The Acute Care Services Production Process’s Efficiency: A DEA Network Model for the Italian Hospitals

The paper conceptualize the production process of the hospital’s acute care services as a network of two sub-processes. A Constant Returns to Scale and Variable Returns to Scale Data Envelopment Analysis network model allows us to estimates relational and sub-process efficiency. Our results show that under the Constant Returns to Scale assumption the Data Envelopment Analysis network model results in a 0.459% level of efficiency on average, while the Data Envelopment Analysis model in a 0.590% efficiency level. Additionally, the Variable Returns to Scale efficiency scores are estimated to be around 0.849% and 0.655% respectively. The efficiency of the medical and assistance sub-processes are individually measured and found to be at the 0.485% and of 0.647% levels respectively under Constant Returns to Scale assumption, and at the 0.564% and 0.706% levels under Variable Returns to Scale. The relational efficiency of the second sub-process is estimated to be around 0.93% and 1.22 respectively under Constant Returns to Scale and Variable Returns to Scale. Concluding statistical tests confirm that modeling the relationship between the two sub-processes using a relational model influences the efficiency measurement, affecting consequently the policy implications.