tud
Hospital Policy and Productivity: Evidence from German States
2016-10-04
[Electronic ed.]
4519974-7
Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden
prv
Saechsische Landesbibliothek- Staats- und Universitaetsbibliothek Dresden, Dresden
Fakultät Wirtschaftswissenschaften
Center of Public and International Economics
male
male
Total factor productivity (TFP) growth allows for additional health care services under restricted resources. We examine whether hospital policy can stimulate hospital TFP growth. We exploit variation across German federal states in the period 1993 to 2013. State governments decide on hospital capacity planning (number of hospitals, departments and beds), ownership, medical students, and hospital investment funding. We show that TFP growth in German hospital care reflects quality improvements rather than increases in output volumes. Second-stage regression results indicate that reducing the length of stay is generally a proper way to foster TFP growth. The effects of other hospital policies depend on the reimbursement scheme: under activity-based (DRG) hospital funding, scope-related policies (privatization, specialization) come with TFP growth. Under fixed daily rate funding, scale matters to TFP (hospital size, occupancy rates). Differences in capitalization in East and West Germany allows to show that deepening capital may enhance TFP growth if capital is scarce. We also show that there is less scope for hospital policies after large-scale restructurings of the hospital sector.
330
QC 000
Wirtschaft , Economics , Volkswirtschaftslehre , Krankenhaus , Produktivität , Deutschland
Krankenhäuser, TFP, Produktivität, Policy, Deutschland
Hospitals, TFP, Productivity, Policy, Germany
urn:nbn:de:bsz:14-qucosa-211304
2510-1196
Technische Universität Dresden
pbl
Technische Universität Dresden, Dresden
Felix
Roesel
aut
Alexander
Karmann
aut
eng
urn:nbn:de:bsz:14-qucosa-209808
007
CEPIE Working Paper
qucosa:29779
07/16
born digital
Sabine Gralka
sabine.gralka@tu-dresden.de
research_paper