Changes in hospital efficiency after privatization

Abstract

We investigated the effects of privatization on hospital efficiency in Germany. To do so, we obtained bootstrapped data envelopment analysis (DEA) efficiency scores in the first stage of our analysis and subsequently employed a difference-in-difference matching approach within a panel regression framework. Our findings show that conversions from public to private for-profit status were associated with an increase in efficiency of between 2.9 and 4.9%. We defined four alternative post-privatization periods and found that the increase in efficiency after a conversion to private for-profit status appeared to be permanent. We also observed an increase in efficiency for the first three years after hospitals were converted to private non-profit status, but our estimations suggest that this effect was rather transitory. Our findings also show that the efficiency gains after a conversion to private for-profit status were achieved through substantial decreases in staffing ratios in all analyzed staff categories with the exception of physicians and administrative staff. It was also striking that the efficiency gains of hospitals converted to for-profit status were significantly lower in the diagnosis-related groups (DRG) era than in the pre-DRG era. Altogether, our results suggest that converting hospitals to private for-profit status may be an effective way to ensure the scarce resources in the hospital sector are used more efficiently.

Eficiência técnica e inovatividade: um estudo em hospitais privados brasileiros

“…Da mesma forma, estudos conduzidos nos Estados Unidos e na Alemanha sugerem que os hospitais privados são menos eficientes do que os públicos, o que se deve ao fato de que as instituições públicas enfrentam limitações de recursos e, por isso, buscam a máxima eficiência de sua utilização (Tiemann et Schreyögg, 2012).…”

“…A inovatividade percebida, especialmente pela forma como atua no mercado e pela forma como os serviços são prestados pelo hospital, não proporciona ganhos aos hospitais quanto ao número de internações, atendimentos de emergências e cirurgias realizadas, dados os recursos de que dispõem para realizá-los. Entretanto, caso a percepção dos gestores reflita a integralidade da inovatividade hospitalar, sugere-se que os ganhos da inovatividade estejam relacionados mais especificamente ao aumento da qualidade dos serviços hospitalares, em consonância com os resultados de pesquisas anteriores (Hollingsworth, 2003;Tiemann et Schreyögg, 2012), inclusive realizadas no Brasil (Proite et Sousa, 2004).…”

The policies of social welfare produced effects in performance of the company? Comparative analysis of European companies

“…Las publicaciones en el Health Care Management Science tratan diferentes aspectos relacionados con las empresas que prestan servicios a personas con dependencia: estudios sobre los efectos de la privatización de los hospitales en la eficiencia de sus servicios (Tiemann & Schreyögg, 2012), y sobre los efectos en los costes de los diferentes tipos de organización del personal de un hospital (Maenhout & Vanhoucke, 2013). También hay estudios sobre el efecto en los precios de los establecimientos residenciales de la participación de la mujer en el mercado laboral así como su nivel educativo (Bauer & Stroka, 2013).…”

Does partial privatisation improve performance? Evidence from a chain of hotels in Portugal

“…When we examine the information presented in Section 1 of Table S1 we find evidence that privatisation had a positive impact on the production efficiency of different companies, including: British Airways, British Gas and Associated British Ports (Boussofiane, Martin & Parker, 1997), Nippon Telegraph and Telephone Corporation (Sueyoshi, 1998), a number of manufacturing enterprises in Malawi (Chirwa, 2001), a sample of German hospitals (Tiemann & Schreyögg, 2012) and a sample of international airports (Assaf & Gillen, 2012).…”