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Assessing Hospital Efficiency: Non-parametric Evidence for Portugal

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  • António Afonso
  • Sónia Fernandes

Abstract

We compute DEA efficiency scores and Malmquist indexes for a panel data set comprising 68 Portuguese public hospitals belonging to the National Health System (NHS) in the period 2000-2005, when several units started being run in an entrepreneurial framework. With data on hospital services’ and resource quantities we construct an output distance function, we assess by how much can output quantities be proportionally expanded without changing input quantities Our results show that, on average, the NHS hospital sector revealed positive but small productivity growth between 2000 and 2004. The mean TFP indices vary between 0.917 and 1.109, implying some differences in the Malmquist indices across specifications. Furthermore, there are significant fluctuations among NHS hospitals in terms of individual efficiency scores from one year to the other.

Suggested Citation

  • António Afonso & Sónia Fernandes, 2008. "Assessing Hospital Efficiency: Non-parametric Evidence for Portugal," Working Papers Department of Economics 2008/07, ISEG - Lisbon School of Economics and Management, Department of Economics, Universidade de Lisboa.
    • Handle: RePEc:ise:isegwp:wp72008
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    References listed on IDEAS

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    Cited by:

    1. Agovino, Massimiliano & Musella, Gaetano & Scaletti, Alessandro, 2022. "Equilibrium and efficiency in the first aid services market: The case of the emergency department of Sorrento," Socio-Economic Planning Sciences, Elsevier, vol. 82(PB).
    2. António Afonso & Ricardo Sousa, 2011. "The macroeconomic effects of fiscal policy in Portugal: a Bayesian SVAR analysis," Portuguese Economic Journal, Springer;Instituto Superior de Economia e Gestao, vol. 10(1), pages 61-82, April.
    3. 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.
    4. António AFONSO, & Mohamed AYADI, & Sourour RAMZI, 2013. "Assessing productivity performance of basic and secondary education in Tunisia: a Malmquist analysis," Working Papers Department of Economics 2013/19, ISEG - Lisbon School of Economics and Management, Department of Economics, Universidade de Lisboa.
    5. Dickens S Omondi Aduda & Collins Ouma & Rosebella Onyango & Mathews Onyango & Jane Bertrand, 2015. "Voluntary Medical Male Circumcision Scale-Up in Nyanza, Kenya: Evaluating Technical Efficiency and Productivity of Service Delivery," PLOS ONE, Public Library of Science, vol. 10(2), pages 1-17, February.
    6. Alexander Karmann & Felix Roesel, 2017. "Hospital Policy and Productivity – Evidence from German States," Health Economics, John Wiley & Sons, Ltd., vol. 26(12), pages 1548-1565, December.
    7. Pereira, Miguel Alves & Figueira, José Rui & Marques, Rui Cunha, 2020. "Using a Choquet integral-based approach for incorporating decision-maker’s preference judgments in a Data Envelopment Analysis model," European Journal of Operational Research, Elsevier, vol. 284(3), pages 1016-1030.
    8. Touqeer Abbas & Muhammad Amir Aslam & Muhammad Waqas, 2011. "Analyzing the Efficiency Differences among Basic Health Units in Sargodha District," Journal of Economics and Behavioral Studies, AMH International, vol. 3(1), pages 42-50.
    9. Abbas, Touqeer & Awan, Masood Sarwar & Aslam, Muhammad Amir & Waqas, Muhammad, 2011. "Analyzing the efficiency differences among basic health units in Sargodha District," MPRA Paper 32244, University Library of Munich, Germany.
    10. PINTO, Claudio, 2013. "Complexity of Treatment, and Changes in Efficiency and Productivity for Directly Managed Italian Hospitals," CELPE Discussion Papers 124, CELPE - CEnter for Labor and Political Economics, University of Salerno, Italy.

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    More about this item

    Keywords

    Public hospitals; Data Envelopment Analysis; Malmquist indices; Portugal.;
    All these keywords.

    JEL classification:

    • C14 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Semiparametric and Nonparametric Methods: General
    • C61 - Mathematical and Quantitative Methods - - Mathematical Methods; Programming Models; Mathematical and Simulation Modeling - - - Optimization Techniques; Programming Models; Dynamic Analysis
    • D24 - Microeconomics - - Production and Organizations - - - Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity
    • H51 - Public Economics - - National Government Expenditures and Related Policies - - - Government Expenditures and Health
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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