We study the presence and the magnitudes of trade-offs between health outcomes and hospitals' efficiency using a data set from Lombardy, Italy, for the period 2008–2011. Our goal is to analyze whether the pressures for cost containment may affect hospital performance in terms of population...

This paper considers the estimation of Kumbhakar et al. (J Prod Anal. doi:<ExternalRef> <RefSource>10.1007/s11123-012-0303-1</RefSource> <RefTarget Address="10.1007/s11123-012-0303-1" TargetType="DOI"/> </ExternalRef>, <CitationRef CitationID="CR30">2012</CitationRef>) (KLH) four random components stochastic frontier (SF) model using MLE techniques. We derive the log-likelihood function of the model using results from the closed-skew normal...</citationref></refsource></externalref>

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...

Cluster-weighted modeling (CWM) is a mixture approach to modeling the joint probability of data coming from a heterogeneous population. Under Gaussian assumptions, we investigate statistical properties of CWM from both theoretical and numerical point of view; in particular, we show that Gaussian...

In recent years, governments and other stakeholders have increasingly used administrative data for measuring healthcare outcomes and building rankings of health care providers. However, the accuracy of such data sources has often been questioned. Starting in 2002, the Lombardy (Italy) regional...

When data sets are multilevel (group nesting or repeated measures), different sources of variations must be identified. In the framework of unsupervised analyses, multilevel simultaneous component analysis (MSCA) has recently been proposed as the most satisfactory option for analyzing multilevel...

Purpose – The purpose of this paper is to propose a practical conceptualization of the balanced scorecard (BSC) to describe the mechanism producing creation of monetary value for hospitals in the territorial context of Lombardy region (Italy). Design/methodology/approach – The authors...