Healthcare public funding efficiency as exemplified by hospitals in Polish regions

Abstract

The aim of this study is to evaluate and compare the financial and managerial efficiency of healthcare inpatient systems in one country. The research question is: What factors give rise to efficiency variations within the regional healthcare system (hospitals)?A two-step approach proposed by Simar and Wilson has been applied. The first step applies the Data Envelopment Analysis to estimate the unit (i.e., a Polish region in our research) efficiency scores, which is followed by truncated regression with double bootstrapping to examine the impact of uncontrolled variables on efficiency scores.The efficiency scores obtained in 16 regions from the output-oriented model with non-increasing returns to scale indicate a full effectiveness of five regions. The DEA scores of the other regions exceed the value of 0.8 and do not differ significantly.The bootstrap-corrected DEA scores do not considerably change the efficiency assessment. The direction of the impact of the ‘percentage of people above 65 years of age’ variable and the ‘growth rate of total liabilities on efficiency’ variable is opposite to that observed for the ‘average salary’ variable.The results obtained suggest that the regional healthcare system efficiency can be affected by the ageing population, pay pressure, and liabilities.