Do quality and access to hospital services impact on their technical efficiency?

Investigating the impact of quality and access to healthcare services on technical efficiency is a hot topic in health economics and healthcare systems management. No satisfactory conclusions have been drawn regarding the link between quality and technical efficiency of public hospitals. Furthermore, the impact of access to healthcare facilities on their efficiency has been barely studied. This study uses a robust non parametric partial frontier method to study the impact of quality and access to healthcare services on their operational efficiency. A set of Portuguese public hospitals (FY2013-FY2016) is considered for this purpose. Findings suggest that good clinical safety practices in hospital services are associated with low technical efficiency levels, thus trade-offs between efficiency and quality are expected in some dimensions. No meaningful link between access and technical efficiency was observed, although highly efficient entities are associated with low childhood mortality ratios. (C) 2018 Elsevier Ltd. All rights reserved.