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

Background: One of the major issues discussed in the literature about hospital efficiency is the impact of hospital size on technical efficiency. Many studies have observed that in some cases, hospital technical inefficiency is correlated with an incorrect size. This paper addresses this topic. In p...

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Main Authors: Monica Giancotti, Giorgia Rotundo, Vito Pipitone, Marianna Mauro
Format: Article
Language:English
Published: Milano University Press 2018-12-01
Series:Epidemiology, Biostatistics and Public Health
Online Access:https://ebph.it/article/view/12929
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author Monica Giancotti
Giorgia Rotundo
Vito Pipitone
Marianna Mauro
author_facet Monica Giancotti
Giorgia Rotundo
Vito Pipitone
Marianna Mauro
author_sort Monica Giancotti
collection DOAJ
description Background: One of the major issues discussed in the literature about hospital efficiency is the impact of hospital size on technical efficiency. Many studies have observed that in some cases, hospital technical inefficiency is correlated with an incorrect size. This paper addresses this topic. In particular, we attempt to identify an optimal size of hospitals in terms of beds. Methods: The study is organized as follow: first, we performed the Data Envelopment Analysis in order to calculate the technical and scale efficiency scores for a sample of 41 Italian public hospitals during the period 2010-2013; second, we investigated the impact of 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 attempted to identify an optimal size for hospitals in terms of beds. Results: Most of the hospitals were inefficient and most of the inefficiency was the results of the presence of waste in terms of input resources. During the period considered, we found that inputs could be reduced by 22% on average. Economies of scale were found 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.
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spelling doaj-art-cf7cdad45147495cbf9991493a967eae2025-08-20T02:12:53ZengMilano University PressEpidemiology, Biostatistics and Public Health2282-09302018-12-0115410.2427/1292911185Efficiency and Optimal size of Italian Public Hospitals: Results from Data Envelopment AnalysisMonica Giancotti0Giorgia Rotundo1Vito Pipitone2Marianna Mauro3Department of Clinical and Experimental Medicine, Magna Graecia University, Viale Europa, Catanzaro, ItalyDepartment of Legal, Historical, Economic and Social Sciences, Magna Graecia University, Catanzaro, ItalyNational Research Council, Mazzara del Vallo, ItalyDepartment of Clinical and Experimental Medicine, Magna Graecia University, Viale Europa, Catanzaro, ItalyBackground: One of the major issues discussed in the literature about hospital efficiency is the impact of hospital size on technical efficiency. Many studies have observed that in some cases, hospital technical inefficiency is correlated with an incorrect size. This paper addresses this topic. In particular, we attempt to identify an optimal size of hospitals in terms of beds. Methods: The study is organized as follow: first, we performed the Data Envelopment Analysis in order to calculate the technical and scale efficiency scores for a sample of 41 Italian public hospitals during the period 2010-2013; second, we investigated the impact of 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 attempted to identify an optimal size for hospitals in terms of beds. Results: Most of the hospitals were inefficient and most of the inefficiency was the results of the presence of waste in terms of input resources. During the period considered, we found that inputs could be reduced by 22% on average. Economies of scale were found 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.https://ebph.it/article/view/12929
spellingShingle Monica Giancotti
Giorgia Rotundo
Vito Pipitone
Marianna Mauro
Efficiency and Optimal size of Italian Public Hospitals: Results from Data Envelopment Analysis
Epidemiology, Biostatistics and Public Health
title Efficiency and Optimal size of Italian Public Hospitals: Results from Data Envelopment Analysis
title_full Efficiency and Optimal size of Italian Public Hospitals: Results from Data Envelopment Analysis
title_fullStr Efficiency and Optimal size of Italian Public Hospitals: Results from Data Envelopment Analysis
title_full_unstemmed Efficiency and Optimal size of Italian Public Hospitals: Results from Data Envelopment Analysis
title_short Efficiency and Optimal size of Italian Public Hospitals: Results from Data Envelopment Analysis
title_sort efficiency and optimal size of italian public hospitals results from data envelopment analysis
url https://ebph.it/article/view/12929
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AT vitopipitone efficiencyandoptimalsizeofitalianpublichospitalsresultsfromdataenvelopmentanalysis
AT mariannamauro efficiencyandoptimalsizeofitalianpublichospitalsresultsfromdataenvelopmentanalysis