title: The impact of economic crisis on the Greek hospitals' productivity.
abstract: During the recent economic crisis, Greece implemented a comprehensive reform in the health care system. The 2010 health reform occurred under the constraints imposed by the memorandum of understanding that the Greek Government signed with its EU/International Monetary Fund creditors to control its deficit. The objective of the study is to examine the impact of the reform on the efficiency and productivity of public hospitals in Greece. We use the Malmquist productivity index to comparatively examine the potential changes before and after the reform years. We compare productivity, efficiency, and technological changes using panel data of 111 public acute hospitals operating in Greece throughout the recession period of 2009 to 2012. Bootstrapping methods are applied to allow for uncertainty owing to sampling error and for statistical inference for the Malmquist productivity index and its decompositions. The analysis indicates that the productivity has been increased following the policy changes. It appears that the expected benefits from the reform in general have been achieved, at least in the short-term. This result is examined in the light of management and operations activities, which are related with the reform process. Therefore, at a second stage, the Malmquist index is regressed on variables that may potentially be statistically associated with productivity growth.
authors.affiliation: Department of Business Administration, Technological Educational Institute of Western Greece, Patras, Greece.
authors.forename: Panagiotis
authors.identifier: http://orcid.org/0000-0002-6450-2670
authors.initials: P
authors.lastname: Mitropoulos
authors.affiliation: Department of Business Administration, Technological Educational Institute of Western Greece, Patras, Greece.
authors.forename: Ioannis
authors.initials: I
authors.lastname: Mitropoulos
authors.affiliation: Department of Informatics and Computer Technology, Technological Educational Institute of Central Greece, Lamia, Greece.
authors.forename: Haralampos
authors.initials: H
authors.lastname: Karanikas
authors.affiliation: Department of Social Management, Democritus University of Thrace, Komotini, Greece.
authors.forename: Nikolaos
authors.initials: N
authors.lastname: Polyzos
mesh_terms: D020811:Biomedical Technology / Q000706:statistics & numerical data; D057172:Economic Recession; D017598:Efficiency, Organizational; D006115:Greece; D018166:Health Care Reform / Q000458:organization & administration; D006779:Hospitals, Public / Q000458:organization & administration / Q000706:statistics & numerical data*; D006801:Humans
keywords: Greek hospital performance; Malmquist index; data envelopment analysis; health care reform