公立病院の経営効率性変化の計測と経営形態の見直しの効果―新公立病院改革プランを対象とした非裁量要因を含むMalmquist指数による計測―

抄録

This paper conducts two major analyses on 378 public hospitals existing during the implementation period of the New Public Hospital Reform Plan, which spans fiscal years 2015 and 2019. The first analysis measures the change in management efficiency between the two time points using the Malmquist index based on NDDEA, which adjusts for differences in non-discretionary factors across public hospitals to avoid any disadvantages in the measurement of their management efficiency. As a result, management efficiency improved or maintained in about 50% of public hospitals. The second analysis uses OLS estimation to examine whether public hospitals that revised their management structure to fully comply with the Local Public Enterprise Law were able to achieve greater improvements in management efficiency compared to hospitals that did not make such changes. The results indicate that revised public hospitals achieved greater improvements in management efficiency. Therefore, it can be concluded that this reform plan is effective as a policy.