Spatial heterogeneity in non-parametric efficiency: An application to Italian hospitals

M Auteri; C Guccio; F Pammolli; G Pignataro; F Vidoli

doi:10.1016/j.socscimed.2019.112544

Spatial heterogeneity in non-parametric efficiency: An application to Italian hospitals

Soc Sci Med. 2019 Oct:239:112544. doi: 10.1016/j.socscimed.2019.112544. Epub 2019 Sep 16.

Authors

M Auteri¹, C Guccio², F Pammolli³, G Pignataro⁴, F Vidoli⁵

Affiliations

¹ Department of Political Science, University of Roma Tre, Italy.
² Department of Economics and Business, University of Catania, Italy.
³ DIG, Department of Management, Economics and Industrial Engineering, Politecnico di Milano, Italy; CADS, Center for Analysis, Decisions and Society, Human Technopole, Politecnico di Milano, Italy.
⁴ DIG, Department of Management, Economics and Industrial Engineering, Politecnico di Milano, Italy; Department of Economics and Business, University of Catania, Italy.
⁵ Department of Political Science, University of Roma Tre, Italy. Electronic address: francesco.vidoli@uniroma3.it.

PMID: 31542651
DOI: 10.1016/j.socscimed.2019.112544

Abstract

This paper introduces a new empirical procedure for the estimation of hospitals' technical efficiency in presence of spatial heterogeneity. We propose a methodology that allows treating spatial heterogeneity independently of a predetermined reference to administrative borders. We define geographical spatial regimes, characterised by spatial proximity and homogeneity of relevant demand characteristics, within which to assess the efficiency of hospitals. The methodology has then been tested on a large sample of Italian hospitals, for which their production efficiency has been assessed within homogeneous demand areas.

Keywords: Conditional non-parametric efficiency; Health sector; Productive efficiency; Spatial heterogeneity.

MeSH terms

Efficiency, Organizational*
Hospital Administration*
Humans
Italy
Models, Statistical
Spatial Analysis*
State Medicine / organization & administration