ArticleHealth care management science2020
Analyzing economies of scale and scope in hospitals by use of case mix planning.
Article in Health care management science, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 10 papers.
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Who cites it
10 citing papers in PubMed.
- Rural-Urban Differences in the Incorporation of Workforce Planning and Development in the Strategic Planning Process of US Hospitals.The Journal of rural health : official journal of the American Rural Health Association and the National Rural Health Care Association · 2026Article
- Assessing the cost implications of integrating and scaling up HIV services for key populations in Kenya and Malawi.Health policy and planning · 2026Article
- Influencing factors of hospitalization costs for patients with subsequent osteoporotic hip fractures: multilevel model analysis by fracture episode.Frontiers in endocrinology · 2026Article
- Economies of scope in the Norwegian public hospital sector.The European journal of health economics : HEPAC : health economics in prevention and care · 2025Article
- Analytical Techniques for Supporting Hospital Case Mix Planning Encompassing Forced Adjustments, Comparisons, and Scoring.Healthcare (Basel, Switzerland) · 2024Article
- Article
- An Overview of Hospital Capacity Planning and Optimisation.Healthcare (Basel, Switzerland) · 2022Review
- Multilevel Zero-One Inflated Beta Regression Model for the Analysis of the Relationship between Exogenous Health Variables and Technical Efficiency in the Spanish National Health System Hospitals.International journal of environmental research and public health · 2021Article
- Patient Mix Optimization in Admission Planning under Multitype Patients and Priority Constraints.Computational and mathematical methods in medicine · 2021Article
- Investigating the link between medical urgency and hospital efficiency - Insights from the German hospital market.Health care management science · 2020Article
Corrections and comments
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Authors and funding
3 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
This study analyzes the effect of economies of scale and scope on the optimal case mix of a hospital or hospital system. With respect to the ideal volume and patient composition, the goal is to evaluate (i) the impact of changes in the efficiency of resource use with increasing scale, and (ii) to determine the potential effects of spreading fixed costs over a greater number of patients. The problem is formulated as a non-linear mixed integer program. It turns out that this non-linear program is too difficult to be solved with standard software. As an alternative, an iterative procedure using piecewise linear approximations to derive lower and upper bounds is proposed and shown to converge to the optimum. The procedure is applied using a public database on German hospital costs and performance statistics. Results indicate that changes in the efficiency of resource use with increasing scale have a considerable impact if similar services can be consolidated, e.g., among different departments. However, if the scope for decision-making regarding the case mix of a hospital is limited, such changes may be negligible.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.