ArticleInternational journal of health economics and management2023
Analyzing the effect of health reforms on the efficiency of Ecuadorian public hospitals.
Article in International journal of health economics and management, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.
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Who cites it
4 citing papers in PubMed.
- Financing Regimes and Case-Mix Complexity in Psychiatric Hospitals Beyond the Pandemic Shock-Insights from a Regional European Healthcare System.Healthcare (Basel, Switzerland) · 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
- Health insurance coverage in Mexico: progress, inequalities and remaining challenges towards UHC2030.Health research policy and systems · 2025Article
- Efficiency and Productivity Change of Public Hospitals in Panama: Do Management Schemes Matter?International journal of environmental research and public health · 2021Article
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Authors and funding
2 authors.
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Abstract
This study aims to assess whether Ecuadorian health reforms carried out since 2008 have affected the efficiency performance of public hospitals in the country. We contribute to the literature by shedding new light on the effects on public healthcare efficiency for developing countries when policies move toward health equity and universal coverage. We follow a two-stage approach, wherein the first stage we make use of factor and cluster analysis to obtain three clusters of public hospitals based on their technological endowment; we exploit Data Envelopment Analysis for panel data in the second stage to estimate robust efficiency measures over time. Our innovative empirical strategy considers the heterogeneity of healthcare institutions in the analysis of their efficiency performance. The results show a significant decrease in the average efficiency of low and intermediate technology hospitals after the new constitution was adopted in 2008. The decline in efficiency coincides with the two reforms of 2010 and 2011 that brought on higher social security coverage.
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