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Efficiency and Program‐Contract Bargaining in Spanish Public Hospitals
Author(s) -
Ventura Juan,
GonzáLez Eduardo,
Cárcaba Ana
Publication year - 2004
Publication title -
annals of public and cooperative economics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.526
H-Index - 37
eISSN - 1467-8292
pISSN - 1370-4788
DOI - 10.1111/j.1467-8292.2004.00262.x
Subject(s) - ratchet effect , credibility , productivity , incentive , index (typography) , economics , bargaining power , total factor productivity , contract management , business , microeconomics , ratchet , economic growth , marketing , political science , management , computer science , law , world wide web , chaotic
This paper analyses the evolution of productivity in Spanish public hospitals during the period characterised by the use of program‐contracts. The results demonstrate that a significant improvement has occurred. The decomposition of the Malmquist productivity index shows that efficiency change has been the main contributor to productivity improvement. We also analyse the dynamic implications of program‐contract bargaining. In particular, the data support the hypothesis that the bargaining process has been subject to a ratchet effect, i.e., the more a hospital does today, the more the hospital is asked to do in the future. This result threatens the credibility of the program‐contract as an incentive system .