@misc{10481/70869,
year = {2021},
url = {http://hdl.handle.net/10481/70869},
abstract = {Background: This article proposes a methodological innovation in health economics
for the second stage analysis of technical efficiency in hospitals. It investigates the relationship
between the installed capacity in regions and hospitals and their ownership structure. Methods:
A multilevel zero-one inflated beta regression model is employed to model pure technical efficiency
more adequately than other models frequently used in econometrics. Results: Compared to publicly
managed hospitals, the mean efficiency index of hospitals with public-private partnership (PPP)
formulas was 4.27-fold. This figure was 1.90-fold for private hospitals. Concerning the efficiency
frontier, the odds ratio (OR) of PPP models vs. public hospitals was 42.06. The OR of private hospitals
vs. public hospitals was 8.17. A one standard deviation increase in the percentage of beds in intensive
care units increases the odds of being situated on the efficiency frontier by 50%. Conclusions: The
proportion of hospital beds in intensive care units relates to a higher chance of being on the efficiency
frontier. Hospital ownership structure is related to the mean efficiency index of Spanish National
Health Service hospitals, as well as the odds of being situated on the efficiency frontier.},
organization = {EUROPEAN REGIONAL DEVELOPMENT FUND (Operative Program: Andalusia 2014–2020. Ministry of Economy. Knowledge. Business and University.
Junta de Andalucía. Spain. Grant number: B-SEJ-266-UGR18.},
publisher = {MDPI},
keywords = {Efficiency},
keywords = {Data envelopment analysis},
keywords = {Multilevel zero-one inflated beta regression},
keywords = {Public hospitals},
keywords = {Private hospitals},
keywords = {Public–private partnership},
keywords = {Intensive care units},
keywords = {Hospitals--Emergency services},
title = {Multilevel Zero-One Inflated Beta Regression Model for the Analysis of the Relationship between Exogenous Health Variables and Technical Efficiency in the Spanish National Health System Hospitals},
doi = {10.3390/ijerph181910166},
author = {Ocaña Riola, Ricardo and Pérez Romero, Carmen and Ortega Díaz, María Isabel and Martín Martín, José Jesús},
}