The impact of managerial and organizational aspects on hospital wards' efficiency: Evidence from a case study

To link to full-text access for this article, visit this link: http://dx.doi.org/10.1016/j.ejor.2007.11.046 Byline: A. Ancarani (a), C. Di Mauro (b), M.D. Giammanco (b) Keywords: OR in health services; Organization; Efficiency; Data envelopment analysis; Hospital Abstract: In spite of its acknowledged relevance, the impact of managerial and organizational aspects on hospital wards' efficiency has been so far overlooked by the literature. In order to explore this issue, this paper presents a model of the relations between the decision making process of a hospital ward and its technical efficiency. In order to test the model, a two-step approach has been adopted. In the first step the technical efficiency of wards belonging to a large Italian Hospital Enterprise has been calculated using DEA. In the second step, efficiency scores have been regressed on a set of variables capturing managerial goals and actions internal to the ward, as well as re-organizations imposed by the hospital central management. Responses to a questionnaire administered to the heads of ward were used to build the independent variables. Results show that both decisions internal to the ward and exogenous re-organizations affect the ward's efficiency, and suggest that these variables are more significant in explaining efficiency than environmental ones. Author Affiliation: (a) DICA - Dipartimento di Ingegneria Civile e Ambientale, Sezione di Ingegneria Gestionale, Economica ed Estimativa, Universita di Catania, Viale A. Doria 6, 95125 Catania, Italy (b) Dipartimento di Analisi dei Processi Politici, Sociali ed Istituzionali, Universita di Catania Palazzo Reburdone, Via Vittorio Emanuele 8, 95131 Catania, Italy Article History: Received 2 February 2006; Accepted 19 November 2007