Operational and economic efficiency analysis of public hospitals in Greece
- 613 Downloads
The continuous growth of hospital costs has driven governments in many countries to seek ways to improve their efficiency. In Greece, this has consistently been a major issue for almost two decades, as efficiency assessment and monitoring systems are lacking. In response to this need, the evaluation of the National Health System hospitals’ efficiency level is a precondition for planning, implementing and monitoring any promising reform. In this paper, a non-parametric modeling approach is employed to assess and analyze the efficiency of 87 Greek public hospitals over the period 2005–2009, using data envelopment analysis. The operational and economic aspects of the hospitals’ operation are considered on the basis of their service/case mix and cost structure. We also investigate the efficiency trends over time with the Malmquist index and a second stage regression analysis is performed to explain the operational and economic efficiency results in terms of the hospitals’ operating characteristics and the environment in which they operate.
KeywordsHospital efficiency Technical efficiency Data envelopment analysis
- Aletras, V., Jones, A., & Sheldon, T. A. (1997). Economies of scale and scope. In B. Ferguson, T. A. Sheldon, & J. Posnett (Eds.), Concentration and choice in healthcare (pp. 23–36). London: Financial Times Healthcare.Google Scholar
- Athanassopoulos, A., Gounaris, C., & Sissouras, A. (1999). A descriptive assessment of the production and cost efficiency of general hospitals of Greece. Healthcare Management Science, 2, 97–106.Google Scholar
- Burgess, J. F., & Wilson, P. W. (1998). Variation in inefficiency among US hospitals. INFOR, 36(3), 84–102.Google Scholar
- Chilingerian, J. A., & Sherman, D. H. (1990). Managing physician efficiency and effectiveness in providing hospital services. Health Services Management Research, 3(1), 3–15.Google Scholar
- Coyne, J. S., Richards, M. T., Short, R., Shultz, K., & Singh, S. G. (2009). Hospital cost and efficiency: Do hospital size and ownership type really matter. Journal of Healthcare Management, 54(3), 163–174.Google Scholar
- Economou, C. (2010). Greece: Health system review. Health Systems in Transition, 12(7), 1–180.Google Scholar
- Färe, R., Grosskopf, S., Norris, M., & Zhang, Z. (1994). Productivity growth, technical progress, and efficiency change in industrialized countries. American Economic Review, 84(1), 66–83.Google Scholar
- Farsi, M., & Filippini, M. (2006). An analysis of efficiency and productivity in Swiss hospitals. Swiss Journal of Economics and Statistics, 142(1), 1–37.Google Scholar
- Hollingsworth, B., & Peacock, S. (2008). Efficiency measurement in health and heath care. New York: Routledge.Google Scholar
- Ifanti, A. A., Argyriou, A. A., Kalofonou, F. H., & Kalofonos, H. P. (2013), Financial crisis and austerity measures in Greece: Their impact on health promotion policies and public health care. Health Policy, 113(1-2), 8–12.Google Scholar
- Lindlbauer, I., & Schreyögg, J. (2014). The relationship between hospital specialization and hospital efficiency: Do different measures of specialization lead to different results? Health Care Management Science . doi: 10.1007/s10729-014-9275-1.
- Magnussen, J. (1996). Efficiency measurement and the operationalisation of hospital production. Health Services Research, 31(1), 21–37.Google Scholar
- OECD. (2012). Health at a Glance: Europe 2012. OECD Publishing. doi: 10.1787/9789264183896-en.
- Or, Z. (2014). Implementation of DRG Payment in France: Issues and recent developments. Health Policy, 117(2), 146–150.Google Scholar
- Patel, B., Chaussalet, T., & Millard, P. (2008). Balancing the NHS balanced scorecard! European Journal of Operational Research, 185(3), 905–914.Google Scholar
- Shelton Brown, H., III., & Pagán, J. A. (2006). Managed care and the scale efficiency of US hospitals. International Journal of Health Care Finance and Economics, 6(4), 278–289.Google Scholar
- Thomas, J. W., Guire, K. E., & Horvat, G. G. (1997). Is patient length of stay related to quality of care? Hospital and Health Services Administration, 42(4), 489–507.Google Scholar