Department of Economics, University of Patras, University Campus Rio, 26504, Patras, Greece,
Eur J Health Econ. 2013 Dec;14(6):979-94. doi: 10.1007/s10198-012-0446-z. Epub 2012 Dec 11.
The purpose of this study was to measure Greek hospital performance using different input-output combinations, and to identify the factors that influence their efficiency thus providing policy makers with valuable input for the decision-making process. Using a unique dataset, we estimated the productive efficiency of each hospital through a bootstrapped data envelopment analysis (DEA) approach. In a second stage, we explored, using a bootstrapped truncated regression, the impact of environmental factors on hospitals' technical and scale efficiency. Our results reveal that over 80% of the examined hospitals appear to have a technical efficiency lower than 0.8, while the majority appear to be scale efficient. Moreover, efficiency performance differed with inclusion of medical examinations as an additional variable. On the other hand, bed occupancy ratio appeared to affect both technical and scale efficiency in a rather interesting way, while the adoption of advanced medical equipment and the type of hospital improves scale and technical efficiency, correspondingly. The findings of this study on Greek hospitals' performance are not encouraging. Furthermore, our results raise questions regarding the number of hospitals that should operate, and which type of hospital is more efficient. Finally, the results indicate the role of medical equipment in performance, confirming its misallocation in healthcare expenditure.
本研究旨在使用不同的投入-产出组合来衡量希腊医院的绩效，并确定影响其效率的因素，从而为决策者的决策过程提供有价值的信息。本研究使用独特的数据集，通过自举数据包络分析（DEA）方法来估算每家医院的生产效率。在第二阶段，我们使用自举截断回归探索环境因素对医院技术和规模效率的影响。研究结果表明，超过 80%的被检查医院的技术效率似乎低于 0.8，而大多数医院似乎具有规模效率。此外，纳入医疗检查作为附加变量会影响效率表现。另一方面，病床占用率似乎以一种有趣的方式影响技术和规模效率，而采用先进的医疗设备和医院类型则相应地提高了规模和技术效率。本研究对希腊医院绩效的发现并不令人鼓舞。此外，我们的研究结果引发了关于应该运营的医院数量以及哪种类型的医院更有效的问题。最后，结果表明医疗设备在绩效中的作用，证实了其在医疗支出中的配置不当。
