Health systems: changes in hospital efficiency and profitability

Abstract

This study investigates potential changes in hospital performance after health system entry, while differentiating between hospital technical and cost efficiency and hospital profitability. In the first stage we obtained (bootstrapped) data envelopment analysis (DEA) efficiency scores. Then, genetic matching is used as a novel matching procedure in this context along with a difference-in-difference approach within a panel regression framework. With the genetic matching procedure, independent and health system hospitals are matched along a number of environmental and organizational characteristics. The results show that health system entry increases hospital technical and cost efficiency by between 0.6 and 3.4 % in four alternative post-entry periods, indicating that health system entry has not a transitory but rather a permanent effect on hospital efficiency. Regarding hospital profitability, the results reveal an increase in hospital profitability only 1 year after health system entry, and the estimations suggest that this effect is a transitional phenomenon. Overall, health system entry may serve as an appropriate management instrument for decision makers to increase hospital performance.

Impact of Health System Affiliation on Hospital Resource Use Intensity and Quality of Care

“…This is a particularly relevant topic given the recent wave of consolidations in the hospital industry (Cutler and Morton ), which some researchers have suggested may lead to higher prices and harm consumers (McDermott ). Contrary to previous studies of the effect of consolidation on hospital costs (Dranove and Lindrooth ; Harrison ; Büchner, Hinz, and Schreyögg ), our results suggest that system hospitals incur higher costs per discharge than do independent hospitals, regardless of whether they own an insurance product. We also find that system hospitals provide superior quality of care compared with independent hospitals.…”

“…System hospitals may outperform independent hospitals because of economies of scale that allow them to operate more efficiently (Menke ; Madison ; Büchner, Hinz, and Schreyögg ). With access to cheaper resources than independent hospitals, system hospitals are better positioned to invest in infrastructure, technology, staff, and care management systems, which enable them to direct patient flow more effectively, share and transfer information, coordinate care between hospitals and across care settings, and comply with evidence‐based clinical protocols (Madison ; Chukmaitov et al.…”

Herausforderungen eines strukturierten Ausfallmanagements in einem regionalen Klinikverbund als Alternative zur Leiharbeit

“…Die Grundidee einer Poollösung wird durch die Unterstützung eines IT-Tools, welches die Koordination dieser Springerkräfte übernehmen soll, ergänzt. Gestützt auf Erkenntnisse des Hamburg Center for Health Economics (HCHE), welches im Jahr 2014 gezeigt hat, dass Krankenhausverbünde langfristig betrachtet effizienter sind als Einzelhäuser [1], wurde anvisiert den Einsatzbereich auf einen regionalen Krankenhausverbund auszuweiten. Im Folgenden wird erläutert, ob aus der Perspektive des verantwortlichen Führungspersonals sowie der Mitarbeitenden der beteiligten Kliniken ein praktischer Bedarf an einem strukturierten Ausfallmanagement in einem Klinikverbund gesehen wird und welche Herausforderungen auftreten können.…”

Benchmarking Inter-Hospital Alliances against Industry Best Practices

“…Changes in hospital funding structures, environmental turbulence, growing complexity and competition as well as financing concerns and increases in resource requirements, cause independent hospitals to rethink their strategy and consider cooperation with other health care providers (Buechner, Hinz, & Schreyoegg, 2014). Whether strategic alliances, participation in networks, or groups (multi-hospital systems with common ownership), cooperation is expected to provide the hospitals with competitive advantage in the form of improved efficiency and cost reductions (Walston, Burns, & Kimberly, 2000).…”

“…Whether strategic alliances, participation in networks, or groups (multi-hospital systems with common ownership), cooperation is expected to provide the hospitals with competitive advantage in the form of improved efficiency and cost reductions (Walston, Burns, & Kimberly, 2000). Many of the anticipated benefits of alliances have failed to materialise, or have done so only temporarily, or after a time lag (Buechner et al, 2014). Still, resources invested in establishing and maintaining such alliances are considerable and warrant a thorough understanding of how certain institutions have successfully integrated and implemented formal cooperation into their strategic planning.…”