Herrero Tabanera Luis, Martín Martín José Jesús, López del Amo González Ma del Puerto
Control de Operaciones, Hospital Infanta Margarita, Cabra, Córdoba, España.
Economía Aplicada, Facultad de Ciencias Económicas y Empresariales, Universidad de Granada, Granada, España.
Gac Sanit. 2015 Jul-Aug;29(4):274-81. doi: 10.1016/j.gaceta.2015.03.001. Epub 2015 Apr 11.
To assess the technical efficiency of traditional public hospitals without their own legal identity and subject to administrative law, and that of public enterprise hospitals, with their own legal identities and partly governed by private law, all of them belonging to the taxypayer-funded health system of Andalusia during the period 2005 -2008.
The study included the 32 publicly-owned hospitals in Andalusia during the period 2005-2008. The method consisted of two stages. In the first stage, the indices of technical efficiency of the hospitals were calculated using Data Envelopment Analysis, and the change in total factor productivity was estimated using the Malmquist index. The results were compared according to perceived quality, and a sensitivity analysis was conducted through an auxiliary model and bootstrapping. In the second stage, a bivariate analysis was performed between hospital efficiency and organization type.
Public enterprises were more efficient than traditional hospitals (on average by over 10%) in each of the study years. Nevertheless, a process of convergence was observed between the two types of organizations because, while the efficiency of traditional hospitals increased slightly (by 0.50%) over the study period, the performance of public enterprises declined by over 2%.
The possible reasons for the greater efficiency of public enterprises include their greater budgetary and employment flexibility. However, the convergence process observed points to a process of mutual learning that is not necessarily efficient.
评估2005 - 2008年期间安达卢西亚纳税人资助的医疗体系中，不具备独立法人资格且受行政法约束的传统公立医院，以及具备独立法人资格且部分受私法约束的公立企业医院的技术效率。
该研究涵盖了2005 - 2008年期间安达卢西亚的32家公立医院。方法包括两个阶段。在第一阶段，使用数据包络分析计算医院的技术效率指标，并使用曼奎斯特指数估计全要素生产率的变化。根据感知质量对结果进行比较，并通过辅助模型和自抽样进行敏感性分析。在第二阶段，对医院效率与组织类型进行双变量分析。
在研究的各年份中，公立企业医院均比传统医院更高效（平均高出10%以上）。然而，观察到两种组织类型之间存在趋同过程，因为在研究期间，传统医院的效率略有提高（提高了0.50%），而公立企业医院的绩效下降了2%以上。
公立企业医院效率更高的可能原因包括其在预算和就业方面具有更大的灵活性。然而，观察到的趋同过程表明这是一个不一定高效的相互学习过程。
