RT Journal Article
T1 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
A1 Ocaña-Riola, Ricardo
A1 Pérez-Romero, Carmen
A1 Ortega-Díaz, Mª Isabel
A1 Martín-Martín, José Jesús
K1 Efficiency
K1 Data envelopment analysis
K1 Multilevel zero-one inflated beta regression
K1 Public hospitals
K1 Private hospitals
K1 Public-private partnership
K1 Intensive care units
K1 Emergency services
K1 Eficiencia
K1 Análisis de datos
K1 Análisis de niveles múltiples
K1 Hospitales públicos
K1 Hospitales privados
K1 Asociaciones entre el sector público y el privado
K1 Unidades de cuidados intensivos
K1 Servicios médicos de urgencia
AB 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.
PB MDPI
SN 1661-7827
YR 2021
FD 2021-09-27
LK http://hdl.handle.net/10668/4528
UL http://hdl.handle.net/10668/4528
LA en
NO Ocaña-Riola R, Pérez-Romero C, Ortega-Díaz MI, Martín-Martín JJ. 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. Int J Environ Res Public Health. 2021 Sep 27;18(19):10166
DS RISalud
RD Apr 7, 2025