Technical Efficiency, Specialization and Ownership Form: Evidences From a Pooling of Italian Hospitals

Silvio Daidone, Francesco D'Amico

Research output: Contribution to journalArticlepeer-review


We evaluate how the productive structure and level of specialization of a hospital affect technical efficiency by analyzing a six-year panel database (2000/2005) drawn from hospital discharge records and Ministry of Health data. We adopt a distance function approach, while measuring the technical efficiency level with stochastic frontier techniques. After controlling for environmental variables and hospital case-mix, inefficiency is negatively associated with specialization and positively associated with capitalization. Capitalization is typical of private structures which, on average, use resources less efficiently with respect to public and not-for-profit hospitals. Finally, by looking at scale elasticities, we find some evidence of
unexploited economies of scale, leaving room for centralization.
Original languageEnglish
Pages (from-to)203
Number of pages216
JournalJournal of Productivity Analysis
Issue number3
Early online date22 Apr 2009
Publication statusPublished - Oct 2009


  • Stochastic Frontiers
  • Hospital Discharge Reccords
  • Hospital Specialization
  • Distance Function
  • Technical Efficiency

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