The effects of upcoding, cream skimming and readmissions on the Italian hospitals efficiency: a population–based investigation

P Berta, G Callea, Gianmaria Martini and Giorgio Vittadini ()

MPRA Paper from University Library of Munich, Germany

Abstract: In this paper we analyze the effects of some distortions induced by prospective payment system, i.e. Upcoding, Cream Skimming and Readmissions, on hospitals’ technical efficiency. We estimate a production function using a population–based dataset composed by all active hospitals in an Italian region during the period 1998–2007. We show that cream skimming and upcoding have a negative impact on hospitals’ technical efficiency, while readmissions have a positive effect. Moreover, we find that private hospitals are more engaged in cream skimming than public and not–for–profit ones, while we observe no ownership differences regarding upcoding. Not–for–profit hospitals have the highest readmission index. Last, not–for–profit and public hospitals have the same efficiency levels, while private hospitals have the lowest technical efficiency.

Keywords: Upcoding; Cream Skimming; Readmission; Hospital Technical Efficiency; Ownership. (search for similar items in EconPapers)
JEL-codes: C50 I11 I18 L33 (search for similar items in EconPapers)
Date: 2009-06-21
New Economics Papers: this item is included in nep-eff
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Citations: View citations in EconPapers (4)

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Related works:
Journal Article: The effects of upcoding, cream skimming and readmissions on the Italian hospitals efficiency: A population-based investigation (2010)
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