Analyzing the effect of health reforms on the efficiency of Ecuadorian public hospitals
Piedra Peña, Juan Andrés (Universitat Autònoma de Barcelona. Departament d'Economia Aplicada)
Prior Jiménez, Diego (Universitat Autònoma de Barcelona. Departament d'Empresa)

Fecha:	2023
Resumen:	This study aims to assess whether Ecuadorian health reforms carried out since 2008 have affected the efficiency performance of public hospitals in the country. We contribute to the literature by shedding new light on the effects on public healthcare efficiency for developing countries when policies move toward health equity and universal coverage. We follow a two-stage approach, wherein the first stage we make use of factor and cluster analysis to obtain three clusters of public hospitals based on their technological endowment; we exploit Data Envelopment Analysis for panel data in the second stage to estimate robust efficiency measures over time. Our innovative empirical strategy considers the heterogeneity of healthcare institutions in the analysis of their efficiency performance. The results show a significant decrease in the average efficiency of low and intermediate technology hospitals after the new constitution was adopted in 2008. The decline in efficiency coincides with the two reforms of 2010 and 2011 that brought on higher social security coverage.
Ayudas:	Agencia Estatal de Investigación ECO2017-88241-R
Nota:	Altres ajuts: acords transformatius de la UAB
Derechos:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Lengua:	Castellà
Documento:	Article ; recerca ; Versió publicada
Materia:	Healthcare efficiency ; Metafrontier ; Health reforms ; Panel data DEA
Publicado en:	International Journal of Health Economics and Management, Vol. 23 (Septembre 2023) , p. 361-392, ISSN 2199-9031

DOI: 10.1007/s10754-023-09346-z
PMID: 36929472

32 p, 1.6 MB

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