Analysis of the technical efficiency of the forms of hospital management based on public‐private collaboration of the Madrid Health Service, as compared with traditional management

Abstract

SummaryFundamentalsThe study aims to carry out a comparative analysis of the technical efficiency of hospital management based on public‐private collaboration, as compared with traditional management. Specifically, we compare traditionally managed public hospitals, public hospitals managed by a private finance initiative (PFI), public hospitals managed through a public‐private partnership (PPP), and hospitals managed through other forms of management, during the period 2009 to 2014, in the hospitals dependent on the Madrid Health Service (SERMAS).MethodsThe study covers all publicly owned general hospitals under SERMAS, consisting of seven PFI hospitals, three PPP hospitals, 11 traditionally managed public hospitals (with the category of general hospital), and four hospitals managed through other forms of hospital management. The technical efficiency indices of the hospitals were calculated using the data envelopment analysis technique. Subsequently, a sensitivity analysis was performed by bootstrapping and variation of model variables to verify their impact on efficiency. Finally, an analysis of the evolution of efficiency in the analyzed period was carried out using the Malmquist Index.ResultsIn all the analysis models carried out in the analyzed period, the hospitals managed based on public‐private collaboration were more efficient than the hospitals under traditional management.ConclusionsThe greater efficiency of hospitals managed based on public‐private collaboration, as compared with traditional management, could be attributed to greater organizational and management flexibility.

A critical look at the Portuguese public–private partnerships in healthcare

“…Even if the concept itself is interesting and potentially advantageous both to the public sphere and the private sector when it is well designed, 3 well managed and well controlled, the practical results did not translate into value gains, especially to the public entity, harming public interest. In fact, some authors claim that healthcare PPPs are more technically efficient than traditionally managed institutions 35 . Still, everything leads one to believe that the existence of healthcare PPP in Portugal was exclusively because of political reasons.…”

Traditional, Dea-Ahp Ranking and Possibilistic Fuzzy Dea Approach for Efficiency Analysis of City Hospitals

“…A unique evidence provides clues about efficiency of city hospitals build with public-private partnership models in Madrid Health Service. It has been stated that greater efficiency is obtained from public-private collaboration models than in traditionally managed hospitals (Franco Miguel et al, 2019). As far as we know, there are no existing studies about the efficiency of large city hospital investments in Turkey.…”

The Evaluation of the Financial Efficiencies of Hospitals Through Data Envelopment Analysis Method in Terms of Their Type and Group - Hastaneleri̇n Türü Ve Grubu Açisindan Fi̇nansal Etki̇nli̇kleri̇ni̇n Vza Yöntemi̇yle Değerlendi̇ri̇lmesi̇

“…Efficiency is obtaining maximum output through minimum effort or cost (Atmaca, Turan, Kartal, & Çiğdem, 2012). There are two main most commonly implemented methods in the world to measure efficiency of hospitals: parametric and non-parametric methods (Franco Miguel, Fullana Belda, & Rua Vieites, 2018) The parametric method, which is represented by Data Envelopment Analysis (DEA), is based on linear programming and is used to measure relative efficiency of hospitals with multiple inputs and multiple outputs (Daraio C & L., 2007).…”

“…The review of literature has revealed that most of the DEA method-based relevant efficiency analyses on hospitals are based on non-financial input and output variables. While the number of health-care employees (such as doctors, assistants, nurses, auxiliary health-care workers) and the total number of beds are used as input variables, the number of outpatients, inpatients, and discharged patients, hospital bed occupancy rate, hospital bed turnover rate, the total number of hospitalization days, the total number of surgical operations, and hospital death rates are used as output variables (Atmaca et al, 2012;Bayraktutan & Pehlivanoğlu, 2012;Franco Miguel et al, 2018;Gülsevin & Türkan, 2012;Kutlar & Salamov, 2016;Li & Dong, 2015;Yiğit, 2016) There are also studies in the literature, although not many, which defined inputs and outputs based on both financial and non-financial data or based only on financial data to measure performances of health care enterprises through DEA method. In such studies, total expenses variable is used as an input variable in addition to variables of specialist physicians, practitioners and the total number of hospital beds, whereas total income is used as an output variable in addition to the variables of outpatients, major surgeries, and the number of hospitalization days (Bal, 2013;Czypionka, Kraus, Mayer, & Rohrling, 2014;Temur, 2010;Temür & Bakırcı, 2008).…”