Market structure and hospital efficiency: Evaluating potential effects of deregulation in a national health service

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Review of Industrial Organization, 13, (1998), pp. 447-466
To cite or link this document: Dalmau, Eulàlia Puig, Jaume
dc.contributor.other Universitat Pompeu Fabra. Departament d'Economia i Empresa 1997-06-01
dc.identifier.citation Review of Industrial Organization, 13, (1998), pp. 447-466
dc.description.abstract In this article we examine the potential effect of market structure on hospital technical efficiency as a measure of performance controlled by ownership and regulation. This study is relevant to provide an evaluation of the potential effects of recommended and initiated deregulation policies in order to promote market reforms in the context of a European National Health Service. Our goal was reached through three main empirical stages. Firstly, using patient origin data from hospitals in the region of Catalonia in 1990, we estimated geographic hospital markets through the Elzinga--Hogarty approach, based on patient flows. Then we measured the market level of concentration using the Herfindahl--Hirschman index. Secondly, technical and scale efficiency scores for each hospital was obtained specifying a Data Envelopment Analysis. According to the data nearly two--thirds of the hospitals operate under the production frontier with an average efficiency score of 0.841. Finally, the determinants of the efficiency scores were investigated using a censored regression model. Special attention was paid to test the hypothesis that there is an efficiency improvement in more competitive markets. The results suggest that the number of competitors in the market contributes positively to technical efficiency and there is some evidence that the differences in efficiency scores are attributed to several environmental factors such as ownership, market structure and regulation effects.
dc.language.iso eng
dc.relation.ispartofseries Economics and Business Working Papers Series; 214
dc.rights L'accés als continguts d'aquest document queda condicionat a l'acceptació de les condicions d'ús establertes per la següent llicència Creative Commons
dc.title Market structure and hospital efficiency: Evaluating potential effects of deregulation in a national health service
dc.type info:eu-repo/semantics/workingPaper 2016-06-04T02:50:19Z
dc.subject.keyword Labour, Public, Development and Health Economics
dc.subject.keyword geographic markets
dc.subject.keyword market concentration
dc.subject.keyword technical efficiency
dc.subject.keyword data envelopment analysis
dc.subject.keyword censored regression model
dc.rights.accessRights info:eu-repo/semantics/openAccess

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