[go: up one dir, main page]
IDEAS home Printed from https://ideas.repec.org/a/wly/hlthec/v13y2004i2p157-169.html
   My bibliography  Save this article

Excess capacity and expense preference behaviour in National Health Systems: an application to the Spanish public hospitals

Author

Listed:
  • Ana Rodríguez‐Álvarez
  • C. A. Knox Lovell
Abstract
The aim of this paper is to study excess capacity in National Health System (NHS) hospitals, which have the characteristics of a bureaucracy, within a theoretically consistent framework. In this sense, we develop and estimate an empirical model which has not previously been applied to this problem. This model, based on an input distance function, is attractive for at least two reasons. Unlike the production function, the input distance function is valid for multiproduct technologies such as that of hospitals, and in contrast to the cost function it permits testing of the cost minimisation hypothesis and therefore allows expense preference behaviour in the context of NHS hospitals. We present an application to the Spanish public hospital sector and observe persistent allocative inefficiency in variable inputs and overcapitalisation in these hospitals. Hence, our results suggest that this sector is not in long‐run equilibrium and that adjustments in variable inputs and capital equipment investments are necessary to control hospital cost. Copyright © 2003 John Wiley & Sons, Ltd.

Suggested Citation

  • Ana Rodríguez‐Álvarez & C. A. Knox Lovell, 2004. "Excess capacity and expense preference behaviour in National Health Systems: an application to the Spanish public hospitals," Health Economics, John Wiley & Sons, Ltd., vol. 13(2), pages 157-169, February.
    • Handle: RePEc:wly:hlthec:v:13:y:2004:i:2:p:157-169
    DOI: 10.1002/hec.803
    as

    Download full text from publisher

    File URL: https://doi.org/10.1002/hec.803
    Download Restriction: no
    File URL: https://libkey.io/10.1002/hec.803?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    References listed on IDEAS

    as
    1. Hausman, Jerry, 2015. "Specification tests in econometrics," Applied Econometrics, Russian Presidential Academy of National Economy and Public Administration (RANEPA), vol. 38(2), pages 112-134.
    2. Mark Pauly, 1980. "Doctors and Their Workshops: Economic Models of Physician Behavior," NBER Books, National Bureau of Economic Research, Inc, number paul80-1.
    3. R. G. Evans, 1971. "'Behavioural' Cost Functions for Hospitals," Canadian Journal of Economics, Canadian Economics Association, vol. 4(2), pages 198-215, May.
    4. Cornes,Richard, 1992. "Duality and Modern Economics," Cambridge Books, Cambridge University Press, number 9780521336017, September.
    5. McGuire, Alistair, 1987. "The measurement of hospital efficiency," Social Science & Medicine, Elsevier, vol. 24(9), pages 719-724, January.
    6. Grosskopf Shawna & Hayes Kathy, 1993. "Local Public Sector Bureaucrats and Their Input Choices," Journal of Urban Economics, Elsevier, vol. 33(2), pages 151-166, March.
    7. Keeler, Theodore E & Ying, John S, 1996. "Hospital Costs and Excess Bed Capacity: A Statistical Analysis," The Review of Economics and Statistics, MIT Press, vol. 78(3), pages 470-481, August.
    8. Fare, Rolf & Grosskopf, Shawna, 1990. "A distance function approach to price efficiency," Journal of Public Economics, Elsevier, vol. 43(1), pages 123-126, October.
    9. Ernst Berndt & Ann Friedlaender & Judy Chiang & Christopher Vellturo, 1993. "Cost effects of mergers and deregulation in the U.S. Rail industry," Journal of Productivity Analysis, Springer, vol. 4(1), pages 127-144, June.
    10. Ferrier, Gary D. & Lovell, C. A. Knox, 1990. "Measuring cost efficiency in banking : Econometric and linear programming evidence," Journal of Econometrics, Elsevier, vol. 46(1-2), pages 229-245.
    11. Guillem López Casasnovas & Adam Wagstaff, 1988. "La combinación de los factores productivos en el hospital: una aproximación a la función de producción," Investigaciones Economicas, Fundación SEPI, vol. 12(2), pages 305-327, May.
    12. Jensen, Gail A & Morrisey, Michael A, 1986. "The Role of Physicians in Hospital Production," The Review of Economics and Statistics, MIT Press, vol. 68(3), pages 432-442, August.
    13. Coelli, Tim & Perelman, Sergio, 1999. "A comparison of parametric and non-parametric distance functions: With application to European railways," European Journal of Operational Research, Elsevier, vol. 117(2), pages 326-339, September.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Briec, Walter & Kerstens, Kristiaan & Prior, Diego & Van de Woestyne, Ignace, 2010. "Tangency capacity notions based upon the profit and cost functions: A non-parametric approach and a general comparison," Economic Modelling, Elsevier, vol. 27(5), pages 1156-1166, September.
    2. Orea, Luis, 2019. "The Econometric Measurement of Firms’ Efficiency," Efficiency Series Papers 2019/02, University of Oviedo, Department of Economics, Oviedo Efficiency Group (OEG).
    3. Fabrizio Erbetta & Carmelo Petraglia, 2011. "Drivers of Regional Efficiency Differentials in Italy: Technical Inefficiency or Allocative Distortions?," Growth and Change, Wiley Blackwell, vol. 42(3), pages 351-375, September.
    4. Ana Rodríguez Álvarez & Víctor Fernández Blanco & José Baños Pino, 2005. "El efecto de la regulación sobre la eficiencia productiva: una aplicación a las compañías ferroviarias europeas," Investigaciones Economicas, Fundación SEPI, vol. 29(2), pages 351-378, May.
    5. C. A. Knox Lovell & Ana Rodríguez‐Álvarez & Alan Wall, 2009. "The effects of stochastic demand and expense preference behaviour on public hospital costs and excess capacity," Health Economics, John Wiley & Sons, Ltd., vol. 18(2), pages 227-235, February.
    6. Rodríguez-Álvarez, Ana & Rosete-Rivero, Mayte, 2017. "Spanish public hospital waiting lists: A theoretical and empirical approach," Economics - The Open-Access, Open-Assessment E-Journal (2007-2020), Kiel Institute for the World Economy (IfW Kiel), vol. 11, pages 1-21.
    7. Rodriguez-Alvarez, Ana & Tovar, Beatriz & Trujillo, Lourdes, 2007. "Firm and time varying technical and allocative efficiency: An application to port cargo handling firms," International Journal of Production Economics, Elsevier, vol. 109(1-2), pages 149-161, September.
    8. Ancarani, Alessandro & Di Mauro, Carmela & Gitto, Simone & Mancuso, Paolo & Ayach, Ali, 2016. "Technology acquisition and efficiency in Dubai hospitals," Technological Forecasting and Social Change, Elsevier, vol. 113(PB), pages 475-485.
    9. Rodríguez-Álvarez, Ana & Tovar de la Fe, Beatriz & Trujillo, Lourdes, 2004. "Technical and Allocative Efficiency in Spanish Port Cargo Handling Firms," Efficiency Series Papers 2004/04, University of Oviedo, Department of Economics, Oviedo Efficiency Group (OEG).
    10. Tim Coelli & Gholamreza Hajargasht & C.A. Knox Lovell, 2008. "Econometric Estimation of an Input Distance Function in a System of Equations," CEPA Working Papers Series WP012008, School of Economics, University of Queensland, Australia.
    11. Blank, Jos L. T. & Vogelaar, Iris, 2004. "Specifying technical change: a research on the nature of technical change in Dutch hospital industry," The Quarterly Review of Economics and Finance, Elsevier, vol. 44(3), pages 448-463, July.
    12. Maria J. Perez-Villadóniga & Ana Rodriguez-Alvarez & David Roibas, 2022. "The contribution of resident physicians to hospital productivity," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(2), pages 301-312, March.
    13. Lota, Tamini D. & Bruno, Larue & West, Gale E., 2011. "Technical Efficiency, Environment Efficiency, Productivity and Beneficial Management Practices," Working Papers 102067, Structure and Performance of Agriculture and Agri-products Industry (SPAA).
    14. Barros, Carlos Pestana & Menezes, Antonio & Vieira, José António Cabral & Peypoch, Nicolas & Solonandrasana, Bernardin, 2007. "An Analysis of Hospital Efficiency and Productivity Growth Using the Luenberger Productivity Indicator," IZA Discussion Papers 2689, Institute of Labor Economics (IZA).
    15. Walter Briec & Kristiaan Kerstens & Diego Prior, 2009. "Tangency Capacity Notions Based upon the Pro?t and Cost Functions: A Non-Parametric Approach and a Comparison," Working Papers 2009-ECO-05, IESEG School of Management.
    16. Jos L. T. Blank & Bart L. Van Hulst, 2009. "Productive innovations in hospitals: an empirical research on the relation between technology and productivity in the Dutch hospital industry," Health Economics, John Wiley & Sons, Ltd., vol. 18(6), pages 665-679, June.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Rodriguez-Alvarez, Ana & Fernandez-Blanco, Victor & Lovell, C. A. Knox, 2004. "Allocative inefficiency and its cost:: The case of Spanish public hospitals," International Journal of Production Economics, Elsevier, vol. 92(2), pages 99-111, November.
    2. Banos-Pino, Jose & Fernandez-Blanco, Victor & Rodriguez-Alvarez, Ana, 2002. "The allocative efficiency measure by means of a distance function: The case of Spanish public railways," European Journal of Operational Research, Elsevier, vol. 137(1), pages 191-205, February.
    3. Luis R. Murillo‐Zamorano, 2004. "Economic Efficiency and Frontier Techniques," Journal of Economic Surveys, Wiley Blackwell, vol. 18(1), pages 33-77, February.
    4. Gema Carrera-Gómez & José Baños-Pino & Pablo Coto-Millán & Vicente López de Sabando, 2005. "Rate of Return Regulation: The Case of Spanish Ports," International Advances in Economic Research, Springer;International Atlantic Economic Society, vol. 11(2), pages 191-200, May.
    5. Ana Rodríguez Álvarez & Víctor Fernández Blanco & José Baños Pino, 2005. "El efecto de la regulación sobre la eficiencia productiva: una aplicación a las compañías ferroviarias europeas," Investigaciones Economicas, Fundación SEPI, vol. 29(2), pages 351-378, May.
    6. Drake, Leigh & Simper, R., 2003. "The measurement of English and Welsh police force efficiency: A comparison of distance function models," European Journal of Operational Research, Elsevier, vol. 147(1), pages 165-186, May.
    7. Rodriguez-Alvarez, Ana & Del Rosal, Ignacio & Baños Pino, Jose, 2002. "Rent-seeking measurement in coal mining by means of labour unrest: an application of the distance function," MPRA Paper 3682, University Library of Munich, Germany.
    8. Tim Coelli & Gholamreza Hajargasht & C.A. Knox Lovell, 2008. "Econometric Estimation of an Input Distance Function in a System of Equations," CEPA Working Papers Series WP012008, School of Economics, University of Queensland, Australia.
    9. repec:kap:iaecre:v:11:y:2005:i:2:p:191-200 is not listed on IDEAS
    10. Drake, Leigh M. & Simper, Richard, 2005. "Police Efficiency in Offences Cleared: An Analysis of English "Basic Command Units"," International Review of Law and Economics, Elsevier, vol. 25(2), pages 186-208, June.
    11. Bouali Guesmi & Teresa Serra & Amr Radwan & José María Gil, 2018. "Efficiency of Egyptian organic agriculture: A local maximum likelihood approach," Agribusiness, John Wiley & Sons, Ltd., vol. 34(2), pages 441-455, March.
    12. Bouali Guesmi & Teresa Serra & Allen Featherstone, 2015. "Technical efficiency of Kansas arable crop farms: a local maximum likelihood approach," Agricultural Economics, International Association of Agricultural Economists, vol. 46(6), pages 703-713, November.
    13. Mike Tsionas & Marwan Izzeldin & Arne Henningsen & Evaggelos Paravalos, 2022. "Addressing endogeneity when estimating stochastic ray production frontiers: a Bayesian approach," Empirical Economics, Springer, vol. 62(3), pages 1345-1363, March.
    14. Kozo Harimaya & Kei Tomimura & Nobuyoshi Yamori, 2015. "Efficiencies of Small Financial Cooperatives in Japan: Comparison of Estimation Methods," Discussion Paper Series DP2015-04, Research Institute for Economics & Business Administration, Kobe University.
    15. Francesco Aiello & Graziella Bonanno, 2018. "On The Sources Of Heterogeneity In Banking Efficiency Literature," Journal of Economic Surveys, Wiley Blackwell, vol. 32(1), pages 194-225, February.
    16. Estache, Antonio & Kouassi, Eugene, 2002. "Sector organization, governance, and the inefficiency of African water utilities," Policy Research Working Paper Series 2890, The World Bank.
    17. Aiken, Deborah Vaughn, 2006. "Application of the distance function to nonmarket valuation of environmental goods and services: An illustrative example," Ecological Economics, Elsevier, vol. 60(1), pages 168-175, November.
    18. C. Lovell & Shawna Grosskopf & Eduardo Ley & Jesús Pastor & Diego Prior & Philippe Eeckaut, 1994. "Linear programming approaches to the measurement and analysis of productive efficiency," TOP: An Official Journal of the Spanish Society of Statistics and Operations Research, Springer;Sociedad de Estadística e Investigación Operativa, vol. 2(2), pages 175-248, December.
    19. Pablo Alonso González & Irene Albarrán Lozano & Andrea Giuliodori Khalil, 2006. "El Impacto del descenso en los Tipos de Interés sobre el margen financiero de las Cajas de Ahorros españolas," Revista de Economía y Estadística, Universidad Nacional de Córdoba, Facultad de Ciencias Económicas, Instituto de Economía y Finanzas, vol. 44(1), pages 98-136, Junio.
    20. Galina Besstremyannaya, 2015. "Heterogeneous effect of residency matching and prospective payment on labor returns and hospital scale economies," Discussion Papers 15-001, Stanford Institute for Economic Policy Research.
    21. Odolinski, Kristofer & Smith, Andrew S.J., 2014. "Assessing the Cost Impact of Competitive Tendering in Rail Infrastructure Maintenance Services: Evidence from the Swedish Reforms (1999 to 2011)," Working papers in Transport Economics 2014:17, CTS - Centre for Transport Studies Stockholm (KTH and VTI), revised 22 May 2015.

    More about this item

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:wly:hlthec:v:13:y:2004:i:2:p:157-169. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Wiley Content Delivery (email available below). General contact details of provider: http://www3.interscience.wiley.com/cgi-bin/jhome/5749 .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.