caa a22 4500 60616748X CHVBK 20210128100703.0 cr unu---uuuuu 210128e20150301xx s 000 0 eng 10.1007/s10754-014-9159-4 doi (NATIONALLICENCE)springer-10.1007/s10754-014-9159-4 Meyer Stefan Department of Health Economics, Faculty of Business and Economics (WWZ), University of Basel, Peter Merian-Weg 6, 4002, Basel, Switzerland aut Payment schemes and cost efficiency: evidence from Swiss public hospitals [Elektronische Daten] [Stefan Meyer] This paper aims at analysing the impact of prospective payment schemes on cost efficiency of acute care hospitals in Switzerland. We study a panel of 121 public hospitals subject to one of four payment schemes. While several hospitals are still reimbursed on a per diem basis for the treatment of patients, most face flat per-case rates—or mixed schemes, which combine both elements of reimbursement. Thus, unlike previous studies, we are able to simultaneously analyse and isolate the cost-efficiency effects of different payment schemes. By means of stochastic frontier analysis, we first estimate a hospital cost frontier. Using the two-stage approach proposed by Battese and Coelli (Empir Econ 20:325-332, 1995), we then analyse the impact of these payment schemes on the cost efficiency of hospitals. Controlling for hospital characteristics, local market conditions in the 26 Swiss states (cantons), and a time trend, we show that, compared to per diem, hospitals which are reimbursed by flat payment schemes perform better in terms of cost efficiency. Our results suggest that mixed schemes create incentives for cost containment as well, although to a lesser extent. In addition, our findings indicate that cost-efficient hospitals are primarily located in cantons with competitive markets, as measured by the Herfindahl-Hirschman index in inpatient care. Furthermore, our econometric model shows that we obtain biased estimates from frontier analysis if we do not account for heteroscedasticity in the inefficiency term. Springer Science+Business Media New York, 2014 Prospective reimbursement nationallicence Inpatient payment systems nationallicence Cost efficiency nationallicence Stochastic frontier analysis nationallicence Heteroscedastic frontier models nationallicence International Journal of Health Economics and Management Springer US; http://www.springer-ny.com 15/1(2015-03-01), 73-97 2199-9023 15:1<73 2015 15 10754 https://doi.org/10.1007/s10754-014-9159-4 text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 research-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10754-014-9159-4 text/html Onlinezugriff via DOI NATIONALLICENCE 100 1- Meyer Stefan Department of Health Economics, Faculty of Business and Economics (WWZ), University of Basel, Peter Merian-Weg 6, 4002, Basel, Switzerland aut NATIONALLICENCE 773 0- International Journal of Health Economics and Management Springer US; http://www.springer-ny.com 15/1(2015-03-01), 73-97 2199-9023 15:1<73 2015 15 10754