ArticleBMC health services research2021
Inefficiency of public hospitals: a multistage data envelopment analysis in an Italian region.
Article in BMC health services research, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 1 of them a synthesis that pooled it.
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Who cites it
27 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Approach in inputs & outputs selection of Data Envelopment Analysis (DEA) efficiency measurement in hospitals: A systematic review.PloS one · 2024Pooled it
- Evaluating Hospital Efficiency and Productivity: A Bootstrap-Corrected DEA and Malmquist Analysis.Healthcare (Basel, Switzerland) · 2026Article
- Operational efficiency in public infectious disease hospitals across 31 provinces in China: a three-phase data envelopment analysis.BMJ open · 2026Article
- Efficiency and spatial equity of healthcare resource allocation in traditional Chinese medicine hospitals in China (2012-2023).BMC health services research · 2026Article
- Evaluation on the efficiencies of centers for disease control and prevention in China: results from a 12-year national survey.BMC public health · 2026Article
- Unravelling heterogeneity in efficiency measurements: a case study of public hospitals in Spain.The European journal of health economics : HEPAC : health economics in prevention and care · 2026Article
- Hospital efficiency assessment: a systematic review of DEA and hybrid DEA-machine learning approaches.Frontiers in medical technology · 2026Review
- Total factor productivity growth and spatial-temporal evolution of China's health system: a three-stage DEA-Malmquist approach.Frontiers in public health · 2026Article
- Correlation analysis between single disease quality management and efficiency indicators of a tertiary hospital in China.BMC health services research · 2025Article
- The efficiency of secondary-level hospitals in hard-to-reach and non-hard-to-reach areas in Bangladesh: a data envelopment analysis approach.BMC health services research · 2025Article
- Performance of Greek Public Hospitals Before and After the Economic Recession and the Pandemic: Application of a Novel Cost Malmquist Index for Comparing Productivity Across Multiple Groups.Healthcare (Basel, Switzerland) · 2025Article
- Efficiency analysis of oral health resource allocation in public medical institutions in Yunnan Province at the end of the 13th five-year plan in China.BMC oral health · 2025Article
- Supporting managerial decisions: a comparison of new robotic platforms through time-driven activity-based costing within a value-based healthcare framework.BMC health services research · 2025Article
- Evaluating hospital performance with additive DEA and MPI: the Isfahan University of Medical Science case study.BMC health services research · 2025Article
- Evaluating the operational efficiency of the compact urban medical group in Qiqihar based on the three-stage DEA and Malmquist index model.Frontiers in public health · 2025Article
- The Impact of Autonomy Reform on the Efficiency of Public Hospitals in China: A DEA-ITSA Combination Analysis.Risk management and healthcare policy · 2025Article
- Application of mathematical models on efficiency evaluation and intervention of medical institutions in China.BMC health services research · 2024Article
- Determination of Ideal Factors for Early Adoption and Standardization of Metagenomic Next-generation Sequencing for Respiratory System Infections.Current pharmaceutical biotechnology · 2024Article
- Definition and understanding of "efficiency" in healthcare provision research: a scoping review.Frontiers in public health · 2024Article
- The efficiency evaluation of traditional Chinese medicine hospitals by data envelopment analysis in Zhengzhou, China.Frontiers in public health · 2024Article
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4 authors.
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Abstract
backgroundThe objective of this study was to assess public hospital efficiency, including quality outputs, inefficiency determinants, and changes to efficiency over time, in an Italian region. To achieve this aim, the study used secondary data from the Veneto region for the years 2018 and 2019.
methodsA nonparametric approach-that is, multistage data envelopment analysis (DEA)-was applied to a sample of 43 hospitals. We identified three categories of input: capital investments (Beds), labor (FTE), operating expenses. We selected five efficiency outputs (outpatient visits, inpatients, outpatient visit revenue, inpatient revenue, bed occupancy rate) and two quality outputs (mortality rate and inappropriate admission rate). Efficiency scores were estimated and decomposed into two components. Slack analysis was then conducted. Further, DEA efficiency scores were regressed on internal and external variables using a Tobit model. Finally, the Malmquist Productivity Index was applied.
resultsOn average, the hospitals in the Veneto region operated at more than 95% efficiency. Technical and scale inefficiencies often occurred jointly, with 77% of inefficient hospitals needing a downsizing strategy to gain efficiency. The inputs identified as needing significant reductions were full-time employee (FTE) administrative staff and technicians. The size of the hospital in relation to the size of the population served and the length of patient stay were important factors for the efficiency score. The major cause of decreased efficiency over time was technical change (0.908) rather than efficiency change (0.974).
conclusionsThe study reveals improvements that should be made from both the policy and managerial perspectives. Hospital size is an important feature of inefficiency. On average, the results show that it is advisable for hospitals to reorganize nonmedical staff to enhance efficiency. Further, increasing technology investment could enable higher efficiency levels.
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