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Secessions of Municipal Health Centre Federations: Expenditure and Productivity Effects

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  • Luoma, Kalevi
  • Moisio, Antti
  • Aaltonen, Juho

Abstract

We examine the expenditure and efficiency effects of secessions of health centre federations between 1990 and 2003. Using both regression and matching techniques we find statistically significant effects. According to results, the per capita primary health care expenditure growth is approximately five percent higher in seceded health centres compared to all non-seceded health centres. Using nearest neighbour matching, we find that the average secession effect is eight percent on per capita primary health care expenditures. We find no effect on specialised health care expenditures. Using an indicator of health centre service volume, we find that secessions had no positive effects on the productivity development in the long term. The rapid expenditure growth of seceded health centres can thus be explained both by increasing service volume and decreasing productivity. Key words: Health care expenditures, health centre secessions, economies of scale

Suggested Citation

  • Luoma, Kalevi & Moisio, Antti & Aaltonen, Juho, 2007. "Secessions of Municipal Health Centre Federations: Expenditure and Productivity Effects," Discussion Papers 425, VATT Institute for Economic Research.
    • Handle: RePEc:fer:dpaper:425
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    References listed on IDEAS

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    1. James J. Heckman & Jeffrey Smith & Nancy Clements, 1997. "Making The Most Out Of Programme Evaluations and Social Experiments: Accounting For Heterogeneity in Programme Impacts," The Review of Economic Studies, Review of Economic Studies Ltd, vol. 64(4), pages 487-535.
    2. Järviö, Maija-Liisa & Luoma, Kalevi, 1992. "Health Centre Productivity in Finland: Productivity change from 1980 to 1990 and productivity differences in 1990," Discussion Papers 42, VATT Institute for Economic Research.
    3. Järviö, Maija-Liisa & Luoma, Kalevi, 2000. "Productivity Changes in Finnish Health Centres: A Malmquist Index Approach," Discussion Papers 218, VATT Institute for Economic Research.
    4. Järviö, Maija-Liisa & Luoma, Kalevi & Räty, Tarmo & Aaltonen, Juho, 2005. "Productivity and its Drivers in Finnish Primary Care 1988-2003," Research Reports 118, VATT Institute for Economic Research.
    5. Michael Lechner, 2002. "Some practical issues in the evaluation of heterogeneous labour market programmes by matching methods," Journal of the Royal Statistical Society Series A, Royal Statistical Society, vol. 165(1), pages 59-82, February.
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