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Do healthcare financing systems influence hospital efficiency? A metafrontier approach for the case of Mexico

Author

Listed:
  • Víctor Giménez

    (Universitat Autònoma de Barcelona
    Universitat Autónoma de Barcelona)

  • Jorge R. Keith

    (Tecnológico de Monterrey)

  • Diego Prior

    (Universitat Autònoma de Barcelona)

Abstract

The objective of this article is to discuss the impact of healthcare financing systems on the efficiency of Mexican hospitals. The Mexican healthcare system is undergoing a process of transformation to establish conditions for allocating limited health resources in order to achieve efficiency and transparency; in this line, there is a concern about the implications of different funding options. In terms of financing arrangements, the Mexican health system is divided into three categories (one private and two public). In the framework of New Public Management theory, non-parametric metafrontier methods are used to estimate differences in efficiency of hospitals under different financing schemes, and in relation to the potential technology available in the healthcare system. Empirical evidence suggests that: 1) an out-of-pocket funding system, on average, incentivizes more efficient behavior; and 2) public funding seems to be the best option for complex and high-technology hospitals, and capitation appears to be the most appropriate way of negotiating their funding.

Suggested Citation

  • Víctor Giménez & Jorge R. Keith & Diego Prior, 2019. "Do healthcare financing systems influence hospital efficiency? A metafrontier approach for the case of Mexico," Health Care Management Science, Springer, vol. 22(3), pages 549-559, September.
    • Handle: RePEc:kap:hcarem:v:22:y:2019:i:3:d:10.1007_s10729-019-9467-9
    DOI: 10.1007/s10729-019-9467-9
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    1. O'Neill, Liam & Rauner, Marion & Heidenberger, Kurt & Kraus, Markus, 2008. "A cross-national comparison and taxonomy of DEA-based hospital efficiency studies," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 158-189, September.
    2. Jos Blank & Evelien Eggink, 2014. "The impact of policy on hospital productivity: a time series analysis of Dutch hospitals," Health Care Management Science, Springer, vol. 17(2), pages 139-149, June.
    3. Mitropoulos, Panagiotis & Talias, Μichael A. & Mitropoulos, Ioannis, 2015. "Combining stochastic DEA with Bayesian analysis to obtain statistical properties of the efficiency scores: An application to Greek public hospitals," European Journal of Operational Research, Elsevier, vol. 243(1), pages 302-311.
    4. Jensen, Michael C. & Meckling, William H., 1976. "Theory of the firm: Managerial behavior, agency costs and ownership structure," Journal of Financial Economics, Elsevier, vol. 3(4), pages 305-360, October.
    5. O'Reilly, Jacqueline & Busse, Reinhard & Häkkinen, Unto & Or, Zeynep & Street, Andrew & Wiley, Miriam, 2012. "Paying for hospital care: the experience with implementing activity-based funding in five European countries," Health Economics, Policy and Law, Cambridge University Press, vol. 7(1), pages 73-101, January.
    6. Cavagnero, Eleonora & Bilger, Marcel, 2010. "Equity during an economic crisis: Financing of the Argentine health system," Journal of Health Economics, Elsevier, vol. 29(4), pages 479-488, July.
    7. Mette Asmild, 2015. "Frontier Differences and the Global Malmquist Index," International Series in Operations Research & Management Science, in: Joe Zhu (ed.), Data Envelopment Analysis, edition 127, chapter 16, pages 447-461, Springer.
    8. Beatriz Gonzalez Lopez-Valcarcel & Patricia Barber Perez, 1996. "Changes in the efficiency of spanish public hospitals after the introduction of program-contracts," Investigaciones Economicas, Fundación SEPI, vol. 20(3), pages 377-402, September.
    9. 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.
    10. 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.
    11. Bertranou, Fabio M., 1999. "Are market-oriented health insurance reforms possible in Latin America?: The cases of Argentina, Chile and Colombia," Health Policy, Elsevier, vol. 47(1), pages 19-36, April.
    12. Billor, Nedret & Hadi, Ali S. & Velleman, Paul F., 2000. "BACON: blocked adaptive computationally efficient outlier nominators," Computational Statistics & Data Analysis, Elsevier, vol. 34(3), pages 279-298, September.
    13. Alessandra Ferrari, 2006. "The internal market and hospital efficiency: a stochastic distance function approach," Applied Economics, Taylor & Francis Journals, vol. 38(18), pages 2121-2130.
    14. Christopher O’Donnell & D. Rao & George Battese, 2008. "Metafrontier frameworks for the study of firm-level efficiencies and technology ratios," Empirical Economics, Springer, vol. 34(2), pages 231-255, March.
    15. Maynard, Alan, 1994. "Can competition enhance efficiency in health care? Lessons from the reform of the U.K. National Health Service," Social Science & Medicine, Elsevier, vol. 39(10), pages 1433-1445, November.
    16. Yasar A. Ozcan, 2014. "Evaluation of Performance in Health Care," International Series in Operations Research & Management Science, in: Health Care Benchmarking and Performance Evaluation, edition 2, chapter 0, pages 3-14, Springer.
    17. Wilson, Paul W, 1993. "Detecting Outliers in Deterministic Nonparametric Frontier Models with Multiple Outputs," Journal of Business & Economic Statistics, American Statistical Association, vol. 11(3), pages 319-323, July.
    18. Mette Asmild & Bruce Hollingsworth & Stephen Birch, 2013. "The scale of hospital production in different settings: one size does not fit all," Journal of Productivity Analysis, Springer, vol. 40(2), pages 197-206, October.
    19. Wranik, Dominika, 2012. "Healthcare policy tools as determinants of health-system efficiency: evidence from the OECD," Health Economics, Policy and Law, Cambridge University Press, vol. 7(2), pages 197-226, April.
    20. THIRY, Bernard & TULKENS, Henry, 1992. "Allowing for inefficiency in parametric estimation of production fucntions for urban transit firms," LIDAM Reprints CORE 994, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    21. George Battese & D. Rao & Christopher O'Donnell, 2004. "A Metafrontier Production Function for Estimation of Technical Efficiencies and Technology Gaps for Firms Operating Under Different Technologies," Journal of Productivity Analysis, Springer, vol. 21(1), pages 91-103, January.
    22. Simar, Leopold & Wilson, Paul W., 2002. "Non-parametric tests of returns to scale," European Journal of Operational Research, Elsevier, vol. 139(1), pages 115-132, May.
    23. George E. Battese & D. S. Prasada Rao, 2002. "Technology Gap, Efficiency, and a Stochastic Metafrontier Function," International Journal of Business and Economics, School of Management Development, Feng Chia University, Taichung, Taiwan, vol. 1(2), pages 87-93, August.
    24. Alonso, José M. & Clifton, Judith & Díaz-Fuentes, Daniel, 2015. "The impact of New Public Management on efficiency: An analysis of Madrid's hospitals," Health Policy, Elsevier, vol. 119(3), pages 333-340.
    25. Iriart, Celia & Elías Merhy, Emerson & Waitzkin, Howard, 2001. "Managed care in Latin America: the new common sense in health policy reform," Social Science & Medicine, Elsevier, vol. 52(8), pages 1243-1253, April.
    26. R. D. Banker & A. Charnes & W. W. Cooper, 1984. "Some Models for Estimating Technical and Scale Inefficiencies in Data Envelopment Analysis," Management Science, INFORMS, vol. 30(9), pages 1078-1092, September.
    27. Basilio Acerete & Anne Stafford & Pamela Stapleton, 2012. "New development: New global health care PPP developments—a critique of the success story," Public Money & Management, Taylor & Francis Journals, vol. 32(4), pages 311-314, July.
    28. John C. Langenbrunner & Cheryl Cashin & Sheila O’Dougherty, 2009. "Designing and Implementing Health Care Provider Payment Systems : How-To Manuals," World Bank Publications - Books, The World Bank Group, number 13806.
    29. Kutzin, Joseph, 2001. "A descriptive framework for country-level analysis of health care financing arrangements," Health Policy, Elsevier, vol. 56(3), pages 171-204, June.
    30. Peter Zweifel & Ming Tai-Seale, 2009. "An economic analysis of payment for health care services: The United States and Switzerland compared," International Journal of Health Economics and Management, Springer, vol. 9(2), pages 197-210, June.
    31. Yasar A. Ozcan, 2014. "Health Care Benchmarking and Performance Evaluation," International Series in Operations Research and Management Science, Springer, edition 2, number 978-1-4899-7472-3, July-Dece.
    32. Rhys Andrews & Steven Van de Walle, 2013. "New Public Management and Citizens' Perceptions of Local Service Efficiency, Responsiveness, Equity and Effectiveness," Public Management Review, Taylor & Francis Journals, vol. 15(5), pages 762-783, June.
    33. Gillian McCallion & J. Colin Glass & Robert Jackson & Christine Kerr & Donal McKillop, 2000. "Investigating productivity change and hospital size: a nonparametric frontier approach," Applied Economics, Taylor & Francis Journals, vol. 32(2), pages 161-174.
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    2. See, Kok Fong & Ng, Ying Chu, 2021. "Do hospital reform and ownership matter to Shenzhen hospitals in China? A productivity analysis," Economic Analysis and Policy, Elsevier, vol. 72(C), pages 145-155.
    3. Gao, Qiuming & Wang, Derek, 2021. "Hospital efficiency and equity in health care delivery: A study based in China," Socio-Economic Planning Sciences, Elsevier, vol. 76(C).
    4. José M. Cordero & Agustín García-García & Enrique Lau-Cortés & Cristina Polo, 2021. "Efficiency and Productivity Change of Public Hospitals in Panama: Do Management Schemes Matter?," IJERPH, MDPI, vol. 18(16), pages 1-21, August.
    5. Chin‐wei Huang & Hsiao‐Yin Chen, 2023. "Using nonradial metafrontier data envelopment analysis to evaluate the metatechnology and metafactor ratios for the Taiwanese hotel industry," Managerial and Decision Economics, John Wiley & Sons, Ltd., vol. 44(4), pages 1904-1919, June.
    6. Ming-Miin Yu & Li-Hsueh Chen, 2020. "A meta-frontier network data envelopment analysis approach for the measurement of technological bias with network production structure," Annals of Operations Research, Springer, vol. 287(1), pages 495-514, April.
    7. Kosycarz, Ewa & Dędys, Monika & Ekes, Maria & Wranik, Wiesława Dominika, 2023. "The effects of provider contract types and fiscal decentralization on the efficiency of the Polish hospital sector: A data envelopment analysis across 16 health regions," Health Policy, Elsevier, vol. 129(C).
    8. Nurhafiza Md Hamzah & Ming-Miin Yu & Kok Fong See, 2021. "Assessing the efficiency of Malaysia health system in COVID-19 prevention and treatment response," Health Care Management Science, Springer, vol. 24(2), pages 273-285, June.
    9. Fainman, Emily Zhu & Kucukyazici, Beste, 2020. "Design of financial incentives and payment schemes in healthcare systems: A review," Socio-Economic Planning Sciences, Elsevier, vol. 72(C).

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