SSE/EFI Working Paper Series in Economics and Finance
Internal Markets and Performance in Swedish Health Care
() and Clas Rehnberg
Abstract: A separation of provider and purchaser roles - together
with performance-based reimbursement - were recently introduced in several
county councils, which are the local governments that provide and fund
almost all health care in Sweden. These changes have been motivated by
efficiency and consumer choice arguments. In this paper we analyze the
outcome of the former by studying differences in productive performance for
county councils with and without new internal organizations. Performance
measures are estimated using data envelopment analysis. Using data for the
26 county councils between 1989 and 1994 we find differences in mean
efficiency between the two groups, indicating higher technical efficiency
in the group with performance based reimbursement (internal markets).
Differences in productivity growth are also found, although the differences
are significant in one period only.
Keywords: Internal markets; health care; productivity; data envelopment analysis; (follow links to similar papers)
JEL-Codes: D23; D24; I11; (follow links to similar papers)
28 pages, March 1997
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