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Behavioral Differences Between Public and Private Not-For-Profit Hospitals in the Italian National Health Service

Author

Listed:
  • Gian Paolo Barbetta

    (Istituto di Economia e Finanza (Univ. Cattolica MI)

  • Gilberto Turati

    (Dipartimento di Scienze economiche e Finanziarie)

  • Angelo Zago

    (Dipartimento di Scienze economiche)

Abstract

In this paper we attempt to identify behavioral differences between public and private not-forprofit hospitals, by using the opportunity of the introduction of the DRG-based payment system in the Italian NHS during the second half of the Nineties. We estimate the technical efficiency of a sample of hospitals for the period 1995-2000 considering an output distance function, and adopting both parametric (COLS) and non-parametric (DEA) approaches. All our results show a convergence of mean efficiency scores between not-for-profit and public hospitals, and seem to suggest that differences in economic performances between competing ownership forms are more the result of the institutional settings in which they operate than the effect of the incentive structures embedded in the different proprietary forms. Contrary to expectation we also observe a decline in technical efficiency, probably due to policies aimed at reducing hospitalization rates.

Suggested Citation

  • Gian Paolo Barbetta & Gilberto Turati & Angelo Zago, 2004. "Behavioral Differences Between Public and Private Not-For-Profit Hospitals in the Italian National Health Service," Working Papers 12/2004, University of Verona, Department of Economics.
    • Handle: RePEc:ver:wpaper:12/2004
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    More about this item

    Keywords

    forms; technical efficiency; nonprofit organizations; hospital behavior; payment systems.;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health
    • L31 - Industrial Organization - - Nonprofit Organizations and Public Enterprise - - - Nonprofit Institutions; NGOs; Social Entrepreneurship

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