Title: Evaluating Italian public hospital efficiency using bootstrap DEA and CART

Authors: Arianna De Nicola; Simone Gitto; Paolo Mancuso

Addresses: Dipartimento di Ingegneria dell'Impresa, Università di Roma 'Tor Vergata', Via del Politecnico 1, 00133 Rome, Italy ' Dipartimento di Ingegneria dell'Impresa, Università di Roma 'Tor Vergata', Via del Politecnico 1, 00133 Rome, Italy ' Dipartimento di Ingegneria dell'Impresa, Università di Roma 'Tor Vergata', Via del Politecnico 1, 00133 Rome, Italy

Abstract: We estimate the efficiency of 390 Italian public hospitals in 2007, using the bias-corrected data envelopment analysis (DEA) estimates. Then, classification and regression tree (CART) methodology, based on the bias-corrected DEA results, is used to investigate the relationships between health efficiency of the hospitals, physicians, nurses, beds and discharges. The results show that the main factors affecting health efficiency of the Italian public hospitals are the number of beds and the number of discharges. Finally, the paper shows that a process of bed downsizing may result in a deterioration of health efficiency of the Italian public hospital.

Keywords: data envelopment analysis; bootstrap DEA; resource allocation; hospital efficiency; classification and regression tree; CART; healthcare policy; Italy; public hospitals; bed numbers; patient discharge numbers; bed downsizing.

DOI: 10.1504/IJADS.2013.054953

International Journal of Applied Decision Sciences, 2013 Vol.6 No.3, pp.281 - 292

Received: 29 Nov 2012
Accepted: 14 Feb 2013
Published online: 13 Dec 2013 *

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