The internal market and hospital efficiency: a stochastic distance function approach

Ferrari, Alessandra

doi:10.1080/00036840500427437

Cited by 21 publications

(14 citation statements)

References 27 publications

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“…Theory suggests that NPM-related policies may enhance the efficiency of public service delivery, such as healthcare provision (for a comprehensive overview of NPM and efficiency, see [9]). However, the benefits of NPM-related tools in healthcare delivery have been already questioned from an international perspective (see, for example, [10][11][12][13].…”

Section: Accepted Manuscriptmentioning

confidence: 99%

The impact of New Public Management on efficiency: An analysis of Madrid's hospitals

2015

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Madrid has recently become the site of one of the most controversial cases of public healthcare reform in the European Union. Despite the fact that the introduction of New Public Management (NPM) into Madrid hospitals has been vigorous, little scholarship has been done to test whether NPM actually led to technical efficiency. This paper is one of the first attempts to do so. We deploy a bootstrapped data envelopment analysis to compare efficiency scores in traditionally managed hospitals and those operating with new management formulas. We do not find evidence that NPM hospitals are more efficient than traditionally managed ones. Moreover, our results suggest that what actually matters may be the management itself, rather than the management model.

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Section: Accepted Manuscriptmentioning

confidence: 99%

The impact of New Public Management on efficiency: An analysis of Madrid's hospitals

2015

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“…Hospitals could for example reduce the average length of stay (lower quality level) and/or move towards the treatment of patients on a daybasis (Ferrari, 2005) which could in turn increase the probability of being readmitted, and therefore possibly increase the average waiting time. This scenario is actually not totally unfamiliar to the reformed English NHS with the additional risk of hospitals hiding true information about the real length of their waiting lists when specific targets about these are imposed.…”

Section: Discussionmentioning

confidence: 99%

The Payment of Hospital Services: a Waiting Lists Model

Ferrari

2005

The B.E. Journal of Economic Analysis &Amp; Policy

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This paper analyses the incentive properties of prospective payment systems for hospital contracts, a key feature in many health systems' reforms. Building on current literature, the model explicitly allows for the existence of waiting time, modelled as adversely affecting patients' utility and therefore reducing social welfare. The model shows that rewarding hospitals for their demand leads to the first best solution, identified with respect to the relevant quality and quantity variables. The additional separate payment of a price per case is instead required when the social cost of waiting is introduced alongside the private costs. * Aknowledgments I would like to thank my PHD supervisor at Warwick University Prof. Norman Ireland, whose guidance and advice have assisted considerably in the direction and completion of this work. Thanks go also to the very useful comments of an anonymous referee. Usual disclaimers apply.

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“…Similar mixed results were also reported by studies using data from other countries. Using UK data, Maniadakis et al (1999) found a positive link, whereas Ferrari (2006) found no relationship. Other studies using data from Canada, Spain and Italy also produce contrasting evidence (Dalmau-Matarrodona & Puig-Junoy, 1998;Cellini et al, 2000;Preyra & Pink, 2006).…”

Section: The Link Between Competition and Efficiencymentioning

confidence: 98%

Hospital Competition, Technical Efficiency and Quality

2011

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This paper studies the link between competition and technical efficiency of public hospitals in the state of Victoria, Australia. It finds a positive relationship between efficiency and competition as measured by the Hirschman–Herfindahl Index (HHI) and a negative relationship when the number of competing private hospitals is used instead of HHI. It also finds that whether or not quality is treated as an endogenous output variable influences the statistical estimates of the link between efficiency and competition. The findings point to possibly undesirable resource allocation effects when public hospitals are made to compete with a large number of private hospitals.

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The internal market and hospital efficiency: a stochastic distance function approach

Cited by 21 publications

References 27 publications

The impact of New Public Management on efficiency: An analysis of Madrid's hospitals

The impact of New Public Management on efficiency: An analysis of Madrid's hospitals

The Payment of Hospital Services: a Waiting Lists Model

Hospital Competition, Technical Efficiency and Quality

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