Pilyavsky Anatoly I, Aaronson William E, Bernet Patrick M, Rosko Michael D, Valdmanis Vivian G, Golubchikov Mikhail V
Lviv Academy of Commerce, Lviv, Ukraine.
Health Econ. 2006 Nov;15(11):1173-86. doi: 10.1002/hec.1120.
Ukraine's history has given it a split personality (e.g. divergent cultural influences on economic and managerial behavior), as was observed in the recent political developments both prior to and following the December 2004 elections. Eastern regions were heavily influenced by Russo-Soviet rule, while western regions have more of a European outlook. This study, which is largely exploratory, compares recent trends in hospital efficiency in Ukraine to see if this split personality manifests itself in differential rates of improvement. Given the inflexibility of Soviet-style planned economies, it is hypothesized that western regions will show greater improvement in economic efficiency that can be attributed to higher levels of managerial and medical entrepreneurship. Data for this study comes from three oblasts (i.e. geopolitical regions), one in the west and two in the east, spanning from 1997 to 2001. Data envelopment analysis (DEA) was used to estimate technical efficiency for the hospitals. After correcting for bias, a second-stage Tobit regression was estimated. Results indicate that hospitals in the west improved efficiencies, while those in the east stayed constant. These western areas of the nation, being more amenable to western management and medical 'business' practice, may be quicker to pick up on new techniques to increase healthcare delivery efficiencies. This may stem from the more limited effects of a shorter history of incorporation into a Soviet-style planned and controlled economy in which individual decision-making and entrepreneurship was suppressed in favor of central decision-making by the state.
乌克兰的历史赋予了它一种分裂的特性（例如，不同文化对经济和管理行为的影响），正如在2004年12月选举之前及之后的近期政治发展中所观察到的那样。东部地区深受俄罗斯 - 苏联统治的影响，而西部地区则更具欧洲视野。这项主要是探索性的研究比较了乌克兰医院效率的近期趋势，以查看这种分裂特性是否表现为不同的改善率。鉴于苏联式计划经济的僵化性，研究假设西部地区在经济效率方面将有更大改善，这可归因于更高水平的管理和医疗创业精神。本研究的数据来自三个州（即地缘政治区域），一个在西部，两个在东部，时间跨度为1997年至2001年。数据包络分析（DEA）用于估计医院的技术效率。在纠正偏差后，估计了第二阶段的托比特回归。结果表明，西部的医院提高了效率，而东部的医院则保持不变。该国西部地区更易于接受西方管理和医疗“商业”实践，可能会更快地采用新技术来提高医疗服务效率。这可能源于纳入苏联式计划和控制经济的历史较短，其影响较为有限，在这种经济体制中，个人决策和创业精神受到压制，而有利于国家的中央决策。
