Accounting for Efficiency: Productivity Assessment of Merged Hospitals in Portugal Using DEA–Malmquist Analysis

Natália Maria Pereira Macedo, Anabela Martins Silva and Amélia Silva ()
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Natália Maria Pereira Macedo: School of Economics and Management, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
Anabela Martins Silva: School of Economics and Management, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
Amélia Silva: CEOS.PP, Instituto Superior de Contabilidade e Administração do Porto, Polytechnic of Porto, Rua Jaime Lopes Amorim, s/n, 4465-004 Matosinhos, Portugal

World, 2025, vol. 6, issue 2, 1-19

Abstract: This study analyses the effects of public hospital mergers in Portugal, particularly the creation of hospital centers, on productivity levels. Grounded in the theoretical frameworks of New Public Management and Efficiency Theory, a Data Envelopment Analysis (DEA) approach, combined with the Malmquist Productivity Index, was used to evaluate performance. Results for the 2013–2015 period show no statistically significant difference in productivity levels between merged hospitals (hospital centers) and non-merged hospitals (hospital units). However, for hospitals merged in 2007, there is evidence of significant productivity gains in the post-merger period (2008–2014). These findings partially support the assumptions of New Public Management and Efficiency Theory concerning efficiency improvements through hospital mergers in the public sector.

Keywords: Data Envelopment Analysis (DEA); hospital mergers; Malmquist index; productivity; public hospitals (search for similar items in EconPapers)
JEL-codes: G15 G17 G18 L21 L22 L25 L26 Q42 Q43 Q47 Q48 R51 R52 R58 (search for similar items in EconPapers)
Date: 2025
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