Los nuevos modelos de gestión de hospitales como alternativa para la sostenibilidad del sistema hospitalario público: un análisis de eficiencia en gasto sanitario

Multilevel Analysis of the Relationship between Ownership Structure and Technical Efficiency Frontier in the Spanish National Health System Hospitals

“…In addition, the effect of PPP formulas on the technical efficiency of hospitals compared to alternative direct and indirect management models was investigated. There are very few previous studies that compare the structure of public, private and mixed ownership (PPP models) [53,54], as has been done in this research. Our results indicate that the configuration of PPP models favours efficiency.…”

“…Firstly, the results reveal that, between 2010 and 2012, the odds that SNHS hospitals were positioned on the technical efficiency frontier was 41.7 times higher in PPPs than in traditional public hospitals. Although there are previous studies that carry out second stage analyses to determine the impact that the type of ownership has on the efficiency of hospitals, none of them have determined the likelihood of PPPs achieving maximum technical efficiency compared to other models of hospital management [33,36,40,53,54,[73][74][75][76]. On the other hand, previous studies that use a logit analysis and incorporate the type of ownership among the explanatory variables [58,77,78], do not reach a conclusive result about its influence, nor do they analyse the PPP formula in a differentiated manner.…”

“…There are few prior studies which compare the structure of public, private, and mixed ownership (PPP models), as has been done in this research. In Spain, only two studies using regional frontier methods (DEA) with regional scope have been identified [53,54]. Their results indicate that PPP models obtain high levels efficiency on indices, often located on the frontier of technical efficiency, although in terms of change in productivity, PPPs are not always better than traditional public hospitals.…”

An Orthopedic Healthcare Facility Governance Assessed with a New Indicator System

“…The remaining shortcomings of the healthcare system highlighted the limitations of the evolutionary approach to reforms and suggested that a more revolutionary approach is needed that starts from the bottom up by resizing hospital governance [ 5 ]. From this perspective, it is necessary to analyze the efficiency in healthcare expenses of innovative hospital management models such as Public Private Partnerships or Private Finance Initiatives with the support of new tools dedicated to hospital governance models [ 6 ]. They could be more efficient in healthcare spending and would be a useful tool in planning new healthcare infrastructures.…”

Eficiencia de los hospitales públicos del Sistema de Salud de Castilla y León

“…por un hospital general catalán de 724 camas y 94,35% de índice de ET y lo cierra en el puesto 286 un hospital materno-infantil de 54 camas, también catalán, con una eficiencia del 31,31%. Los 14 hospitales de Castilla y León ocupan los lugares 9 Sin embargo, frente al menor número de estudios de ámbito nacional, donde la muestra hospitalaria analizada es considerable, en España la mayoría de los estudios son de ámbito regional(Calzado Cejas, García Valderrama, Laffarga Briones et al, 1998;Ventura Victoria y González Fidalgo, 1999; Navarro Espigares, 1999; Alfonso Sánchez yGuerrero Fernández, 2002;Prior D, 2006 ; Seijas Díaz e Iglesias Gómez, 2009;Clemente Collado, 2014; Herrero Tabanera, Martín Martín y López del Amo González, 2015;Ferrándiz Gomis, 2017; Franco Miguel y Fullana Belda, 2019, Franco Miguel y Fullana Belda, 2020 e incorporan, lógicamente, un número menor de unidades hospitalarias a analizar, siendo muy relevante el problema de la dimensión del modelo en dichos estudios. Por eso vamos a comparar los resultados de nuestro estudio con algunos de los estudios regionales citados.…”