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Sommersguter-Reichmann, Margit

doi:10.1023/a:1019022230731

Cited by 71 publications

(18 citation statements)

References 8 publications

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“…Sommersguter [109] explored productivity changes in Austrian hospitals after and before hospital financing reform. The results illustrated a considerably positive shift in technology between 1996 and 1998, whereas the intended enhancement in technical efficiency had not yet occurred.…”

Section: Resultsmentioning

confidence: 99%

“…The results showed that the majority of hospitals could increase their efficiency and reduce their costs by diversification of the offered output mix. One study [109] used a sample of government and non-government hospitals to explore productivity changes after and before hospital financing reform. Four studies [5, 95, 106, 107] analysed hospital productivity of a sample of general acute-care hospitals, including teaching hospitals.…”

Section: Resultsmentioning

confidence: 99%

“…Two studies [95,109] applied DEA analysis to explore technical and scale efficiencies of a sample of hospitals and the Malmquist index to analyse productivity changes after and before hospital reform. Blank and Eggink [97] applied the shadow cost function model and SFA to assess technical and allocative efficiency of the Dutch general hospital industry.…”

Section: Resultsmentioning

confidence: 99%

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Efficiency and optimal size of hospitals: Results of a systematic search

Giancotti¹,

Guglielmo²,

Mauro³

2017

PLoS ONE

116

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BackgroundNational Health Systems managers have been subject in recent years to considerable pressure to increase concentration and allow mergers. This pressure has been justified by a belief that larger hospitals lead to lower average costs and better clinical outcomes through the exploitation of economies of scale. In this context, the opportunity to measure scale efficiency is crucial to address the question of optimal productive size and to manage a fair allocation of resources.Methods and findingsThis paper analyses the stance of existing research on scale efficiency and optimal size of the hospital sector. We performed a systematic search of 45 past years (1969–2014) of research published in peer-reviewed scientific journals recorded by the Social Sciences Citation Index concerning this topic. We classified articles by the journal’s category, research topic, hospital setting, method and primary data analysis technique. Results showed that most of the studies were focussed on the analysis of technical and scale efficiency or on input / output ratio using Data Envelopment Analysis. We also find increasing interest concerning the effect of possible changes in hospital size on quality of care.ConclusionsStudies analysed in this review showed that economies of scale are present for merging hospitals. Results supported the current policy of expanding larger hospitals and restructuring/closing smaller hospitals. In terms of beds, studies reported consistent evidence of economies of scale for hospitals with 200–300 beds. Diseconomies of scale can be expected to occur below 200 beds and above 600 beds.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Efficiency and optimal size of hospitals: Results of a systematic search

Giancotti¹,

Guglielmo²,

Mauro³

2017

PLoS ONE

116

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“…the practice of charging maximum tariffs. Systematically extending the limits of Diagnosis-Related Group (DRG) coding was the reason for the ‘artificial’ technological progress in the Austrian hospital sector, which was identified immediately after the introduction of the DRG financing [85]. A recent study in Germany found evidence of selective up-coding regarding the birth weight of newborns, which is a major remuneration element in the German DRG-based hospital reimbursement system [86].…”

Section: Proposal To Link Different Typologies Of Corruptionmentioning

confidence: 99%

Individual and Institutional Corruption in European and US Healthcare: Overview and Link of Various Corruption Typologies

Sommersguter-Reichmann

Wild

Stepan³

et al. 2018

Appl Health Econ Health Policy

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In recent years, the fight against healthcare corruption has intensified. Estimates from the European Healthcare Fraud and Corruption Network calculate an approximate €56 billion annual loss to Europe as a result of corruption. To promote understanding of the complexity and interconnection of corrupt activities, we aim to present healthcare-related corruption typologies of the European Union and European Healthcare Fraud and Corruption Network. We subsequently link them to the typology of individual and institutional corruption introduced by Dennis Thompson in the context of investigating misconduct of US Congressional members. According to Thompson, individual corruption is the personal gain of individuals performing duties within an institution in exchange for nurturing private interests, while institutional corruption pertains to the failure of the institution in directing the individual’s behaviour towards the achievement of the institution’s primary purpose because the institutional design promotes the pursuit of individual goals. Effective anti-corruption activities not only require the enactment of anti-corruption laws but also the monitoring and, where appropriate, revision of institutional frameworks to prevent the undermining of the primary purposes of health systems or institutions. To gain further understanding of the similarities and differences of the three typologies, prime examples of corrupt activities in the health sector in the European Union and USA (along with their potential remedies) are provided. Linking corruption cases to Thompson’s typology revealed that many corrupt activities may show elements of both individual and institutional corruption because they are intertwined, partly overlap and may occur jointly. Hence, sanctioning individual actors only does not target the problem.

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“…Estes índices parciais são importantes porque permitem verifi car se um eventual aumento da efi ciência relativa de um período para o outro deve ser atribuído ao aumento da produtividade da unidade avaliada ou à contração da fronteira de produção. 8,17 Uma das principais vantagens da aplicação de DEA para identifi cação da fronteira de efi ciência está no fato de que as medidas de mudanças de produtividade podem ser analisadas a partir de dois componentes distintos: as "mudanças na tecnologia" (decorrente do deslocamento da fronteira no tempo) e as "mudanças na efi ciência técnica" (desempenho comparativo da unidade analisada). Nos referidos estudos, houve acompanhamento dos resultados por, no míni-mo, quatro anos consecutivos e, em ambos os casos, observou-se melhora expressiva da fronteira tecnoló-gica nos anos que sucederam a reforma, sem alteração signifi cativa na efi ciência técnica dos hospitais.…”

Section: O íNdice De Malmquist Orientado a Input é Dado Porunclassified

Impacto da reforma de financiamento de hospitais de ensino no Brasil

Lobo

Silva²,

Lins³

et al. 2009

Rev. Saúde Pública

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OBJETIVO: Avaliar o impacto da reforma de financiamento na produtividade de hospitais de ensino. MÉTODOS: A partir do Sistema de Informações dos Hospitais Universitários Federais, foram construídas fronteiras de eficiência e produtividade em 2003 e 2006 com técnicas de programação linear, por meio de análise envoltória de dados, considerando retornos variáveis de escala e orientação a input. Calculou-se o Índice de Malmquist para identificar mudanças de desempenho ao longo dos anos quanto à eficiência técnica (razão entre os escores de eficiência em tempos distintos) e eficiência tecnológica (deslocamento da fronteira no período considerado). RESULTADOS: Houve aumento do aporte financeiro em 51% e da eficiência técnica dos hospitais de ensino (de 11, passaram a ser 17 na fronteira empírica de eficiência), o mesmo não ocorrendo com a fronteira tecnológica. O uso de análise envoltória de dados estabeleceu os benchmarks para as unidades ineficientes (antes e depois da reforma) e os escores de eficiência mostraram uma possível correlação entre a eficiência técnica encontrada e a intensidade e dedicação de ensino. CONCLUSÕES: A reforma permitiu o desenvolvimento de melhorias gerenciais, mas é necessário maior tempo de acompanhamento para observar mudanças mais efetivas do modelo de financiamento.

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Untitled

Cited by 71 publications

References 8 publications

Efficiency and optimal size of hospitals: Results of a systematic search

Efficiency and optimal size of hospitals: Results of a systematic search

Individual and Institutional Corruption in European and US Healthcare: Overview and Link of Various Corruption Typologies

Impacto da reforma de financiamento de hospitais de ensino no Brasil

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