Antonio Rúa Vieites

Analysis of the technical efficiency of the forms of hospital management based on public-private collaboration of the Madrid Health Service, as compared with traditional management

FUNDAMENTALS The study aims to carry out a comparative analysis of the technical efficiency of hospital management based on public-private collaboration, as compared with traditional management. Specifically, we compare traditionally managed public hospitals, public hospitals managed by a private finance initiative (PFI), public hospitals managed through a public-private partnership (PPP), and hospitals managed through other forms of management, during the period 2009 to 2014, in the hospitals dependent on the Madrid Health Service (SERMAS). METHODS The study covers all publicly owned general hospitals under SERMAS, consisting of seven PFI hospitals, three PPP hospitals, 11 traditionally managed public hospitals (with the category of general hospital), and four hospitals managed through other forms of hospital management. The technical efficiency indices of the hospitals were calculated using the data envelopment analysis technique. Subsequently, a sensitivity analysis was performed by bootstrapping and variation of model variables to verify their impact on efficiency. Finally, an analysis of the evolution of efficiency in the analyzed period was carried out using the Malmquist Index. RESULTS In all the analysis models carried out in the analyzed period, the hospitals managed based on public-private collaboration were more efficient than the hospitals under traditional management. CONCLUSIONS The greater efficiency of hospitals managed based on public-private collaboration, as compared with traditional management, could be attributed to greater organizational and management flexibility.

Fiscal policy and economic growth: European Union experience

Traditionally, economists have been concerned over factors that improve economic growth, initially introducing physical capital and later human capital. We will consider a new factor, social capital. Also, we will introduce in this paper the effect of the fiscal policy on economic growth. In addition, we will analyse the effects that the use of fiscal policy has on economic growth. Concretely, we will study public capital, which if it introduces production factors, as well as physical capital, human capital and social capital, could influence economic growth. Finally, we will realise an econometric estimation to analyse the effects of these production factors on economic growth using data for European countries before amplification for the period 1982–2000.