The effects of upcoding,cream skimming and readmissions on the Italian hospitals efficiency: A population-based investigation |
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Authors: | Paolo Berta Giuditta Callea Gianmaria Martini Giorgio Vittadini |
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Institution: | 1. CRISP, University of Milan Bicocca, Department of Quantitative Methods, Italy;2. University of Bergamo, Department of Economics and Technology Management, Italy |
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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. |
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Keywords: | C51 I11 I18 L33 |
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