Chapter 6 Innovations and Productivity: An Empirical Investigation in Dutch Hospital Industry

There is a large body of literature on the efficiency and productivity of hospitals. Most studies focus on the effects of environmental pressures on hospital efficiency, such as payment systems ( Dismuke & Sena, 1999 ; Sommersguter-Reichmann, 2000 ), competition (Rosko, 1999, 2004), Sari, 2003 ), and property rights ( Gruca & Nath, 2001 ). Other studies pinpoint their attention to economic phenomena, such as economies of scale ( Lindrooth, Lo Sasso, & Bazzoli, 2003 ; Dranove & Lindrooth, 2003 ), economies of scope ( Prior & Sola, 2000 ; Grosskopf, Margaritis, & Valdmanis, 2001 ; Li & Rosenman, 2001 ), chain membership ( Menke, 1997 ), economic behavior ( Blank & Merkies, 2004 ), and expense preference ( Rodriguez-Alvarez & Lovell, 2004 ).