Congestion analysis to evaluate the efficiency and appropriateness of hospitals in Sicily

Domenica Matranga and Francesca Sapienza

Health Policy, 2015, vol. 119, issue 3, 324-332

Abstract: Over the past twenty years, important changes in the Italian National Health System have been made in order to obtain significant improvements in the efficiency, appropriateness and quality of health care delivery, while reducing health expenditure. In this paper we proposed a multidimensional approach to assess the impact of organization inappropriateness on the efficiency evaluation of hospitals in Sicily for the year 2009. This study was based on cross-sectional data for 116 (out of 129) short-term, acute-care hospitals. The analysis considered beds, physicians, nurses and other personnel as inputs, ordinary discharges and day-hospital admissions as desirable outputs and inappropriate discharges and day-hospitals as undesirable outputs of the health care process. We refer to output-congestion to measure the loss of desirable outcome, which is related to the simultaneous occurrence of inappropriateness. The main findings of our analysis indicate that most of the measured overall inefficiency of Sicilian hospitals could be attributed to congestion and pure technical inefficiency and that congestion was statistically different among hospital trusts, local public hospitals and for-profit hospitals and along the provinces. In Sicily, significant shares of inputs are still employed to supply inappropriate care, with the effect of producing less desirable health care outcomes than expected.

Keywords: Efficiency; Appropriateness; Data envelopment analysis; Output-congestion; Undesirable outputs (search for similar items in EconPapers)
Date: 2015
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (17)

Downloads: (external link)
http://www.sciencedirect.com/science/article/pii/S0168851014003467
Full text for ScienceDirect subscribers only

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:eee:hepoli:v:119:y:2015:i:3:p:324-332

DOI: 10.1016/j.healthpol.2014.12.012

Access Statistics for this article

Health Policy is currently edited by Katrien Kesteloot, Mia Defever and Irina Cleemput

More articles in Health Policy from Elsevier
Bibliographic data for series maintained by Catherine Liu () and ().