Analyzing the effect of health reforms on the efficiency of Ecuadorian public hospitals

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...

Descripción completa

Detalles Bibliográficos
Autores: Piedra Peña, Juan Andrés|||0000-0001-9867-4123, Prior Jiménez, Diego|||0000-0002-4669-2861
Tipo de recurso: artículo
Fecha de publicación:2023
País:España
Institución:Universitat Autònoma de Barcelona
Repositorio:Dipòsit Digital de Documents de la UAB
Idioma:español
OAI Identifier:oai:ddd.uab.cat:273106
Acceso en línea:https://ddd.uab.cat/record/273106
https://dx.doi.org/urn:doi:10.1007/s10754-023-09346-z
Access Level:acceso abierto
Palabra clave:Healthcare efficiency
Metafrontier
Health reforms
Panel data DEA
Descripción
Sumario: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.