Does restructuring hospitals results in greater efficiency? - An empirical test using diachronic data

Braithwaite, J; Westbrook, MT; Hindle, D; Iedema, RA; Black, DA

Does restructuring hospitals results in greater efficiency? - An empirical test using diachronic data

Braithwaite, J Westbrook, MT Hindle, D Iedema, RA

Black, DA

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Publication Type:: Journal Article
Citation:: Health Services Management Research, 2006, 19 (1), pp. 1 - 12
Issue Date:: 2006-02-01

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Field	Value	Language
dc.contributor.author	Braithwaite, J	en_US
dc.contributor.author	Westbrook, MT	en_US
dc.contributor.author	Hindle, D	en_US
dc.contributor.author	Iedema, RA https://orcid.org/0000-0001-6792-1048	en_US
dc.contributor.author	Black, DA	en_US
dc.date.issued	2006-02-01	en_US
dc.identifier.citation	Health Services Management Research, 2006, 19 (1), pp. 1 - 12	en_US
dc.identifier.issn	0951-4848	en_US
dc.identifier.uri	http://hdl.handle.net/10453/9664
dc.description.abstract	Hospitals are being restructured more frequently. Increased cost efficiency is the usual justification given for such changes. All 20 major teaching hospitals in Australia's two most populous states were investigated by classifying each over a 5-6 year period in terms of their cost efficiency (average cost per case weighted by Australian diagnosis-related group [AN-DRG] data and adjusted for inflation) and structure, categorized as traditional-professional (TP), clinical-divisional (CD), or clinical-institute (CI). In all, 12 hospitals changed structure during the study period. There was slight evidence that CD structures were more efficient than TP structures but this was not supported by other evidence. There were no significant differences in efficiency in the first or second years following changes from either TP to CD or TP to CI structures. All four hospitals changing from CD to CI structure became significantly less efficient. This may be due to frequency rather than type of change as they were the only hospitals that implemented two structural changes. Hospitals that changed or did not change structure were similar in efficiency at the beginning and at the end of the study period, in overall efficiency during the period, and in trends toward efficiency over time. The findings challenge those who advocate restructuring hospitals on the grounds of improving cost efficiency. © Health Services Management Centre 2006.	en_US
dc.relation.ispartof	Health Services Management Research	en_US
dc.relation.isbasedon	10.1258/095148406775322016	en_US
dc.subject.classification	Health Policy & Services	en_US
dc.subject.mesh	Empirical Research	en_US
dc.subject.mesh	Hospitals, Teaching	en_US
dc.subject.mesh	Hospital Restructuring	en_US
dc.subject.mesh	Efficiency, Organizational	en_US
dc.subject.mesh	New South Wales	en_US
dc.title	Does restructuring hospitals results in greater efficiency? - An empirical test using diachronic data	en_US
dc.type	Journal Article
utslib.citation.volume	1	en_US
utslib.citation.volume	19	en_US
utslib.for	1117 Public Health and Health Services	en_US
utslib.for	1605 Policy and Administration	en_US
pubs.embargo.period	Not known	en_US
pubs.organisational-group	/University of Technology Sydney
pubs.organisational-group	/University of Technology Sydney/Faculty of Arts and Social Sciences
utslib.copyright.status	closed_access
pubs.issue	1	en_US
pubs.publication-status	Published	en_US
pubs.volume	19	en_US

Abstract:

Hospitals are being restructured more frequently. Increased cost efficiency is the usual justification given for such changes. All 20 major teaching hospitals in Australia's two most populous states were investigated by classifying each over a 5-6 year period in terms of their cost efficiency (average cost per case weighted by Australian diagnosis-related group [AN-DRG] data and adjusted for inflation) and structure, categorized as traditional-professional (TP), clinical-divisional (CD), or clinical-institute (CI). In all, 12 hospitals changed structure during the study period. There was slight evidence that CD structures were more efficient than TP structures but this was not supported by other evidence. There were no significant differences in efficiency in the first or second years following changes from either TP to CD or TP to CI structures. All four hospitals changing from CD to CI structure became significantly less efficient. This may be due to frequency rather than type of change as they were the only hospitals that implemented two structural changes. Hospitals that changed or did not change structure were similar in efficiency at the beginning and at the end of the study period, in overall efficiency during the period, and in trends toward efficiency over time. The findings challenge those who advocate restructuring hospitals on the grounds of improving cost efficiency. © Health Services Management Centre 2006.

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http://hdl.handle.net/10453/9664