Abstract
In this paper we look at the Italian NationalHealth System as a case study, in order to investigate whethercompetition exerts positive effects on the efficiency of hospitals.Using the DEA technique we measure the efficiency of Italianhospital production; secondly, we take a regression analysisapproach to analyse its determinants. A general conclusion stemmingout of the analysis is that competition is not a value per seand that its effects on hospitals' performance are affected bythe rules governing the health system.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Artoni, R. (1999). Lezioni di Scienza delle Finanze, Il Mulino, Bologna.
Banker, R. D., H. Charnes, and W. W. Cooper, (1984). “Some Models for Estimating Technical and Scale Inefficiency in Data Envelopment Analysis.” Management Science 30, 1078-1092.
Belli, P. (1996). “L'effetto della Riforma dei Quasi-mercati sulla Concorrenza fra Fornitori di Servizi Sanitari.” Econpubblica, Working Paper n. 38.
Burgess, J. F. and P. W. Wilson, (1996). “Hospital Ownership and Technical Efficiency.” Management Science 42(1), 110-123.
Cellini, R., G. Pignataro, and I. Rizzo, “Competition and Efficiency in Health Care: An Analysis of the Italian Regions.” w.p. 354 Universit`a di Bologna (http://www.dse.unibo.it).
Coelli, T. (1996). “A guide to DEAP Version 2.1: A Data Envelopment Analysis (Computer) Program.” CEPA Working Paper 96/08.
Dalmau-Matarrodona, E. and J. Puig-Junoy, (1998). “Market Structure and Hospital Efficiency: Evaluating Potential Effects of the Regulation in a National Health Service.” Review of Industrial Economics 13(4), 447-466.
Dirindin, N. and P. Vineis, (1999). Elementi di Economia Sanitaria, Il Mulino, Bologna.
Ehreth, J. L. (1994). “The Development and Evaluation of Hospital Performance Measures for Policy Analysis.” Medical Care 32, 568-587.
Galizzi, B., M. Novara, and E. Vassallo, (1999). “Efficienza dell'Assistenza Ospedaliera Italiana in un'Analisi Territoriale.” Economia Pubblica 29(3), 37-73.
Gerdtham, U-G. and M. Lothgren, (1998). “Health Care System Effects on Cost Efficiency in the OECD Countries.” Stockholm School of Economics, Working Paper series in economics and finance, No. 247.
Gerdtham, U-G., M. Lothgren, M. Tambour, and C. Rehnberg, (1998). “Internal Markets and Health Care Efficiency: A Multiple-output Stochastic Frontier Analysis.” Stockholm School of Economics, Working Paper series in economics and finance, No. 222.
Giuffrida, A., F. Lapecorella, and G. Pignataro, (1999). “Efficiency of Health Care Production in Different Hierarchically Structured Hospitals.” CHE Technical Paper, 14.
Kalisch, D. W., T. Aman, and L. A. Buchele, (1998). Social and Health Policies in OECD Countries: A Survey of Current Programmes and Recent Developments. OECD-Occasional Paper, n. 33, Paris.
Islam, N. “Growth Empirics: A Panel Data Approach.” Quarterly Journal of Economics 110, 1127-1170.
Istat (1998). Annuario di Statistiche Sanitarie. Istat, Roma.
Istat (1999). Contabilità Regionale. Electronic Database. Istat, Roma.
Mapelli, V. (1999). Il Sistema Sanitario Italiano, il Mulino, Bologna.
Nuti, F. (1998). Introduzione all'Economia Sanitaria e alla Valutazione Economica delle Decisioni Sanitarie, Giappichelli, Torino.
Sherman, H. D. (1984). “Hospital Efficiency Measurement and Evaluation.” Medical Care 22, 922-938.
Ugolini, C. and D. Fabbri, (1998). “Mobilità Sanitaria ed Indici di Entropia.” Mecosan 7(26), 9-24.
Zwazinger, J. and G. Melnick, (1988). “The Effects of Hospital Competition and the Medicare PPS Program on Hospital Cost Behavior in California.” Journal of Health Economics 7, 301-320.
Rights and permissions
About this article
Cite this article
Cellini, R., Pignataro, G. & Rizzo, I. Competition and Efficiency in Health Care: An Analysis of the Italian Case. International Tax and Public Finance 7, 503–519 (2000). https://doi.org/10.1023/A:1008737506560
Issue Date:
DOI: https://doi.org/10.1023/A:1008737506560