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Does the Extent of per Case Payment System Affect Hospital Efficiency?

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  • Marina Cavalieri
  • Calogero Guccio
  • Domenico Lisi
  • Giacomo Pignataro

Abstract

Recently increasing public pressure to contain costs in the health care sector has led many national governments to introduce some type of prospective payment system and reduce the scope of global budgeting. This study investigates the extent to which the reimbursement systems of the Italian hospital sector have an impact on hospitals’ technical efficiency. Because of high variation in the financing and provision of health care services among regions and hospitals, Italy represents an interesting case study to test these effects. A two-stage data envelopment analysis was employed, in which the efficiency scores of all Italian hospitals were first calculated and then regressed on different environmental variables to capture the role of reimbursement systems. The results found a significant impact of the use of diagnostic-related group-based prospective payment systems on hospitals’ efficiency.

Suggested Citation

  • Marina Cavalieri & Calogero Guccio & Domenico Lisi & Giacomo Pignataro, 2018. "Does the Extent of per Case Payment System Affect Hospital Efficiency?," Public Finance Review, , vol. 46(1), pages 117-149, January.
    • Handle: RePEc:sae:pubfin:v:46:y:2018:i:1:p:117-149
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    Citations

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    Cited by:

    1. Sebastian Kohl & Jan Schoenfelder & Andreas Fügener & Jens O. Brunner, 2019. "The use of Data Envelopment Analysis (DEA) in healthcare with a focus on hospitals," Health Care Management Science, Springer, vol. 22(2), pages 245-286, June.
    2. Guccio, Calogero & Pignataro, Giacomo & Romeo, Domenica & Vidoli, Francesco, 2024. "Is austerity good for efficiency, at least? A counterfactual assessment for the Italian NHS," Socio-Economic Planning Sciences, Elsevier, vol. 92(C).
    3. Guccio, C. & Lisi, D. & Martorana, M.F. & Pignataro, G., 2020. "Incorporating quality in the efficiency assessment of hospitals using a generalized directional distance function approach," Health, Econometrics and Data Group (HEDG) Working Papers 20/17, HEDG, c/o Department of Economics, University of York.
    4. Cristian Barra & Raffaele Lagravinese & Roberto Zotti, 2022. "Exploring hospital efficiency within and between Italian regions: new empirical evidence," Journal of Productivity Analysis, Springer, vol. 57(3), pages 269-284, June.
    5. Zhang, Cai Wen & Yang, Yuanhui, 2023. "Appraisal of regional hospital efficiency and healthcare quality in China: Impacts of subsidies and marketization," Socio-Economic Planning Sciences, Elsevier, vol. 89(C).
    6. Zhensheng Chen & Xueli Chen & Tomas Baležentis & Xiaoqing Gan & Vivian Valdmanis, 2020. "Productivity change and its driving forces in Chinese healthcare sector," PLOS ONE, Public Library of Science, vol. 15(12), pages 1-16, December.
    7. Germà Bel & Marc Esteve, 2018. "“Is Private Production of Hospital Services Cheaper than Public Production? A Meta-Regression of Public vs Private Costs and Efficiency for Hospitals”," IREA Working Papers 201824, University of Barcelona, Research Institute of Applied Economics, revised Oct 2018.
    8. Zhensheng Chen & Xueli Chen & Xiaoqing Gan & Kaixuan Bai & Tomas Baležentis & Lixin Cui, 2020. "Technical Efficiency of Regional Public Hospitals in China Based on the Three-Stage DEA," IJERPH, MDPI, vol. 17(24), pages 1-17, December.
    9. Yuxi Wang & Simone Ghislandi & Aleksandra Torbica, 2020. "Investigating the geographic disparity in quality of care: the case of hospital readmission after acute myocardial infarction in Italy," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 21(8), pages 1149-1168, November.
    10. Asrul Akmal Shafie & Noor Syahireen Mohammed & Kok Fong See & Hishamshah Mohd Ibrahim & Jacqueline Hui Yi Wong & Irwinder Kaur Chhabra, 2022. "Efficiency and management factors: finding the balance in Thalassaemia care centres," Health Economics Review, Springer, vol. 12(1), pages 1-13, December.
    11. Marina Cavalieri & Calogero Guccio & Domenico Lisi & Ilde Rizzo, 2020. "Does Institutional Quality Matter for Infrastructure Provision? A Non-parametric Analysis for Italian Municipalities," Italian Economic Journal: A Continuation of Rivista Italiana degli Economisti and Giornale degli Economisti, Springer;Società Italiana degli Economisti (Italian Economic Association), vol. 6(3), pages 521-562, November.
    12. 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).
    13. Cavalieri, Marina & Di Caro, Paolo & Guccio, Calogero & Lisi, Domenico, 2020. "Does neighbours' grass matter? Testing spatial dependent heterogeneity in technical efficiency of Italian hospitals," Social Science & Medicine, Elsevier, vol. 265(C).

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