In this paper we analyze the effects of some distortions induced by the prospective payment system, i.e. upcoding, cream skimming and readmissions, on hospitals' technical efficiency. We estimate a production function using a population-based dataset composed by all active hospitals in an Italian region during the period 1998–2007. We show that cream skimming and upcoding have a negative impact on hospitals' technical efficiency, while readmissions have a positive effect. Moreover, the results indicate that private hospitals engage more in cream skimming than public and not-for-profit ones, while we observe no ownership differences regarding upcoding. Not-for-profit hospitals have the highest readmission index. Last, not-for-profit and public hospitals have the same efficiency levels, while private hospitals have the lowest technical efficiency.

Berta, P., Callea, G., Martini, G., Vittadini, G. (2010). The effetcs of upcoding, creamskimming and readmissions on the Italian hospitals efficiency modelling: a populaiton-based investigtion. ECONOMIC MODELLING, 27(4), 789-890.

The effetcs of upcoding, creamskimming and readmissions on the Italian hospitals efficiency modelling: a populaiton-based investigtion

BERTA, PAOLO;VITTADINI, GIORGIO
2010

Abstract

In this paper we analyze the effects of some distortions induced by the prospective payment system, i.e. upcoding, cream skimming and readmissions, on hospitals' technical efficiency. We estimate a production function using a population-based dataset composed by all active hospitals in an Italian region during the period 1998–2007. We show that cream skimming and upcoding have a negative impact on hospitals' technical efficiency, while readmissions have a positive effect. Moreover, the results indicate that private hospitals engage more in cream skimming than public and not-for-profit ones, while we observe no ownership differences regarding upcoding. Not-for-profit hospitals have the highest readmission index. Last, not-for-profit and public hospitals have the same efficiency levels, while private hospitals have the lowest technical efficiency.
Articolo in rivista - Articolo scientifico
Upcoding, Cream Skimming, Readmission, Hospital Technical Efficiency, Ownership
English
Berta, P., Callea, G., Martini, G., Vittadini, G. (2010). The effetcs of upcoding, creamskimming and readmissions on the Italian hospitals efficiency modelling: a populaiton-based investigtion. ECONOMIC MODELLING, 27(4), 789-890.
Berta, P; Callea, G; Martini, G; Vittadini, G
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/10281/8532
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