Bernet Patrick Michael, Rosko Michael D, Valdmanis Vivian G
School of Business, Florida Atlantic University, Boca Raton, FL, USA.
J Health Care Finance. 2008 Summer;34(4):66-88.
U.S. Hospitals rely heavily on debt financing to fund major capital investments. Hospital efficiency is at least partly determined by the amount and quality of plant and equipment it uses. As such, a hospital's access to debt and credit rating may be related to its efficiency. This study explores this relationship using a broad sample of hospitals and associated bond issuance histories. Employing stochastic frontier analysis (SFA), we measure cost inefficiency to gauge the impact of debt issuance and debt rating. We find that hospitals with recent bond issues were less inefficient. Although we do not find a perfectly linear relationship between debt rating and inefficiency, we have evidence that hints at such a relation. Finally, we find an increase in inefficiency in the years following bond issues, consistent with the possibility of a debt death spiral.
美国医院严重依赖债务融资来为重大资本投资提供资金。医院效率至少部分取决于其使用的厂房和设备的数量及质量。因此，医院获得债务的能力和信用评级可能与其效率相关。本研究使用广泛的医院样本及相关债券发行历史来探究这种关系。采用随机前沿分析（SFA），我们衡量成本无效率以评估债券发行和债务评级的影响。我们发现近期发行债券的医院效率较低。虽然我们未发现债务评级与无效率之间存在完美的线性关系，但有证据暗示了这种关系。最后，我们发现债券发行后的几年里无效率有所增加，这与债务死亡螺旋的可能性相符。
