0000000000267798
AUTHOR
Francesca Sapienza
Evaluating the effect of organization and context on technical efficiency: a second-stage DEA analysis of Italian hospitals
Objective: the purpose of this study was to compare the technical efficiency of Italian hospitals at a regional level and to examine if differences could be explained by organisational and contextual factors. Technical efficiency was defined as the ability of the operating units evaluated to use optimal resource levels for their level of output.Methods: the effect of external factors was explored through a second stage Data Envelopment Analysis (DEA). Efficiency scores were calculated for each hospital using the DEA method (Stage I). Through Tobit regression analysis, the estimated efficiency scores were regressed against a set of organisational and contextual characteristics beyond manager…
Valutazione degli effetti della legge di riordino del Servizio Sanitario Regionale siciliano su efficienza e appropriatezza delle prestazioni ospedaliere
La Legge Regionale n. 5 del 14 aprile 2009 segna un punto di svolta nel processo di riforme che ha interessato il Servizio Sanitario della Regione Siciliana, introducendo, tra l’altro, interventi mirati alla razionalizzazione della rete ospedaliera. Obiettivo del presente lavoro è valutare gli effetti della riforma sulla produzione dei servizi ospedalieri in termini di efficienza e di appropriatezza. L’ipotesi da verificare è se il mutamento del quadro normativo, entro il quale si sono trovati ad operare gli ospedali pubblici e privati accreditati, ha reso possibile il raggiungimento degli obiettivi prestabiliti di efficienza, di riduzione degli sprechi nell’utilizzo delle risorse e miglior…
Evaluating the Reform of Healthcare System in Sicily: variations of efficiency and appropriateness between 2008 and 2010

 
 Background. Sicilian government has developed a very ambitious Reform through the Regional Law n. 5 (14th April 2009). Hospitals were requested to ensure the quality of care through monitoring of appropriateness and quality of service. The aim of this study was to assess variations of efficiency and organizational appropriateness of healthcare delivery before and after this Reform and to show patterns associated to different types of healthcare delivery organizations.
 Methods. This study was based on repeated cross-sectional data for 118 (out of 129) short-term, acute-care, non teaching-and-research Sicilian hospitals, in 2008 and 2010. Congestion and slacks analysis was…
Congestion analysis to evaluate the efficiency and appropriateness of hospitals in Sicily
Over the past twenty years, important changes in the Italian National Health System have been made in order to obtain significant improvements in the efficiency, appropriateness and quality of health care delivery, while reducing health expenditure. In this paper we proposed a multidimensional approach to assess the impact of organization inappropriateness on the efficiency evaluation of hospitals in Sicily for the year 2009. This study was based on cross-sectional data for 116 (out of 129) short-term, acute-care hospitals. The analysis considered beds, physicians, nurses and other personnel as inputs, ordinary discharges and day-hospital admissions as desirable outputs and inappropriate di…