IDEAS home Printed from https://ideas.repec.org/p/bol/bodewp/318.html
   My bibliography  Save this paper

Efficienza tecnica e produzione ospedaliera: una valutazione con Data Envelopment Analysis delle prestazioni ospedaliere nel periodo della riforma

Author

Listed:
  • D. Fabbri

Abstract

In questi ultimi anni il Sistema Sanitario Nazionale stato sottoposto ad un sostanziale processo di tra-sformazione e di riforma. Uno fra gli ambiti pi investiti dalle trasformazioni in atto certamente quello della produzione di servizi ospedalieri. Nel quadro istituzionale che si va delineando i produttori vengono sempre pi responsabilizzati a perseguire strategie di razionalizzazione nell uso delle risorse e di raziona-mento della domanda. E in questo contesto che il miglioramento dell efficienza produttiva assume il valo-re di obiettivo prioritario. In questo studio ci concentriamo sulla componente tecnica dell efficienza nella produzione ospedaliera al fine di valutare se e in quale misura le recenti riforme abbiano contribuito ad accrescerla. L analisi viene condotta, impiegando la tecnica di Data Envelopment Analysis (DEA), sugli ospedali pubblici della regione Emilia-Romagna, i cui dati d attivit sono stati rilevati per il periodo fra il 1994 e il 1995. I risultati confermano la presenza di un significativo miglioramento delle prestazioni in ter-mini di efficienza tecnica che si realizza in assenza di progresso tecnologico. Il miglioramento pronunciato e statisticamente significativo nell ambito della produzione di ricoveri , mentre risulta statisticamente non significativo nella produzione di giornate di degenza . L inefficienza si concentra nell utilizzo del per-sonale amministrativo e di quello infermieristico. L utilizzo dei letti e del personale medico risulta presso-ch pienamente efficiente. Sul versante degli output si riscontra il permanere di una rilevante capacit inutilizzata nella produzione di ricoveri di elevata complessit . Questo porta a concludere che nel periodo esaminato gli incentivi introdotti dalla riforma hanno raggiunto l obiettivo di migliorare l efficienza nell uso delle risorse tuttavia sono stati insufficienti rispetto al contenimento della produzione sanitaria e al razio-namento della domanda.

Suggested Citation

  • D. Fabbri, 1998. "Efficienza tecnica e produzione ospedaliera: una valutazione con Data Envelopment Analysis delle prestazioni ospedaliere nel periodo della riforma," Working Papers 318, Dipartimento Scienze Economiche, Universita' di Bologna.
    • Handle: RePEc:bol:bodewp:318
    as

    Download full text from publisher

    File URL: http://amsacta.unibo.it/4990/1/318.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Sudit, Ephraim F., 1995. "Productivity measurement in industrial operations," European Journal of Operational Research, Elsevier, vol. 85(3), pages 435-453, September.
    2. Fried, Harold O. & Lovell, C. A. Knox & Schmidt, Shelton S. (ed.), 1993. "The Measurement of Productive Efficiency: Techniques and Applications," OUP Catalogue, Oxford University Press, number 9780195072181.
    3. 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.
    4. Valdmanis, Vivian, 1992. "Sensitivity analysis for DEA models : An empirical example using public vs. NFP hospitals," Journal of Public Economics, Elsevier, vol. 48(2), pages 185-205, July.
    5. Cutler, David M, 1995. "The Incidence of Adverse Medical Outcomes under Prospective Payment," Econometrica, Econometric Society, vol. 63(1), pages 29-50, January.
    6. Grosskopf, S. & Valdmanis, V., 1987. "Measuring hospital performance : A non-parametric approach," Journal of Health Economics, Elsevier, vol. 6(2), pages 89-107, June.
    7. Breyer, Friedrich, 1987. "The specification of a hospital cost function : A comment on the recent literature," Journal of Health Economics, Elsevier, vol. 6(2), pages 147-157, June.
    8. Rajiv D. Banker, 1993. "Maximum Likelihood, Consistency and Data Envelopment Analysis: A Statistical Foundation," Management Science, INFORMS, vol. 39(10), pages 1265-1273, October.
    9. Sajal Chattopadhyay & Dennis Heffley, 1994. "Are For-Profit Nursing Homes More Efficient? Data Envelopment Analysis with a Case-Mix Constraint," Eastern Economic Journal, Eastern Economic Association, vol. 20(2), pages 171-186, Spring.
    10. Antonio Giuffrida & Hugh Gravelle, 2001. "Measuring performance in primary care: econometric analysis and DEA," Applied Economics, Taylor & Francis Journals, vol. 33(2), pages 163-175.
    11. Rajiv D. Banker & Robert F. Conrad & Robert P. Strauss, 1986. "A Comparative Application of Data Envelopment Analysis and Translog Methods: An Illustrative Study of Hospital Production," Management Science, INFORMS, vol. 32(1), pages 30-44, January.
    12. Nyman, John A & Bricker, Dennis L, 1989. "Profit Incentives and Technical Efficiency in the Production of Nursing Home Care," The Review of Economics and Statistics, MIT Press, vol. 71(4), pages 586-594, November.
    13. Newhouse, Joseph P., 1994. "Frontier estimation: How useful a tool for health economics?," Journal of Health Economics, Elsevier, vol. 13(3), pages 317-322, October.
    14. Kooreman, Peter, 1994. "Nursing home care in The Netherlands: a nonparametric efficiency analysis," Journal of Health Economics, Elsevier, vol. 13(3), pages 301-316, October.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Villani, Salvatore & D'alessio, Lidia & Pica, Federico, 2008. "La questione dei costi standard ed i problemi del Mezzogiorno [The issue of standard costs and problems of the Southern Italy]," MPRA Paper 30214, University Library of Munich, Germany, revised Aug 2008.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Daniele Fabbri, 2000. "Riforma sanitaria e produzione ospedaliera," Politica economica, Società editrice il Mulino, issue 1, pages 131-164.
    2. N. Maniadakis & N. Kotsopoulos & P. Prezerakos & J. Yfantopoulos, 2009. "Health Care Services Performance Measurement: Theory, Methods and Empirical Evidence," European Research Studies Journal, European Research Studies Journal, vol. 0(3), pages 151-170.
    3. 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.
    4. Andrew Worthington, 1999. "An Empirical Survey Of Frontier Efficiency Measurement Techniques In Healthcare Services," School of Economics and Finance Discussion Papers and Working Papers Series 067, School of Economics and Finance, Queensland University of Technology.
    5. Puig-Junoy, Jaume, 2000. "Partitioning input cost efficiency into its allocative and technical components: an empirical DEA application to hospitals," Socio-Economic Planning Sciences, Elsevier, vol. 34(3), pages 199-218, September.
    6. Erlandsen,E. & Forsund,F.R., 1999. "Efficiency in the provision of municipal nursing- and home-care services : the Norwegian experience," Memorandum 32/1999, Oslo University, Department of Economics.
    7. Reuben Elan & Verma Bharat Bhushan & Bhat Ramesh, 2001. "Hospital Efficiency: An Empirical Analysis of District and Grant-in-Aid Hospitals in Gujarat," IIMA Working Papers WP2001-07-05, Indian Institute of Management Ahmedabad, Research and Publication Department.
    8. Jacques Ngoie Kibambe & Steven F. Koch, 2005. "DEA Applied to a Gauteng Sample of South African Public Hospitals," Working Papers 200512, University of Pretoria, Department of Economics.
    9. Chang, Hsi-Hui, 1998. "Determinants of Hospital Efficiency: the Case of Central Government-owned Hospitals in Taiwan," Omega, Elsevier, vol. 26(2), pages 307-317, April.
    10. Giokas, Dimitris I., 2001. "Greek hospitals: how well their resources are used," Omega, Elsevier, vol. 29(1), pages 73-83, February.
    11. Chang, Hsihui & Cheng, Mei-Ai & Das, Somnath, 2004. "Hospital ownership and operating efficiency: Evidence from Taiwan," European Journal of Operational Research, Elsevier, vol. 159(2), pages 513-527, December.
    12. Banker, Rajiv D. & Chang, Hsihui, 1995. "A simulation study of hypothesis tests for differences in efficiencies," International Journal of Production Economics, Elsevier, vol. 39(1-2), pages 37-54, April.
    13. Rowena Jacobs, 2000. "Alternative methods to examine hospital efficiency: Data Envelopment Analysis and Stochastic Frontier Analysis," Working Papers 177chedp, Centre for Health Economics, University of York.
    14. Jaume Puig‐Junoy, 1998. "Technical efficiency in the clinical management of critically ill patients," Health Economics, John Wiley & Sons, Ltd., vol. 7(3), pages 263-277, May.
    15. Harold Fried & Shelton Schmidt & Suthathip Yaisawarng, 1999. "Incorporating the Operating Environment Into a Nonparametric Measure of Technical Efficiency," Journal of Productivity Analysis, Springer, vol. 12(3), pages 249-267, November.
    16. Vincenzo Patrizii & Giuliano Resce, 2015. "Public Sector Contribution To Competitiveness," Italian Economic Journal: A Continuation of Rivista Italiana degli Economisti and Giornale degli Economisti, Springer;Società Italiana degli Economisti (Italian Economic Association), vol. 1(3), pages 401-443, November.
    17. Shiovan Ni Luasa & Declan Dineen & Marta Zieba, 2018. "Technical and scale efficiency in public and private Irish nursing homes – a bootstrap DEA approach," Health Care Management Science, Springer, vol. 21(3), pages 326-347, September.
    18. Martin, Cécile, 2014. "Concurrence, prix et qualité de la prise en charge en EHPAD en France : Analyses micro-économétriques," Economics Thesis from University Paris Dauphine, Paris Dauphine University, number 123456789/13712 edited by Dormont, Brigitte.
    19. George Fragkiadakis & Michael Doumpos & Constantin Zopounidis & Christophe Germain, 2016. "Operational and economic efficiency analysis of public hospitals in Greece," Post-Print hal-01414677, HAL.
    20. Javier Salinas-Jimenez & Peter Smith, 1994. "Data envelopment analysis applied to quality in primary health care," Working Papers 124chedp, Centre for Health Economics, University of York.

    More about this item

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:bol:bodewp:318. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Dipartimento Scienze Economiche, Universita' di Bologna (email available below). General contact details of provider: https://edirc.repec.org/data/sebolit.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.