Original Articles

Efficiency and Optimal size of Italian Public Hospitals: Results from Data Envelopment Analysis


Abstract


Background: One of the major question discussed in the literature about hospital efficiency is the impact of the hospital size on technical efficiency. Many studies observed that in some cases, the hospital technical inefficiency is correlated to an uncorrected size. This paper addresses this topic. In particular, we attempt to identify an optimal size of the hospitals in terms of beds.

 

Methods: The study is organized as follow: first, we performed a Data Envelopment Analysis in order to calculated the technical and scale efficiency scores for a sample of 41 Italian public hospitals during the period 2010-2013; in a second step we investigated about the impact of the size on hospital efficiency identifying the magnitudes of input reductions needed to make inefficient public hospitals efficient. Finally, we calculated the most productive scale size for each hospital in the sample. According to these results, through an overall observation, we attempt to identify an optimal size of the hospitals in terms of beds.

 

Results: Most of the hospitals were inefficient and most of the inefficiency was correlated to the presence of wastages in terms of input resources. During the period considered, we found that inputs could be reduced by 22% on average. Economies of scale were evident around 200 beds for 20.000 discharges per year.

 

Conclusions: The identification of an optimal size of hospitals in terms of beds still requires further efforts in the literature. However, this study contributes to support hospital managers in resource allocation choices through a quantitative approach.

 

Keywords: Hospitals, Italy, Optimal Size, Beds, Dea Analysis       




DOI: https://doi.org/10.2427/12929

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EBPH Epidemiology, Biostatistics and Public Health | ISSN 2282-0930

Creative Commons License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.