ArticleThe European journal of health economics : HEPAC : health economics in prevention and care2014
Cost effects of hospital mergers in Portugal.
Article in The European journal of health economics : HEPAC : health economics in prevention and care, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 37 citations in OpenAlex.
- Article
- Academic medical centres in the Netherlands: muddling through or radical change?Frontiers in public health · 2023Article
- An Incentive-Based Framework for Analyzing the Alignment of Institutional Interventions in the Public Primary Healthcare Sector: The Portuguese Case.Healthcare (Basel, Switzerland) · 2021Article
- Assessing the performance of hospitals before and after the implementation of Iran's Health Sector Evolution Plan (HSEP) using the Pabon Lasso model.Medical journal of the Islamic Republic of Iran · 2021Article
- Efficiency and scale effect of county public hospitals in Shandong Province, China: a cross-sectional study.BMJ open · 2020Article
- Balancing the health workforce: breaking down overall technical change into factor technical change for labour-an empirical application to the Dutch hospital industry.Human resources for health · 2017Article
- Review
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Authors and funding
2 authors at 1 institution in 1 country.
Funding
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Abstract
The Portuguese hospital sector has been restructured by wide-ranging hospital mergers, following a conviction among policy makers that bigger hospitals lead to lower average costs. Since the effects of mergers have not been systematically evaluated, the purpose of this article is to contribute to this area of knowledge by assessing potential economies of scale to explore and compare these results with realized cost savings after mergers. Considering the period 2003-2009, we estimate the translog cost function to examine economies of scale in the years preceding restructuring. Additionally, we use the difference-in-differences approach to evaluate hospital centres (HC) that occurred between 2004 and 2007, comparing the years after and before mergers. Our findings suggest that economies of scale are present in the pre-merger configuration with an optimum hospital size of around 230 beds. However, the mergers between two or more hospitals led to statistically significant post-merger cost increases, of about 8 %. This result indicates that some HC become too large to explore economies of scale and suggests the difficulty of achieving efficiencies through combining operations and service specialization.
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