Decomposition of potential efficiency gains from hospital mergers in Greece
Angeliki Flokou (),
Vassilis Aletras () and
Dimitris Niakas ()
Additional contact information
Angeliki Flokou: Hellenic Open University
Vassilis Aletras: Hellenic Open University
Dimitris Niakas: Hellenic Open University
Health Care Management Science, 2017, vol. 20, issue 4, 467-484
Abstract This paper evaluates the technical efficiency of 71 Greek public hospitals and examines potential efficiency gains from 13 candidate mergers among them. Efficiency assessments are performed using bootstrapped Data Envelopment Analysis (DEA) whilst merger analysis is conducted by applying the Bogetoft and Wang methodology which allows the overall potential merger gains to be decomposed into three main components of inefficiency, namely technical (or learning), scope (or harmony) and scale (or size) effects. Thus, the analysis provides important insights not only on the magnitude of the potential total efficiency gains but also on their sources. The overall analysis is conducted in the context of a complete methodological framework where methods for outlier detection, returns to scale identification, and bias corrections for DEA estimations are also applied. Mergers are analyzed under the assumptions of constant, variable and non-decreasing returns to scale in an input oriented DEA model with three inputs and three outputs. The main finding of the study indicates that almost all mergers show substantial potential room for efficiency improvement, which is mainly attributed to the pre-merger technical inefficiencies of the individual hospitals and therefore it might be possible to be achieved without the need of implementing full-scale mergers. The same -though, at a lower extent- applies to the harmony effect whilst the size effect shows marginal or even negative gains.
Keywords: Data envelopment analysis; Hospital Efficiency; Benchmarking; Bootstrapping; Merger Analysis; 90-XX (search for similar items in EconPapers)
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (1) Track citations by RSS feed
Downloads: (external link)
http://link.springer.com/10.1007/s10729-016-9365-3 Abstract (text/html)
Access to the full text of the articles in this series is restricted.
This item may be available elsewhere in EconPapers: Search for items with the same title.
Export reference: BibTeX
RIS (EndNote, ProCite, RefMan)
Persistent link: https://EconPapers.repec.org/RePEc:kap:hcarem:v:20:y:2017:i:4:d:10.1007_s10729-016-9365-3
Ordering information: This journal article can be ordered from
Access Statistics for this article
Health Care Management Science is currently edited by Yasar Ozcan
More articles in Health Care Management Science from Springer
Bibliographic data for series maintained by Sonal Shukla ().