Assessing the effect of standardized cost systems on financial performance. A difference-in-differences approach for hospitals according to their technological level

Financial Performance of SDG Mutual Funds Focused on Biotechnology and Healthcare Sectors

“…The adoption of a differentiation or a cost leadership business strategy depending on the lack or existence of a universal healthcare system is congruent with the findings of Lin et al [23], that Taiwanese privately owned hospitals bear lower operational costs than those owned publicly, and those of Woolhandler et al [24] showing that the costs of delivering health services are higher for US private hospitals than for Canadian private hospitals [25]. These operational costs could increase due to the implementation of high-tech medical technologies as a differentiation business strategy [26], allowing them to grow their revenues proportionately, justified by a higher value added of rare and imperfectly imitable medical technology resources that provide them with a competitive advantage, enhancing long-term corporate financial performance according to the firm resource-based theory [27]. However, admissions to private hospitals decrease at times of financial crisis, with patients moving into public hospitals [28], which could affect private hospitals' financial performance.…”

Influence of cost systems on efficiency. An analysis of Spanish hospitals using public national databases

“…While being unsatisfied about the standardized CS and viewing it as non-optimal, hospitals may still consider the system sufficient and therefore use it for their decision-making processes (Cardinaels et al, 2004). In fact, the results of the present research confirm the findings of comparable studies that show that advanced standardized CS contribute to the reduction of unit cost (García-Cornejo & Pérez-Méndez, 2018a, 2018b, which is concordant with an improvement in efficiency.…”

“…Another study analyzed a sample of public health organizations in Italy and found no relationship between the design of CS and the operating costs (Macinatti & Anessi-Pessina, 2014). In Spain, two recent studies found that an advanced CS contributes to the reduction of the unit cost (cost per adjusted patient day) in the period (García-Cornejo & Pérez-Méndez, 2018a, 2018b.…”

“…an index for each RHS according to four dimensions indicative of a more developed CS. The index, its calculation and the values obtained for each RHS can be consulted in a previous study (García-Cornejo & Pérez-Méndez, 2018b) and in the appendix of the present work. Moreover, based on prior literature, we consider additional control variables as possible determinants of efficiency: average cost of personnel (Wu et al, 2014), occupancy rate (Puig Junoy, 1988;Lawrence, 1990;Wu et al, 2014); endowment of high technology 6 and teaching status (Sloan et al, 1983;Vitaliano, 1987); and, as quality indicators, ambulatory surgery rate (SECA, 2012) and readmission rate (Alonso et al, 2015).…”

“…Nevertheless, only a few studies have investigated the relationship between CS characteristics and hospital efficiency in large hospital samples and results regarding the contribution of advanced CS to cost control are apparently inconsistent (Lawrence, 1990;Pizzini, 2006;Macinatti & Anessi-Pessina, 2014;García-Cornejo & Pérez-Méndez, 2018a;2018b). All of these studies use as a proxy of efficiency financial measures such as total operating costs, cost per case or cost per inpatient stay.…”