Healthcare reform in Italy: an analysis of efficiency based on nonparametric methods

Nicola, Arianna De; Gitto, Simone; Mancuso, Paolo; Valdmanis, Vivian

doi:10.1002/hpm.2183

Cited by 33 publications

(33 citation statements)

References 45 publications

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“…One of these [68] analysed how the different organizational models adopted in Italy’s healthcare services and patient mobility might affect healthcare efficiency at the regional level. The analysis of the regression results indicated that the national reimbursement system produced a significantly negative effect on healthcare efficiency.…”

Section: Resultsmentioning

confidence: 99%

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%

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

Giancotti¹,

Guglielmo²,

Mauro³

2017

PLoS ONE

116

View full text Add to dashboard Cite

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“…Focusing on the Italian healthcare market, which is the specific case study proposed by the authors, we can identify both public and private providers of healthcare services [ 17 – 20 ]. On the one hand, there are public services currently offered by Local Health Authorities (LHAs) through Family Doctors (FDs), who are responsible for the comprehensive healthcare of patients.…”

Section: Introductionmentioning

confidence: 99%

The private healthcare market and the sustainability of an innovative community nurses programme based on social entrepreneurship - CoNSENSo project

Ippoliti

Falavigna

Montani

et al. 2018

BMC Health Serv Res

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BackgroundCoNSENSo is a project funded by the European Union, which is aimed at developing an innovative care model based on community nurses to support active ageing in mountain areas. The planned sustainability of this innovative approach relies on social entrepreneurship on the healthcare market, and this work highlights the necessary conditions for the successful implementation of these entrepreneurial initiatives.MethodsConsidering municipalities in the Piedmont Region and those aged 65 or older as target population, the authors propose several negative binomial regression models to estimate the effectiveness of current private healthcare services in supporting the active aging process. Such effectiveness may represent the ex-ante (positive) reputation of these new social entrepreneurial initiatives on the market.ResultsAccording to our results, the private supply of healthcare services can effectively support the aging process. Indeed, given that the other predictor variables in the model are held constant, there are statistically significant negative relations between the number of hip fractures and the private supply of healthcare services by dental practitioners and psychologists (p-value < 0.05), as well as the private supply of opportunities for social interaction by coffee bars (p-value < 0.05).ConclusionsThe authors expect a favourable environment for the entrepreneurial initiatives of community nurses in mountain areas. Accordingly, policy makers cannot reject the hypothesis that the goals reached by the CoNSENSo project may be maintained for the sake of the future generations, avoiding its collapse as soon as public funding shifts to new programmes.

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“…In the second stage, we estimated the impact of religious diversity and other explanatory variables on efficiency using truncated regression. As we discuss below, advanced bootstrap techniques were adopted, in line with a growing literature on the determinants of efficiency in the healthcare industry (De Nicola, Gitto and Mancuso, 2012;De Nicola et al, 2014).…”

Section: Methodsmentioning

confidence: 99%

Does Religious Diversity in Health Team Composition Affect Efficiency? Evidence from Dubai

Ancarani

Ayach

Mauro

et al. 2016

British J of Management

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Team cultural diversity, the degree to which working team members differ in culture-related factors, may affect healthcare teams’ outcomes. This paper focuses on one particular source of cultural diversity, namely religion, and examines its relation to the production efficiency of hospital wards. Building on the categorization-elaboration model of organizational diversity, the authors test an empirical model positing that team religious diversity has non-linear effects on efficiency, and considering the role of moderating variables of the relation diversity–efficiency. Empirically, the authors adopt a two-step approach, whereby the first step applies data envelopment analysis to estimate efficiency scores for each team, and the second investigates the effect of diversity and of moderating variables. The model is tested on a sample of hospital wards from three large hospitals in Dubai. The results suggest an inverse U-shaped relation between religious diversity and the wards’ efficiency. Evidence is provided that the relation is moderated by task complexity, task conflict, team leader tenure and diversity in nationality. This study advances research on the management of hospital team diversity by emphasizing the complexity of diversity effects and the importance of contextual factors

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Healthcare reform in Italy: an analysis of efficiency based on nonparametric methods

Cited by 33 publications

References 45 publications

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

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

The private healthcare market and the sustainability of an innovative community nurses programme based on social entrepreneurship - CoNSENSo project

Does Religious Diversity in Health Team Composition Affect Efficiency? Evidence from Dubai

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