attention from the policymakers and hospital managers.

Suggested Citation

  • Diogo Cunha Ferreira & Alexandre Morais Nunes, 2019. "Technical efficiency of Portuguese public hospitals: A comparative analysis across the five regions of Portugal," International Journal of Health Planning and Management, Wiley Blackwell, vol. 34(1), pages 411-422, January.
    • Handle: RePEc:bla:ijhplm:v:34:y:2019:i:1:p:e411-e422
    DOI: 10.1002/hpm.2658
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    References listed on IDEAS

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    1. Ferreira, Diogo Cunha & Nunes, Alexandre Morais & Marques, Rui Cunha, 2018. "Doctors, nurses, and the optimal scale size in the Portuguese public hospitals," Health Policy, Elsevier, vol. 122(10), pages 1093-1100.
    2. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128, October.
    3. 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.
    4. Diogo Ferreira & Rui Marques, 2015. "Did the corporatization of Portuguese hospitals significantly change their productivity?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 16(3), pages 289-303, April.
    5. José M. Alonso & Judith Clifton & Daniel Díaz-Fuentes, 2015. "Did New Public Management Matter? An empirical analysis of the outsourcing and decentralization effects on public sector size," Public Management Review, Taylor & Francis Journals, vol. 17(5), pages 643-660, May.
    6. 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.
    7. Diego Prior & Magda Solà, 2000. "Technical efficiency and economies of diversification in health care," Health Care Management Science, Springer, vol. 3(4), pages 299-307, September.
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    1. Dinesh R. Pai & Fatma Pakdil & Nasibeh Azadeh-Fard, 2024. "Applications of data envelopment analysis in acute care hospitals: a systematic literature review, 1984–2022," Health Care Management Science, Springer, vol. 27(2), pages 284-312, June.
    2. Alexandre Morais Nunes & Diogo Cunha Ferreira, 2022. "A Critical Analysis of Decentralizing the Portuguese Public Healthcare Provision Services," IJERPH, MDPI, vol. 19(20), pages 1-10, October.

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