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Decomposing the productivity differences between hospitals in the Nordic countries

Author

Listed:
  • Kittelsen, Sverre A.C.

    (Frisch Centre)

  • Persson, Benny Adam

    (Frisch Centre)

  • Rehnberg, Clas

    (Karolinska Institutet, Stockholm)

  • Anthun, Kjartan S.

    (SINTEF)

  • Goude, Fanny

    (Karolinska Institutet)

  • Rättö, Hanna

    (National Institute for Health and Welfare – THL, Helsinki)

  • Hope, Øyvind

    (SINTEF)

  • Häkkinen, Unto

    (National Institute for Health and Welfare – THL, Helsinki)

  • Medin, Emma

    (Karolinska Institutet, Stockholm)

  • Kalseth, Birgitte

    (SINTEF)

  • Kilsmark, Jannie

    (Danish Institute of health research, Copenhagen)

Abstract
Previous studies indicate that Finnish hospitals have significantly higher productivity than in the other Nordic countries. We decompose the productivity levels into technical efficiency, scale efficiency and country specific possibility sets (technical frontiers). Data have been collected on operating costs and patient discharges in each DRG group for all hospitals in the Nordic countries. We find that there are small differences in scale and technical efficiency between countries, but large differences in production possibilities (frontier position). The results are robust to the choice of bootstrapped Data Envelopment Analysis (DEA) or Stochastic Frontier Analysis (SFA) as frontier estimation methodology.

Suggested Citation

  • Kittelsen, Sverre A.C. & Persson, Benny Adam & Rehnberg, Clas & Anthun, Kjartan S. & Goude, Fanny & Rättö, Hanna & Hope, Øyvind & Häkkinen, Unto & Medin, Emma & Kalseth, Birgitte & Kilsmark, Jannie, 2014. "Decomposing the productivity differences between hospitals in the Nordic countries," HERO Online Working Paper Series 2013:4, University of Oslo, Health Economics Research Programme.
    • Handle: RePEc:hhs:oslohe:2013_004
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    References listed on IDEAS

    as
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    Full references (including those not matched with items on IDEAS)

    Citations

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    Cited by:

    1. Mª Isabel Ortega-Díaz & Ricardo Ocaña-Riola & Carmen Pérez-Romero & José Jesús Martín-Martín, 2020. "Multilevel Analysis of the Relationship between Ownership Structure and Technical Efficiency Frontier in the Spanish National Health System Hospitals," IJERPH, MDPI, vol. 17(16), pages 1-19, August.
    2. Anthun, Kjartan Sarheim & Kittelsen, Sverre Andreas Campbell & Magnussen, Jon, 2017. "Productivity growth, case mix and optimal size of hospitals. A 16-year study of the Norwegian hospital sector," Health Policy, Elsevier, vol. 121(4), pages 418-425.
    3. Kerstens, Kristiaan & O’Donnell, Christopher & Van de Woestyne, Ignace, 2019. "Metatechnology frontier and convexity: A restatement," European Journal of Operational Research, Elsevier, vol. 275(2), pages 780-792.
    4. Kao, Chiang & Pang, Rui-Zhi & Liu, Shiang-Tai & Bai, Xue-Jie, 2021. "Most productive types of hospitals: An empirical analysis," Omega, Elsevier, vol. 99(C).
    5. Sverre A. C. Kittelsen & Kjartan S. Anthun & Fanny Goude & Ingrid M. S. Huitfeldt & Unto Häkkinen & Marie Kruse & Emma Medin & Clas Rehnberg & Hanna Rättö & on behalf of the EuroHOPE study group, 2015. "Costs and Quality at the Hospital Level in the Nordic Countries," Health Economics, John Wiley & Sons, Ltd., vol. 24(S2), pages 140-163, December.
    6. Mariarosaria Agostino & Sabrina Ruberto & Francesco Trivieri, 2018. "Lasting lending relationships and technical efficiency. Evidence on European SMEs," Journal of Productivity Analysis, Springer, vol. 50(1), pages 25-40, October.

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    More about this item

    Keywords

    Productivity; Hospitals; Efficiency; DEA; SFA;
    All these keywords.

    JEL classification:

    • C14 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Semiparametric and Nonparametric Methods: General
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

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