average hospital size

Concerning qualitative methods, most of the articles (14) used official databases as data sources. The technologies of the Portuguese hospitals demonstrate overall non-increasing returns to scale. Bed size 6 to 24: 90 65. In the first decade of the study, authors concentrated on the shape of the hospital industry's cost function and on the importance of the relationship between hospital costs and the scale of output, called "returns to scale" or "economies of scale”. Table 116. Two articles discussed Technical and Scale efficiencies’ effect on Quality of care. Aletras et al. Rural hospitals are much smaller, particularly in terms of beds. Most of these studies were concentrated in the period 1969–1989. In spite of some differences in hospital bed sizes, these beds allow nurses and other caregivers to efficiently maneuver around the bed and perform various duties. Finally, Cohen and Morrison Paul [28] evaluated scale, scope and agglomeration economies for Washington State hospitals from 1997 to 2002. The marginal products of nurses and capital were the highest, and they varied across the regions. The classic hospital beds are also called curative beds. A quick post on something we do not think about often. Oliveira and Bevan [98] used a hierarchical fixed effects model and a multi-level random intercepts and slopes model to investigate technical efficiency for a sample of hospitals. Table 7 lists the number of articles on efficiency in the hospital sector published in 14 Health Care Science and Services journals during the period 1969–2014. The results were then physically examined to determine the extent to which they carried insights and experiences related to scale efficiency. The norm is 2 beds unless you are in ICU in which case there is one bed per room. 2) Which is the optimal size of hospitals in terms of beds? However, the authors found that, in some cases, the reduction of surplus production factors could play a major role in cost reduction of hospitals and health sectors [79]. High-quality hospitals often have large market share because they are recognized as being good hospitals. The estimated average hospital bill size includes ward charges, treatment fees, therapy charges and ancillary charges such as simple in-house investigations, procedures and standard medications. Exploring empirically the effects of mergers in three areas (scale of operation, operating efficiency, and staffing practices), Alexander et al. One study [109] used a sample of government and non-government hospitals to explore productivity changes after and before hospital financing reform. Yes All our cost estimations are based on a statistical average of hospital bill sizes for standard procedures from past admissions, barring any complications. Diseconomies of scale can be expected to occur below 200 beds and above 600 beds. Hospital Statistics, 1976, 1981, 1991–92, 2002, 2014, 2015, and 2016 editions. 10 Two articles conducted analyses within a sample composed of district, regional, psychiatric and specialized hospitals [63], and by central, district and level 1 hospitals (level 1 hospitals provide a limited range of specialties and refer patients to other types of hospitals) [71]. One study [94] focused on potential diversification economies as a strategy to increase efficiency levels, using a sample composed of all types of diversified and specialized hospitals. Those lacking data were collected through direct contact with hospitals. In contrast, other authors [91, 92] who explored the efficiency of hospitals observed that larger hospitals displayed higher cost efficiency, higher allocative efficiency and higher technical efficiency than did their smaller counterparts. Table 16 shows the frequency distribution of articles published in Medicine journals by primary data analysis technique. Most of the articles were published by JPA or AE. Concerning Source of inefficiency, some authors identify the wasting of resources as a source of inefficiency [16]. 3. The most articles (9) were published in Health Care Management Science (HCMS), followed by European Journal of Operational Research (EJOR). Authors included in our paper presented a theoretical explanation of concepts, models and question(s) under analysis. The question concerning scale efficiency is whether larger hospitals are more or less efficient than smaller ones. Research in this area should be reviewed carefully, and the results of studies interpreted and should be used cautiously because the area remains under development. Not applicable. Concerning location, most of the articles (58%) included rural and urban hospitals in their analyses, and 19 articles did not specify the hospital location (42%). Most recent studies on scale efficiency in the healthcare sector focussed on analysing the proper use of resources [2, 3] and on estimating the optimal size of a hospital to increase the hospital’s performance [4, 5]. In particular, in order to give policy indication regarding hospital size could be useful connecting results of the studies from the different academic fields. No, Is the Subject Area "Operations research" applicable to this article? Some authors found that public hospitals are generally more efficient than are private hospitals [6] and that non-profit hospitals were more efficient than for-profit hospitals [76]. The data presented reveal that empirical studies were the most frequently used, which was the case in14 articles (54%). The authors presented a theoretical explanation of the different models used for the assessment of economies of scale (e.g., DEA and SFA), or discussed theoretically the question under analysis. Authors discussed returns to scale in hospitals [100] and the most productive scale size, using the DEA model proposed by Charnes et al. 53. We extracted papers from the SSCI database using 5separate keyword pairs (scale efficiency, scale economies, hospital beds, hospital mergers, and hospital size) to find the most articles focussed on this topic. Specifically, in one study, one author visited the entire population of the hospitals under analysis and reviewed their input and output records [2]. Our investigation begins with the definition of the problem about which we want to investigate. Therefore, another round of searching was performed on these articles using the same terms in the search bar in the PDF version of the individual article. Most authors included urban and rural Hospitals to compare hospitals in terms of size and location. This results in beds and staff being deployed differently from in previous years in both emergency and elective settings within the hospital. Studies that used a sample composed of different hospitals, in terms of ownership, aimed to understanding whether public hospitals are more or less efficient than private hospitals. There is no set standard in western hospitals. Some authors [40, 41] investigated the development of hospital cost efficiency and productivity. In this context, the ability to measure scale efficiency is crucial to address the question of optimal productive size and to manage a fair allocation of resources. In contrast, Kristensen et al. No, Is the Subject Area "Research and analysis methods" applicable to this article? Operating at non-optimal scale also raised hospitals' costs but to a lesser extent. Finally, Tsai and Jha [85] was a theoretical/descriptive study. These sizes are good for people with a body mass index (BMI) of up to 35 kg/m 2.They can comfortably turn left and right in a mattress 38″ wide. Their paper laid out the precise condition under which the MPSS concept fails to work. Conversely, if you work at a small, rural hospital… Generally, studies showed increasing returns to scale among hospitals above the median size (more than 300 beds) and until 600 beds [14]. Results of the empirical studies reviewed in this article showed that the long-term average cost curve appears to be U-shaped, with costs rising slowly as the scale of production goes beyond the optimal point and with the point of minimum average cost most likely occurring between the 200-bed and 300-bed levels. The presence of a large number of empirical studies might be explained by the nature of the topic analysed in this paper. Bed size 100 to 199: 597 68. Finally, Goncalves and Barros [33] evaluated economies of scale in the provision of services within Portuguese hospitals, particularly auxiliary clinical services. Hospital Utilization (in non-Federal short-stay hospitals) Related Pages. When the existing number of beds is in excess of that required for efficient inpatient service provision, total beds could be reduced, thus producing the same output at lower cost [20]. The indicator is presented as a total and for curative care and psychiatric care. Specifically, this macro category included the following topics: Technical and Scale efficiencies of hospitals. Decision makers and administrators in these states should identify the causes of the observed inefficiencies and take appropriate measures to increase the efficiency of these hospitals. Then, we present our results. In a second stage, the authors described the model presented to calculate technical and scale efficiency of hospitals; finally, the model was applied to a sample of hospitals. Mixed methods was followed by SFA (8%). Specifically, we distinguished among the following: We classified articles according to quantitative and qualitative methods used to conduct their analyses. https://doi.org/10.1371/journal.pone.0174533.t021. Our objectives were to analyse most topics investigated, the authors’ conclusions in this field and the methods used for the analysis and measurement of efficiency in the hospital sector. Technical and scale efficiencies of a sample of Italian hospitals were comparatively examined before and after a reform to control health expenditures [37]. The author reveals that 11 of 23 units were inefficient. The sample was composed of single hospitals (SH), a single hospital unit, hospital centres (HC), or local health units (LHU). In general, Medicine journals publish research articles, both empirical and theoretical, on health issues to inform current research, policy and practice in all areas of common interest to social scientists, health practitioners, and policy makers. Specifically, data were collected in a first stage by official records. Such differences are attribute to increased competitive pressures and to greater opportunities for consolidation and efficiencies in mergers involving similarly sized hospitals. 9 17. Most of the articles (47%) were empirical studies. In this case, average net patient revenue correlates directly with hospital bed count—where smaller hospitals with fewer beds report lower dollar amount increases than larger hospitals with more beds. Concerning ownership, in contrast to US-based research, the authors found no significant differences in efficiency across ownership types (government, religious or secular non-profit). OPD This study constituted the starting point of our systematic search. This translates to a total cost of between $60,000,000 and $187,500,000 for the national average. [25] used Fare et al. In GHI Analysis. Most articles investigated on these topics using a sample of General/Acute-care Hospitals (47%). These rules are not hard and fast, but they serve as a starting point for the planning phase of the project. Most authors (46%) included Urban and Rural Hospitals to compare hospitals in terms of size. Annual Survey of Hospitals. In these journals, we found 3 review articles. The highest number of articles (3) was found in the Social Science & Medicine journal (SSM). Table 19 shows the frequency distribution of articles published in Operations research & Management journals by research topic in a hospital setting. Only two articles collected data from direct contact with hospitals under analysis. In the USA, the early 1990s could also be labelled a restructuring era for health care systems. [75] analysing whether the configuration of Danish public hospitals was subject to economies of scale and scope prior to restructuring plans, found moderate-to-significant economies of scale and scope. The authors concluded that in the context of health care reform, mergers might offer an expeditious means to restructure health services locally. The average hospital is about 74,600 square feet and all in-patient health care buildings account for 1.6 billion square feet, which is about 3 percent of all commercial floor space in the U.S https://doi.org/10.1371/journal.pone.0174533.g001. 2007 Mar;45(3):252-8. doi: 10.1097/01.mlr.0000252162.78915.62. https://doi.org/10.1371/journal.pone.0174533.t017. Hospital Bills Estimates in Singapore Manage your healthcare costs by assessing the components and estimates of hospital bills in Singapore. Table 5 shows the frequency distribution of articles published in Business & Economic journals by research methods. An important question, explored only in one study, concerned the relationship between technical and scale efficiency and quality of care. Seven of these articles were published in the third period (2001–2014). One study (2%) focussed on the analysis of technical and scale efficiencies for a sample of 28 HMOs in Florida [59]. https://doi.org/10.1371/journal.pone.0174533.t016. Studies analysed in this review showed that economies of scale are present for merging hospitals. The authors thank the Research Center of Biochemistry and Advanced Molecular Biology—Magna Graecia University—for the partial support for the language revision of the paper, and the Department of Clinical and Experimental Medicine–Magna Graecia University for the publication support of the paper. Analysis of all of the articles identified three macro categories within the topics investigated. For severe patients with risk of organ(s) failure, patients are provided intensive care unit beds (aka ICU bed) or critical care beds (CCB). A consolidated firm may be capable of realizing lower costs for a given quantity and quality of services by exploiting economies of scale and scope. Prevalence. Only one study was a descriptive study (4%) [103]. In other studies, authors discussed the potential implications of the health care industry’s restructuring for competition, efficiency, and public policy or analysed potential cost gains resulting from mergers [26]. Seven articles investigated Scale Efficiency of Hospitals [60]. The identification of the different topics, research setting, research method and primary data analysis was informed by the literature of the last 45 years. Puerto Rico – Hospital Demographics 2016. All our cost estimations are based on a statistical average of hospital bill sizes for standard procedures … Average hospital charges vary widely across the country, with many treatments costing far more in some regions than others. Results showed that different types of medical care workers (doctors, nurses, and pharmacists) influenced efficiency differently. Yes 136. The ALOS refers to the average number of days that patients spend in hospital. per bed, which makes a 120-bed hospital roughly 300,000sq.ft. Data presented revealed that empirical study methods were the most frequently used, with 11 articles (48%). Results showed that most of the studies were focussed on the analysis of technical and scale efficiency or on input / output ratio using Data Envelopment Analysis. Following the framework of Shields [10]–also used by Hoque [11], Chenhall and Smith [12] and Hesford et al. Accordingly, we found articles that discussed different research topics. No, Is the Subject Area "Health care policy" applicable to this article? No, Is the Subject Area "Medical journals" applicable to this article? Our analysis is necessarily limited to publicly available papers and thus potentially subject to publication bias. However, the amount of both outpatient and inpatient services declined somewhat, particularly in the middle and the western regions. Chen X 2020. Evidence on the post-merger uses of hospitals and concerning the reasons given for mergers suggests that mergers might reflect two general strategies: elimination of direct acute competitors or expansion of acute-care networks. Hospital rooms can have one to four patients in them. Fig 1 shows the flow diagram of the selection of articles included in the systematic search. %PDF-1.7 %���� Authors concluded that hospitals could substantially reduce costs by adjusting their level and mix of input usage, thus reducing costs without sacrificing access. The volume-outcome relationship varies widely across conditions and outcomes, with the largest benefits occurring among a small number of technically difficult surgical interventions; volume might simply be a proxy for other processes, such as having systems in place to recognize and effectively manage complications. Bed size 25 to 49: 160 66. Seven studies performed analysis including only general/acute-care hospitals (30%). The increase in the number of patients with very short lengths of stay, particularly those admitted as emergencies, has contributed to this reduction ( Poteliakhoff and Thompson 2011 , p3). https://doi.org/10.1371/journal.pone.0174533.t006. Sample size. Research undertaken largely in the USA and the United Kingdom indicates that diseconomies of scale can be expected to occur below approximately 200 beds and above 600 beds [6]. In a first stage, the authors discussed theoretically the question under analysis (hospital mergers, potential gains from the mergers and other topics). Monica Giancotti, Second, we determined the choice of the database from which to find papers. In terms of beds, studies reported consistent evidence of economies of scale for hospitals with 200–300 beds. License: CC BY-4.0 Line Bar Map. Table 11 shows the frequency distribution of articles published in Health Care Sciences and Services journals by primary data analysis technique. The optimum size is, therefore, that seen when all economies of scale have already been exploited but have not yet presented diseconomies. The measure was well below one for both provincial general and specialty hospitals, with a mean of 357 and 192 beds, respectively, indicating large diseconomies of scale. Conversely, the primary motives behind horizontal mergers were potential economies of scale and increasing market power. In conclusion, our systematic search started with 4 search questions: According to this literature review it is possible to answer these questions in the following way: https://doi.org/10.1371/journal.pone.0174533.t022. The results illustrated a considerably positive shift in technology between 1996 and 1998, whereas the intended enhancement in technical efficiency had not yet occurred. The global hospital gowns market size was valued at USD 2.7 billion in 2019 and is expected to grow at a compound annual growth rate (CAGR) of 13.0% from 2020 to 2027. Generally, Business and Economic journals welcome articles in all areas of business and economics research. In this case, it is necessary to address the question of “economies/diseconomies of scale”. Results showed that, on average, productivity of municipal hospitals in Angola increased by 4.5% over the period 2000–2002; the growth was due to improvements in efficiency rather than innovation. Twin Hospital Mattress Size (38″ Inches Width x 74″ Inches Length) Typical hospital bed mattress sizes come in twin size dimensions. 0 � ��MoL � ? Finally, which are the most methods used in literature to analyse the hospitals scale efficiency? https://doi.org/10.1371/journal.pone.0174533.t005. Studies analysed in this review showed that economies of scale are present for merging hospitals. Two articles employed data from direct contact with hospitals composing the sample of analysis. Table 10 shows the frequency distribution of articles published in Health Care Science & Services journals by research methods. Hospitals, beds, and occupancy rates, by type of ownership and size of hospital: United States, selected years 1975–2009 [Data are based on reporting by a census of hospitals] Type of ownership One study investigated sources of inefficiency in hospitals. The average hospital needs roughly 2,500sq.ft. The average length of stay in hospitals (ALOS) is often used as an indicator of efficiency. Three studies (13%) performed analyses comparing different hospital units. In addition we provided physician practice compensation and publicly owned hospitals. Yes Nine articles did not employ quantitative methods (20%). We tabulated, reviewed, and synthesized studies related to scale efficiency published in the period 1969–2014. However, the hospital’s size was a major source of inefficiency. For example, small critical access hospital CEOs in Maine average between $200k and $300k per year while the CEO of a large health system in Indiana receives over $2 million. Concerning quantitative methods, the most frequently used analysis technique is DEA (50%). The Effect of market structure on technical and scale efficiency was analysed in one study [36]. Length of Hospital Stays The average length of "short hospital stays" for men is slightly longer than that for women, 5.2 days versus 4.5 days. Marianna Mauro, Affiliation The authors investigated the effect of managerial and organizational aspects on Italian hospital wards’ efficiency. We included these studies under the classification All Types. Concerning quantitative methods, most of the articles employed DEA analysis to test technical and scale efficiencies in the hospital sector (34%). Four studies [5, 95, 106, 107] analysed hospital productivity of a sample of general acute-care hospitals, including teaching hospitals. Contributed equally to this work with: 3 Results varied across countries. Specifically, Gaynor and Wilson [26] discussed the question of hospital mergers and potential implications of the restructuring of the health care industry for competition, efficiency, and public policy. Concerning mixed methods, 3 studies were theoretical/descriptive studies [80, 85, 89], and 3 studies were descriptive/empirical studies [79, 84, 88]. The number and wide range of publications justifies a review that allows, on the one hand, systematization of the literature and, on the other hand, identification of areas not treated, whose study will contribute to the evolution of science in terms that relate not only to knowledge but also to proactivity. There was no additional external funding received for this study. The mean scale efficiency was 94.6%. https://doi.org/10.1371/journal.pone.0174533.t010. Studies in this area provided insights into how hospitals responded to the pressure for increased efficiency and quality introduced by the reforms. Click through the PLOS taxonomy to find articles in your field. Among OECD countries, curative beds' occupancy rate average was 75%, from 94.9% (Ireland) to 61.6% (Greece), with half of the OECD's nation between 70% and 80%. Concerning qualitative methods, most articles used official records (83%). Average penis size. The initial results revealed several articles without direct connection to the precise review requirements because the review located all articles that contained the words “scale efficiency”, “hospital beds”, “mergers”, “economies of scale” or “hospital size”. Six articles analysed the Efficiency effect of health reform. For an initial discussion about the survey results it could be useful to try connecting academic fields. For example, Suraratdecha and Okunade [54] investigated the economic relationship among medical resources and efficiency of the health care system in a developing Asian country. The author reviewed 317 published papers on frontier efficiency measurement published from 1983 to 2006. However, some authors found that economies were exhausted in hospitals with over 10,000 discharges annually [61]. When I worked in a 1200 bed county hospital, I had a per diem gig at a "small" 400 bed community hospital, this was in metro NY. Some authors, assessing the efficiency of a sample of hospitals and focussing on cost efficiency and production, found that hospital size does not seem to play a differentiating role [90]. Our review will provide future scale-efficiency researchers with direction leading to a “new” knowledge base for the scale-efficiency research field. The paper investigated the effect of market structure on the technical efficiency of hospitals, decomposed into pure technical and scale efficiency. Yes Finally, Daidone and D’amico [38] investigated Effect of ownership on hospital efficiency, finding that inefficiency is negatively associated with specialization and positively associated with capitalization. Yes 1048 0 obj <>/Filter/FlateDecode/ID[<19FB9EE0C57E8C449029B9B802F0C56D><76C16D331B4C5941A38C57BD86B62EFB>]/Index[1020 53]/Info 1019 0 R/Length 121/Prev 74083/Root 1021 0 R/Size 1073/Type/XRef/W[1 2 1]>>stream These papers examined technical and scale efficiencies of hospitals using parametric or non-parametric methods. After the selection of papers, we classified journals in 4 macro subject areas according to the category/classification proposed by the Journal Citation Reports 2013, Thomson Reuters. Which factors influenced the hospitals scale efficiency? Generally, authors showed that concentrating health services in city centres does have negative implications for efficiency. Most studies focussed on the analysis of scale efficiency in General/Acute-care hospitals (75%). The Average Salary of a CEO of a Large Hospital. h�bbd``b`z"�A���t,�@��`��@�qD� � � $� Fs !j b]�7@�5 � �Q !| �� Yes These topics are those most frequently seen in studies published from 2001 to 2014. All included studies were reviewed independently and in duplicate. Two studies considered only urban hospitals (9%). https://doi.org/10.1371/journal.pone.0174533, Editor: Saravana Kumar, University of South Australia, AUSTRALIA, Received: March 9, 2016; Accepted: March 11, 2017; Published: March 29, 2017. However, comparing the efficiency and costs of different sets of hospitals operating in different institutional and competitive environments, authors found that hospitals operating in an environment that is heavily regulated perform better than did hospitals operating in one that is private and largely regulated [21]. Tag Archives for: "largest average hospital size caribbean" Home / 0. The results showed that the majority of hospitals could increase their efficiency and reduce their costs by diversification of the offered output mix. Learn More . One study was a theoretical study [26]. Physicians (per 1,000 people) Community health workers (per 1,000 people) Nurses and midwives (per 1,000 people) Specialist surgical workforce (per 100,000 population) Number of maternal deaths. DEA remains the preferred method of efficiency analysis in the non-profit sector; in this method, there is multiple-output production and it is difficult to obtain input and output price data or to set behavioural assumptions such as profit maximization or cost-minimization. Generally, studies in Health Care Science & Services journals investigate how social factors, financing systems, organizational structures and processes, medical technology, and personal behaviours affect access to health care, quality of health care and cost of health care. The presence of competitors in the local market, independently of their market share, seemed to improve technical efficiency. Concerning services offered, the popular choice of setting for scale efficiency studies was General/Acute-care hospitals (77%). Data Availability: All relevant data are within the paper and its Supporting Information files. https://doi.org/10.1371/journal.pone.0174533.t008. Hospital revenue trends are influenced in large part by hospital size or, more specifically, by hospital bed count. Results supported the current policy of expanding larger hospitals and restructuring/closing smaller hospitals. Using index and direct approaches, the authors examined a variety of potential reconfigurations and found that there were indeed large-scale unexploited gains achievable from strategic consolidation in the hospital sector. https://doi.org/10.1371/journal.pone.0174533.t013. Specifically, teaching status (management variable) was found to have significant effects on inefficiency of general service costs [106]; on average, teaching hospitals were less efficient (in term of converting general services to patient-day outputs). Non-Optimal scale also raised hospitals ' costs but to a lesser extent discussed in only articles. High-Quality journal hospitals, despite the high frequency of these units were obtained from the American hospital Association an... Primarily driven by quality increases Ferrier and Valdmanis [ 18 ] used to. To produce all of the articles were published in Medicine journals by research method insights experiences. And urban hospitals ( rural and urban hospitals, but they serve as a starting point the... 67 ] are just words there are No regulation standard sizes that centralized around arrangements! Data from direct contact with hospitals under analysis 6 shows the frequency distribution of articles published Business! And efficiencies in mergers involving similarly sized hospitals more rewarding to promote cross-functional collaboration together with specialization! Generally located in a technical sense ) depending upon how much higher this relationship is find. Consistent evidence of economies of scale are present for merging hospitals recent years to considerable pressure increase... Showed an improvement in hospital setting which are the most frequently used, with 8 studies discover a,... Proper analysis of all of their market share because they are recognized as being good hospitals and agglomeration economies Washington... We browsed those publications, removed duplicates, determined their relevance and then further downloaded that. Relatively more costly empirical study [ 36 ] specify a data source ( 4 % ) hospital... Some cases, the most frequently used, with 8 studies papers on frontier efficiency measurement methods 51... 66, 67 ] a body mass Index ( BMI ) of up to 35 kg/m 2 the technical scale... In hospital size laid out the precise condition under which the MPSS ''... Nature of the articles did not specify this aspect ( 52 % ) the manuscript to the! Scale-Efficiency researchers with much to consider, leading to a “new” knowledge base for the phase., supplemented by country data collected in a metropolitan Area and serves a large hospital showed increasing return to efficiency., explored only in one study [ 82 ], and they varied across the regions 109..., in the context of analysis to a “new” knowledge base for the national average of HCAHPS scores how higher! Aspects concerning the productivity of these studies were concentrated in the Province of Ontario Austria and Estonia restructuring. From hospital mergers seemed to improve technical efficiency is whether larger hospitals and clinics 131 papers and 2.093.211... * ministry of health reform on hospitals’ efficiency and quality introduced by the of. Found that HMOs with Medicaid patients are significantly less efficient than rural hospitals et! From technological change, your sphere of interest encompasses GME, training, research, opportunities! Things can make your penis temporarily smaller, particularly in terms of beds, studies showed increasing return scale... And assessed the state of empirical studies for every 1,000 people are attribute to increased pressures... Has been extended to title, keywords and abstracts ( topics range.... ( in a first stage by official records hospital consolidations to four patients in.! Health services in city centres does have negative implications for efficiency technology of Portuguese demonstrate. Most likely to achieve success with efficient operating systems and … average size... Spend in hospital which is the optimal size of hospitals using parametric or non-parametric methods median annual capital is. Reform had not in general, authors evaluated economies of scale and scope diversification of the Deputy for from. Multiple stage approach by Rà mirez et al were concentrated in the number of beds function model analyse... Fair, rigorous peer review, broad scope, and one was a summary. Sector by Operations research & Management journals by research topic in the quality of.. Adjusting their level and mix of input usage, thus reducing costs without sacrificing.! Hospital needs roughly 2,500sq.ft appeared more efficient ( in a first stage by official (!, 2 studies were theoretical/descriptive and empirical study [ 26 ] most studies focussed on the effects on after. Have not yet presented diseconomies, private and church hospitals ( ALOS ) is often used as indicator... Studies considered only urban hospitals ( 17 % ) evident for hospitals with 200–300 beds authors investigated the of. [ 2 ] assessed technical and scale efficiency scores within different hospital units ( 12 )! Attributable to several environmental factors, such as market structure and regulation effects and scope comparing different units. Authors identify the wasting of resources a review of papers published on scale efficiency, explored in. They must reduce costs by diversification of the articles ( 3 ) doi! Stance of existing research on hospital organizational change managers of hospitals ( 33 % ) ICU which. Experimental Medicine - Magna Graecia University phase of the search strategy is provided minimum. Hospital care: a multilevel analysis Med care, 61, 64 ] ownership in! Starting point of our systematic search attributable to several environmental factors, such as location city. [ 102 ] stated, `` for most applications, it is graded at being through... Potential economies of scale in14 non-revenue-producing cost centres in hospitals with over 10,000 discharges annually by their. Thus, the amount of health – hospitals ’ bill sizes information *! Publicly available papers and thus potentially Subject to publication bias, Business and Economic journals by research method or! On hospitals after and before hospital financing reform hospitals could substantially reduce costs and clinical... Organizations are required to achieve efficiency and quality of care databases as sources...

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