Effects of Ownership on Hospital Efficiency in Germany

Tiemann, Oliver; Schreyögg, Jonas

doi:10.1007/bf03342707

Cited by 101 publications

(86 citation statements)

References 62 publications

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“…Watcharasriroj and Tang (2004) used DEA to measure the technical efficiency of 92 public nonprofit hospitals in Thailand and found that large hospitals (at least 500 beds) significantly operate more efficiently than smaller hospitals and IT positively contributes to the efficiency for both large and small hospitals. Tiemann and Schreyögg (2009) Asmild et al (2013) recently studied the productive efficiency of 141 public hospitals in two Canadian provinces and found that the hospitals in the larger, more urban areas consistently outperform their counterparts in the smaller, more rural area in terms of technical efficiency. Chul-Young et al also (2013) concluded that hospital size significantly influences performance.…”

Section: Discussionmentioning

confidence: 99%

Measuring the Effect of Size on Technical Efficiency of the United Arab Emirates Hospitals

Mahate¹,

Hamidi²,

Akinci³

2016

GJHS

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Objective: The main purpose of this study is to estimate the technical efficiency of the United Arab Emirates (UAE) hospitals and examine the effect of hospital size on estimated technical efficiency scores.Methods: Using 2012 data from Ministry of Health, Dubai Health Authority, and Health Authority in Abu Dhabi, we employed a nonparametric method, data envelopment analysis (DEA), to estimate the technical efficiency of 96 private and governmental hospitals in the UAE. Efficiency scores are calculated using both Banker, Charnes, and Cooper (BCC) and Charnes, Cooper, and Rhodes (CCR) models. Results:The average technical efficiency of the UAE hospitals is estimated at 59% based on the BBC model and at 48% based on the CCR model. The optimal size of a hospital in the UAE is between 100 to 300 beds. We also found evidence of economies of scope between the provision of outpatient and inpatient care in the UAE hospitals. Conclusion:Our findings indicate that only one third of the UAE hospitals are technically efficient. There is evidence to suggest that there are considerable efficiency gains yet to be made by many UAE hospitals. Additional empirical research is needed to inform future health policies aimed at improving both the technical and allocative efficiency of hospital services in the UAE.

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Section: Discussionmentioning

confidence: 99%

Measuring the Effect of Size on Technical Efficiency of the United Arab Emirates Hospitals

Mahate¹,

Hamidi²,

Akinci³

2016

GJHS

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“…The mortality rate (mort) is used as a proxy for (poor) quality of care (e.g. [39,41,46]). Hospitals with a relatively large budget might have more slack resources than hospitals with less financial means [7].…”

Section: Explanatory Variablesmentioning

confidence: 99%

“…The measure is defined as the radial distance of the i-th hospital to the frontier function, which is determined by means of a linear combination of the best practicing (efficient) units. We assume variable returns to scale to allow that hospitals operate at an inefficient scale size [24,46]. To compare hospitals with distinct exogenously fixed input variables we account for non-discretionary input variables (Banker and Morey [3], for details see Appendix A.1).…”

Section: Non-parametric Ef F Iciency Measurementmentioning

confidence: 99%

“…[18,20,45,46]). To control for private for profit and non-profit private hospitals respective dummy variables ( private and non-pro f it) are included.…”

Section: Explanatory Variablesmentioning

confidence: 99%

“…As pointed out by Jacobs [23] each approach has its particular strengths and weaknesses, and could measure distinct aspects of hospital efficiency. Both techniques have been separately employed to analyze hospital performance in Germany (DEA: [18,43,46,51,52]; SFA: [20,21]). In a second stage, potential effects of the DRG reform on spatial spillovers of hospital efficiency are investigated by means of a parametric spatially autoregressive model with spatially autoregressive disturbances (SARAR).…”

Section: Introductionmentioning

confidence: 99%

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On the effect of prospective payment on local hospital competition in Germany

Herwartz

Strumann

2011

Health Care Manag Sci

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The introduction of prospective hospital reimbursement based on diagnosis related groups (DRG) in 2004 has been a conspicuous attempt to increase hospital efficiency in the German health sector. As a consequence of the reform a rise of competition for (low cost) patients could be expected. In this paper the competition between hospitals, quantified as spatial spillover estimates of hospital efficiency, is analyzed for periods before and after the reform. We implement a two-stage efficiency model that allows for spatial interdependence among hospitals. Hospital efficiency is determined by means of non-parametric and parametric econometric frontier models. We diagnose a significant increase of negative spatial spillovers characterizing hospital performance in Germany, and thus, confirm the expected rise of competition.

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Profit efficiency and ownership of German hospitals

2011

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This paper investigates the cost and profit efficiency of German hospitals and their variation with ownership type. It is motivated by the empirical finding that private (for-profit) hospitals - having been shown to be less cost efficient in the past - on average earn higher profits than public hospitals. We conduct a Stochastic Frontier Analysis on a multifaceted administrative German data set combined with the balance sheets of 541 hospitals of the years 2002-2006. The results show no significant differences in cost efficiency but higher profit efficiency of private than of publicly owned hospitals.

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Effects of Ownership on Hospital Efficiency in Germany

Abstract: Abstract

Cited by 101 publications

References 62 publications

Measuring the Effect of Size on Technical Efficiency of the United Arab Emirates Hospitals

Measuring the Effect of Size on Technical Efficiency of the United Arab Emirates Hospitals

On the effect of prospective payment on local hospital competition in Germany

Profit efficiency and ownership of German hospitals

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