Dimensione ottima degli ospedali in uno Stato federale

Crivelli, Luca and Filippini, Massimo and Lunati, Diego (2001) Dimensione ottima degli ospedali in uno Stato federale. Economia Pubblica, 31 (5). pp. 97-119. ISSN 0390-6140

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Switzerland is a federal State where policy decisions and implementation regarding regional hospital plans are by rights incumbent to the regional and local governments (Canton and Town Council). This situation is in part responsible for the large number of small hospitals that have been built in recent years. In Switzerland, in fact, approx. 70% of hospitals have a capacity of less than 135 beds. The purpose of this study is to analyse the cost structure of the Swiss hospitals in order to assess economies of scale and to estimate a typical hospital’s optimum size. A translog cost function was estimated using panel data for a sample of 145 hospitals over the period 1989-’91. The results indicate the existence of economies of scale for most output levels. Empirical evidence suggests that a hospital’s optimum size is reached with 300 beds, even though a capacity of 135 beds is sufficient to absorb most of the economies of scale.

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