impact of fiscal decentralisation on hospital efficiency

Master's Thesis from the year 2015 in the subject Medicine - Hospital Environment, Clinical Medicine, grade: 80, University of Hertfordshire, language: English, abstract: This report analyses the efficiency of hospitals in England and Germany. Data Envelopment Analysis (DEA) is utilised to estimate a best practice frontier and to evaluate the performance characteristics of different hospitals in the two countries. The measurement categories of input factors are represented by the hospital size (amount of beds), number of wards, number of employed medical specialists, sum of total inpatient admissions, demographic environment (population density in population/km²), and one output factor (mortality rates).Regarding these factors, the main findings reveal that the allocation of inefficient hospitals in England is broadly spread and, therefore, the mean efficiency value of hospitals in England is ≈44% (whereas 100% describes efficient units). In contrast, the mean efficiency value of German hospitals equates to ≈91%. Consequently, the allocation of inefficient German hospitals is less spread and the overall performance of hospital health supply is more efficient in Germany compared to England.Most remarkably, the amount of inpatient admissions is one of the main drivers for efficiency and especially the English hospitals suffer from high numbers of inpatient admissions, which may be reduced due to improvements in the primary healthcare supply provided by general practitioners...

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