Efficiency Evaluation of Private Hospitals in Brazil: A Two-Stage Analysis

Abstract

Purpose: This study aims to describe the efficiency of private hospitals in Brazil and to understand the influence of property structure, specialization, accreditation, and teaching activity on the efficiency of private hospitals. Originality/value: Our findings suggested that private hospitals’ efficiency stands out due to their quest for quality and safety certification and investigates controversial factors in the hospital efficiency literature. Besides, it contributes to the development of the national literature as regards hospitals efficiency in Brazil through a two-stage analysis. Design/methodology/approach: The efficiencies of 98 hospitals of the National Association of Private Hospitals (ANAHP) were estimated through the modeling Data Envelopment Analysis (DEA). Three inputs and three outputs were selected referring to the performance of hospitals in the year 2017. In the first stage, the input-oriented efficiencies were analyzed using a non-discretionary variable. In the second, bootstrapped measures were estimated, and the influences of hospital efficiency factors were investigated through econometric models. Findings: The results enabled the description of resource management aspects related to the inputs and outputs investigated, to improve efficiency in private hospitals in Brazil, and to understand the influence of ownership, specialization, and accreditation factors on the efficiency of private hospitals.

The impact of hospital accreditation on the quality of healthcare: a systematic literature review

“…A total of eight studies evaluating the economic effects of accreditation have been included [83,90,[112][113][114][115][116][117]. Most of them (n = 5) showed a positive impact on various economic outcomes, particularly healthcare efficiency.…”

“…Another observational study found that hospital accreditation, ceteris paribus, was associated with 119% improvement on a quality index relative to baseline data, which translated into a combined saving of US$ 593.000 in two hospitals over 3 years [90]. On the contrary, participating in accreditation programs was found to have an inverse effect on hospital efficiency secondary to higher staffing demand and investment in equipment [116]. Other studies did not detect a major impact of accreditation on operating room efficiency [117], cash-flow margin, and total cost per case [83].…”

A DEA-Based Complexity of Needs Approach for Hospital Beds Evacuation during the COVID-19 Outbreak

“…The nonparametric frontier estimations of data envelopment analysis can aid managers and policymakers in attaining such a prospect. The weight optimization based on pairwise evaluations scales the used resources and generated products of each service unit, providing a robust measure for the technical efficiency, which can be adapted for inverse output/input relations [ 12 ], exogenous or nondiscretionary resources [ 13 – 15 ], and time-series self-evaluations [ 16 – 18 ]. As a result, an estimation for the optimal production capacity for any size service unit is available for decision-making.…”

Evidence on hospital accreditation to leverage its prospects for improvement

“…A total of eight studies evaluating the economic effects of accreditation have been included [43,122,128,[149][150][151][152][153]. Most of them (n = 5) showed a positive impact on various economic outcomes, particularly healthcare efficiency.…”

“…Another observational study found that hospital accreditation, ceteris paribus, was associated with a 119% improvement in a quality index relative to baseline data, which translated into a combined saving of US$ 593.000 in two hospitals over three years [128]. On the contrary, participating in accreditation programs was found to have an inverse effect on hospital efficiency secondary to higher staffing demand and investment in equipment [152]. Other studies did not detect a major impact of accreditation on operating room efficiency [153], cash-flow margin, and total cost per case [122].…”