The effect of activity-based financing on hospital efficiency: A panel data analysis of DEA efficiency scores 1992-2000

被引:102
作者
Erik Biørn
Terje P. Hagen
Tor Iversen
Jon Magnussen
机构
[1] Department of Economics, University of Oslo, NO-0317 Oslo
[2] Health Economics Research Programme, University of Oslo (HERO)
[3] Center for Health Administration, University of Oslo, Rikshospitalet
[4] SINTEF Unimed Hlth. Serv. Research
关键词
DEA-scores; Efficiency; Financing; Norway; Panel data; Public hospitals;
D O I
10.1023/A:1026212820367
中图分类号
学科分类号
摘要
Activity-based financing (ABF) was implemented in the Norwegian hospital sector from 1 July 1997. A fraction of the block grant from the state to the county councils has been replaced by a matching grant depending upon the number and composition of hospital treatments. As a result of the reform, the majority of county councils have introduced activity-based contracts with their hospitals. This paper studies the effect of activity-based funding on hospital efficiency. We predict that hospital efficiency will increase because the benefit from cost-reducing efforts in terms of number of treated patients is increased under ABF as compared with global budgets. The prediction is tested using a panel data set from the period 1992-2000. Efficiency indicators are estimated by means of data envelopment analysis (DEA) with multiple inputs and outputs. Using a variety of econometric methods, we find that the introduction of ABF has improved efficiency when measured as technical efficiency according to DEA analysis. The result is less uniform with respect to the effect on cost-efficiency.
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页码:271 / 283
页数:12
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