Fourlopoulou Argyro, Xenos Panos, Messinios George, Maniadakis Nikolaos
Department of Public Health Policy, University of West Attica, 196 Alexandras Avenue, 11521 Athens, Greece.
Department of Statistics and Insurance Science, University of Piraeus, 80 Karaoli and Demetriou Str., 18534 Piraeus, Greece.
Healthcare (Basel). 2025 May 26;13(11):1253. doi: 10.3390/healthcare13111253.
: This study introduces the (CMgm), a novel tool for comparing and ranking the cost efficiency of multiple groups of similar decision-making units operating in different contexts. It was applied to Greek public hospitals to assess productivity change between 2009 and 2021, covering the period before the economic recession and after the second lockdown during the COVID-19 pandemic. The study aimed to determine the impact of these external shocks on hospital efficiency and to identify differences in cost productivity based on hospital size and regional location. : Data envelopment analysis was employed to compute the Malmquist indices for productivity change and ranking. Overall, 109 Greek public hospitals were analysed using three models: as a single group, classified by bed capacity, and classified by regional health authority (RHA). Cost productivity was decomposed into its core measures. : During the economic crisis, hospitals improved their cost productivity by 13.2%, whereas during the pandemic, it declined by 32.1%, primarily due to cost frontier deterioration resulting from increased healthcare demand and strained resources. Medium-sized hospitals exhibited higher cost efficiency than small and large hospitals. Regional disparities were also observed, with hospitals in the 5 and 7 RHAs outperforming those in 1 and 2 RHAs. : The findings highlight the pandemic's disruptive impact on hospital cost productivity compared to the efficiency gains during the economic crisis. It is encouraging, though, that hospitals are recovering again after the lifting of strict lockdown measures. The CMgm is a valuable tool for policymakers, offering insights into hospital performance across multiple groups. Future healthcare policies should prioritise resource optimisation and address regional disparities to enhance system-wide efficiency and resilience in times of crisis.
本研究介绍了成本管理增长模型（CMgm），这是一种用于比较和排名在不同背景下运营的多组类似决策单元成本效率的新型工具。该工具应用于希腊公立医院，以评估2009年至2021年期间的生产率变化，涵盖经济衰退前以及新冠疫情期间第二次封锁后的时期。该研究旨在确定这些外部冲击对医院效率的影响，并根据医院规模和地区位置确定成本生产率的差异。：采用数据包络分析来计算生产率变化和排名的Malmquist指数。总体而言，使用三种模型对109家希腊公立医院进行了分析：作为一个单一组、按床位容量分类以及按地区卫生当局（RHA）分类。成本生产率被分解为其核心指标。：在经济危机期间，医院的成本生产率提高了13.2%，而在疫情期间，成本生产率下降了32.1%，这主要是由于医疗需求增加和资源紧张导致成本前沿恶化。中型医院的成本效率高于小型和大型医院。还观察到地区差异，第5和第7个地区卫生当局的医院表现优于第1和第2个地区卫生当局的医院。：研究结果突出了疫情与经济危机期间效率提升相比，对医院成本生产率的破坏性影响。不过，令人鼓舞的是，在严格的封锁措施解除后，医院正在再次恢复。CMgm是政策制定者的宝贵工具，能为多组医院的绩效提供见解。未来的医疗政策应优先考虑资源优化并解决地区差异，以提高危机时期全系统的效率和恢复力。
