Do hospital mergers increase hospital efficiency? Evidence from a National Health Service country.
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.
Kjekshus
Lars
L
Faculty of Medicine, Institute of Health Management and Health Economics, University of Oslo, Oslo, Norway. l.e.kjekshus@medisin.uio.no
Hagen
Terje
T
D017598:Efficiency, Organizational / Q000191:economics / Q000592:standards; D019317:Evidence-Based Medicine; D006273:Health Facility Merger; D006801:Humans; D009313:National Health Programs; D009664:Norway