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Internal markets and health care efficiency : A multiple-output stochastic frontier analysis

Gerdtham, U. G. LU orcid ; Löthgren, M. ; Tambour, M. and Rehnberg, C. (1999) In Health Economics 8(2). p.151-164
Abstract

This paper has two purposes. The first purpose is methodological and aims to extend previous work on efficiency analysis by implementing a multiple-output stochastic ray frontier production function model. This model generalizes the single-output stochastic frontier model to multiple-input, multiple-output technologies and allows simultaneous estimation of technical efficiency and analysis of influential variables on efficiency. The second, empirical, purpose is to test for existence and magnitude of the effect of purchaser/provider split combined with new reimbursement schemes on technical efficiency in the Swedish public hospital system. The analysis is carried out with a panel data set covering the total population of 26 Swedish... (More)

This paper has two purposes. The first purpose is methodological and aims to extend previous work on efficiency analysis by implementing a multiple-output stochastic ray frontier production function model. This model generalizes the single-output stochastic frontier model to multiple-input, multiple-output technologies and allows simultaneous estimation of technical efficiency and analysis of influential variables on efficiency. The second, empirical, purpose is to test for existence and magnitude of the effect of purchaser/provider split combined with new reimbursement schemes on technical efficiency in the Swedish public hospital system. The analysis is carried out with a panel data set covering the total population of 26 Swedish County Councils from 1989 to 1995. Our empirical results support the frontier model specification and indicate that output-based reimbursement improves technical efficiency. The potential saving in costs due to a switch from budget-based allocation to output-based allocation is estimated to be almost 10%.

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Please use this url to cite or link to this publication:
author
; ; and
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Internal markets, Panel data, Stochastic ray frontier model, Technical efficiency
in
Health Economics
volume
8
issue
2
pages
14 pages
publisher
John Wiley & Sons Inc.
external identifiers
  • scopus:0344609777
  • pmid:10342728
ISSN
1057-9230
DOI
10.1002/(SICI)1099-1050(199903)8:2<151::AID-HEC411>3.0.CO;2-Q
language
English
LU publication?
no
id
af892ca3-d013-46d2-9674-711028c20b7a
date added to LUP
2018-10-09 12:24:10
date last changed
2024-06-24 21:14:40
@article{af892ca3-d013-46d2-9674-711028c20b7a,
  abstract     = {{<p>This paper has two purposes. The first purpose is methodological and aims to extend previous work on efficiency analysis by implementing a multiple-output stochastic ray frontier production function model. This model generalizes the single-output stochastic frontier model to multiple-input, multiple-output technologies and allows simultaneous estimation of technical efficiency and analysis of influential variables on efficiency. The second, empirical, purpose is to test for existence and magnitude of the effect of purchaser/provider split combined with new reimbursement schemes on technical efficiency in the Swedish public hospital system. The analysis is carried out with a panel data set covering the total population of 26 Swedish County Councils from 1989 to 1995. Our empirical results support the frontier model specification and indicate that output-based reimbursement improves technical efficiency. The potential saving in costs due to a switch from budget-based allocation to output-based allocation is estimated to be almost 10%.</p>}},
  author       = {{Gerdtham, U. G. and Löthgren, M. and Tambour, M. and Rehnberg, C.}},
  issn         = {{1057-9230}},
  keywords     = {{Internal markets; Panel data; Stochastic ray frontier model; Technical efficiency}},
  language     = {{eng}},
  month        = {{03}},
  number       = {{2}},
  pages        = {{151--164}},
  publisher    = {{John Wiley & Sons Inc.}},
  series       = {{Health Economics}},
  title        = {{Internal markets and health care efficiency : A multiple-output stochastic frontier analysis}},
  url          = {{http://dx.doi.org/10.1002/(SICI)1099-1050(199903)8:2<151::AID-HEC411>3.0.CO;2-Q}},
  doi          = {{10.1002/(SICI)1099-1050(199903)8:2<151::AID-HEC411>3.0.CO;2-Q}},
  volume       = {{8}},
  year         = {{1999}},
}