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A two-stage DEA model to evaluate the efficiency of the Italian health system

Author

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  • De Nicola, Arianna
  • Gitto, Simone
  • Mancuso, Paolo

Abstract

Over the past twenty years, important changes in the Italian health system have led to different approaches in organizing, delivering and financing health services throughout the regions of the country. This study aims to examine the impact these factors have had on efficiency. The methodology adopted is based on the developments in bootstrapping Data Envelopment Analysis (DEA). In particular, employing a two-stage procedure, we analyzed the impact that political interventions have produced on healthcare efficiency. The data, which were at the local health unit level for the period 2004-2005, were aggregated to the provincial level in order to take into account patient mobility. The study reveals that the organizational model adopted by the Lombardia region allows for the best results in healthcare efficiency. Second, administrative decentralization from the regional governments to local health units is a source of inefficiency. Third, adjusting the cost of delivering care, by taking into consideration regional health characteristics, improves efficiency. Finally, future policy interventions should make careful valuations of the impacts of patient mobility on healthcare efficiency.

Suggested Citation

  • De Nicola, Arianna & Gitto, Simone & Mancuso, Paolo, 2011. "A two-stage DEA model to evaluate the efficiency of the Italian health system," MPRA Paper 39126, University Library of Munich, Germany.
    • Handle: RePEc:pra:mprapa:39126
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    References listed on IDEAS

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    Cited by:

    1. Bettina Campedelli & Andrea Guerrina & Giulia Romano & Chiara Leardini, 2014. "La performance della rete ospedaliera pubblica della regione Veneto. L?impatto delle variabili ambientali e operative sull?efficienza," MECOSAN, FrancoAngeli Editore, vol. 2014(92), pages 119-142.
    2. Rahab Mbau & Anita Musiega & Lizah Nyawira & Benjamin Tsofa & Andrew Mulwa & Sassy Molyneux & Isabel Maina & Julie Jemutai & Charles Normand & Kara Hanson & Edwine Barasa, 2023. "Analysing the Efficiency of Health Systems: A Systematic Review of the Literature," Applied Health Economics and Health Policy, Springer, vol. 21(2), pages 205-224, March.
    3. Resta, Emanuela & Resta, Onofrio & Costantiello, Alberto & Leogrande, Angelo, 2023. "The Hospital Emigration to Another Region in the Light of the Environmental, Social and Governance Model in Italy During the Period 2004-2021," MPRA Paper 119624, University Library of Munich, Germany.

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    More about this item

    Keywords

    healthcare efficiency; two-stage estimation; Data Envelopment Analysis; patient mobility; bootstrap;
    All these keywords.

    JEL classification:

    • C14 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Semiparametric and Nonparametric Methods: General
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • D24 - Microeconomics - - Production and Organizations - - - Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity
    • I1 - Health, Education, and Welfare - - Health

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