医院合并能提高医院效率吗？来自一个国民医疗服务体系国家的证据。
Do hospital mergers increase hospital efficiency? Evidence from a National Health Service country.
作者信息
Kjekshus Lars, Hagen Terje
机构信息
Faculty of Medicine, Institute of Health Management and Health Economics, University of Oslo, Oslo, Norway.
出版信息
J Health Serv Res Policy. 2007 Oct;12(4):230-5. doi: 10.1258/135581907782101561.
OBJECTIVES
To analyse the effects on technical and cost efficiency of seven hospital mergers over the period 1992-2000 in Norway. The mergers involved 17 hospitals.
METHODS
First, efficiency scores were generated using Data Envelopment Analysis for 53 merged and non-merged hospitals over the nine years. Second, the effect of mergers was estimated through panel data analysis.
RESULTS
In general, the mergers showed no significant effect on technical efficiency and a significant negative effect of 2-2.8% on cost efficiency. However, positive effects on both cost and technical efficiency were found in one merger where more hospitals were involved, and where administration and acute services were centralized.
CONCLUSION
The findings indicate that large mergers involving radical restructuring of the treatment process may improve efficiency as intended, but most mergers do not.
目的
分析1992年至2000年期间挪威七起医院合并案对技术效率和成本效率的影响。这些合并案涉及17家医院。
方法
首先，运用数据包络分析法对9年间53家合并与未合并医院的效率得分进行计算。其次，通过面板数据分析评估合并的效果。
结果
总体而言，合并对技术效率无显著影响，对成本效率有2%-2.8%的显著负面影响。然而，在涉及更多医院且行政和急症服务集中化的一起合并案中，发现了对成本和技术效率的积极影响。
结论
研究结果表明，涉及治疗流程彻底重组的大型合并案可能如预期提高效率，但大多数合并案并非如此。
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