Behavioral Differences Between Public and Private Not-For-Profit Hospitals in the Italian National Health Service

Gian Paolo Barbetta (), Gilberto TURATI () and Angelo Zago
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Gian Paolo Barbetta: Istituto di Economia e Finanza (Univ. Cattolica MI

No 12, Working Papers from Università di Verona, Dipartimento di Scienze economiche

Abstract: In this paper we attempt to identify behavioral differences between public and private not-forprofit hospitals, by using the opportunity of the introduction of the DRG-based payment system in the Italian NHS during the second half of the Nineties. We estimate the technical efficiency of a sample of hospitals for the period 1995-2000 considering an output distance function, and adopting both parametric (COLS) and non-parametric (DEA) approaches. All our results show a convergence of mean efficiency scores between not-for-profit and public hospitals, and seem to suggest that differences in economic performances between competing ownership forms are more the result of the institutional settings in which they operate than the effect of the incentive structures embedded in the different proprietary forms. Contrary to expectation we also observe a decline in technical efficiency, probably due to policies aimed at reducing hospitalization rates.

Keywords: forms; technical efficiency; nonprofit organizations; hospital behavior; payment systems. (search for similar items in EconPapers)
JEL-codes: I11 I18 L31 (search for similar items in EconPapers)
New Economics Papers: this item is included in nep-eff and nep-hea
Date: 2004-10
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Forthcoming on Health Economics

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http://dse.univr.it/RePEc/ver/Wpaper/WP12.pdf First version (application/pdf)

Related works:
Journal Article: Behavioral differences between public and private not-for-profit hospitals in the Italian national health service (2007)
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