title: Do hospital mergers increase hospital efficiency? Evidence from a National Health Service country.
abstract: OBJECTIVE
  To analyse the effects on technical and cost efficiency of seven hospital mergers over the period 1992-2000 in Norway. The mergers involved 17 hospitals.
  
  
  METHODS
  First, efficiency scores were generated using Data Envelopment Analysis for 53 merged and non-merged hospitals over the nine years. Second, the effect of mergers was estimated through panel data analysis.
  
  
  RESULTS
  In general, the mergers showed no significant effect on technical efficiency and a significant negative effect of 2-2.8% on cost efficiency. However, positive effects on both cost and technical efficiency were found in one merger where more hospitals were involved, and where administration and acute services were centralized.
  
  
  CONCLUSIONS
  The findings indicate that large mergers involving radical restructuring of the treatment process may improve efficiency as intended, but most mergers do not.
authors.affiliation: Faculty of Medicine, Institute of Health Management and Health Economics, University of Oslo, Oslo, Norway. l.e.kjekshus@medisin.uio.no
authors.forename: Lars
authors.initials: L
authors.lastname: Kjekshus
authors.forename: Terje
authors.initials: T
authors.lastname: Hagen
mesh_terms: D017598:Efficiency, Organizational / Q000191:economics / Q000592:standards; D019317:Evidence-Based Medicine; D006273:Health Facility Merger; D006801:Humans; D009313:National Health Programs; D009664:Norway