title: [Technical efficiency of traditional hospitals and public enterprises in Andalusia (Spain)].
abstract: OBJECTIVE
  To assess the technical efficiency of traditional public hospitals without their own legal identity and subject to administrative law, and that of public enterprise hospitals, with their own legal identities and partly governed by private law, all of them belonging to the taxypayer-funded health system of Andalusia during the period 2005 -2008.
  
  
  METHODS
  The study included the 32 publicly-owned hospitals in Andalusia during the period 2005-2008. The method consisted of two stages. In the first stage, the indices of technical efficiency of the hospitals were calculated using Data Envelopment Analysis, and the change in total factor productivity was estimated using the Malmquist index. The results were compared according to perceived quality, and a sensitivity analysis was conducted through an auxiliary model and bootstrapping. In the second stage, a bivariate analysis was performed between hospital efficiency and organization type.
  
  
  RESULTS
  Public enterprises were more efficient than traditional hospitals (on average by over 10%) in each of the study years. Nevertheless, a process of convergence was observed between the two types of organizations because, while the efficiency of traditional hospitals increased slightly (by 0.50%) over the study period, the performance of public enterprises declined by over 2%.
  
  
  CONCLUSIONS
  The possible reasons for the greater efficiency of public enterprises include their greater budgetary and employment flexibility. However, the convergence process observed points to a process of mutual learning that is not necessarily efficient.
authors: Control de Operaciones, Hospital Infanta Margarita, Cabra, Córdoba, España.
authors: Luis
authors: L
authors: Herrero Tabanera
authors: Economía Aplicada, Facultad de Ciencias Económicas y Empresariales, Universidad de Granada, Granada, España. Electronic address: jmartin@ugr.es.
authors: José Jesús
authors: JJ
authors: Martín Martín
authors: Economía Aplicada, Facultad de Ciencias Económicas y Empresariales, Universidad de Granada, Granada, España.
authors: Ma del Puerto
authors: Mdel P
authors: López del Amo González
mesh_terms: D004526:Efficiency; D017598:Efficiency, Organizational; D006779:Hospitals, Public / Q000145:classification / Q000191:economics / Q000331:legislation & jurisprudence; D009936:Organizational Innovation; D011787:Quality of Health Care; D013030:Spain
keywords: Análisis envolvente de datos; Data envelopment analysis; Efficiency; Eficiencia; Eficiencia organizativa; Empresas públicas hospitalarias; Health care sector; Hospitales públicos; Innovación organizativa; Malmquist index; Organizational efficiency; Organizational innovation; Public hospital enterprises; Public hospitals; Sector sanitario; Índice de Malmquist