DOI QR코드

DOI QR Code

Economies of Scale and Scope in Hospitals

병원의 규모와 범위의 경제

  • Ham, U-Sang (The Institute cf Management Research, Kangwon National University)
  • 함유상 (강원대학교 경영연구소)
  • Published : 2008.03.31

Abstract

This study investigates economies of scale, cost complementarity and economies of scope for healthcare organizations using econometric approaches. The economies of scale appear to exist in each service provided by a hospital such as inpatient treatment services, outpatient treatment services, and other patient treatment services, respectively. When we test all services in aggregate level, it also indicates that the healthcare industry on average exhibits the economies of scale of 6 percent, which implies that scaling up hospital sizes will bring substantial cost savings to them Evidence shows that cost complementarity exists between outpatient services and other services for patients and, i.e., these other services for patients experience the reduction in marginal costs as the outputs of the outpatient services increase. For the economies of scope, they are present in most service areas; aggregate level services, outpatient services, and other services for patients, respectively. Inpatient treatment services, however, do not show any evidence of the economies of scope. Results show that the economies of scope are achieved by the general hospital type that provides all service areas such as inpatient treatments, outpatient treatments, and other services for patients. The existence of the economies of scope provides the rationale for extending the existing line of business in a hospital into more diverse areas of services where its benefit comes in the form of cost savings. In sum, it overall provides evidence that the M&As in this industry are encouraged to achieve cost reductions from the economies of scale and scope by changing the size and the output mix.

Keywords

References

  1. 김인기, 김장희. 한국 은행산업의 규모와 범위의 경제성 연구. 금융연구 1991;5(2): 37-88
  2. 박경삼, 김윤태, 정홍식. DEA 및 DEA윈도우분석을 이용한 대규모 종합병원의 시대별 경영효율성 변화분석. 경영학연구 2005;34(1):267-287
  3. 안인환, 양동현. DEA모형을 이용한 종합병원의 효율성 측정과 영향요인. 병원경영학회지 2005;10(1):71-92
  4. 유완식. 우리나라 은행산업의 X-비효율성 분석. 금융연구 1997;11(2):47-73
  5. 이필상, 문한근. 은행의 규모 및 범위의 경제효과분석. 경영논총 1990;99-114
  6. 이준구. 미시경제학. 서울:법문사;2002
  7. 전기홍, 조우현, 김양균, 우리나라 병원의 규모의 경제에 관한 연구. 보건행정학회지, 1994;4(1):107-122
  8. 정운찬, 정지만, 함시창, 김규한. 우리나라 은행산업의 효율성 : Fourier Flexible 비용함수의 분석을 중심으로. 경제학연구. 2000;48(1):85-114
  9. 정익준. 은행업의 대형화와 효율성 : 비용효과를 중심으로. 조사통계월보 1993;20-42
  10. 좌승희. 우리나라 은행산업의 효율성분석과 제도개선방향. 한국개발연구 1992;14(2):109-153
  11. Baumol WJ, Panzar JC, Willig RD. Contestable Markets and the Theory of Industry Structure. New York:Harcourt Brace Jovanovich Inc;1982
  12. Benston GJ, Hanweck GA, Humphrey DB. Scale Economies in Banking. Journal of Money, Credit and Banking 1982;14(4):435-456 https://doi.org/10.2307/1991654
  13. Berger AN, Hanweck GA, Humphrery DB. Competitive Viability in Banking : Scale, Scope, and Product Mix Economic. Journal of Monetary Economics 1987;20(3):501-520 https://doi.org/10.1016/0304-3932(87)90039-0
  14. Berger AN, Hunter, Timme. The Efficiency of Financial Institutions : A Review and Preview of Research-Past, Present and Future. Journal of Banking and Finance 1993;17(2-3):221-249 https://doi.org/10.1016/0378-4266(93)90030-H
  15. Berger AN, Leusne JH, Mingo JJ. The Efficiency of Bank Branched. Journal of Monetary Economics 1997;40(1):141-162 https://doi.org/10.1016/S0304-3932(97)00035-4
  16. Berger AN, Mester LJ. Inside the Black Box : What Explains Differences in The Efficiencies of Financial Institutions?. Journal of Banking and Finance 1997;21(7):895-947 https://doi.org/10.1016/S0378-4266(97)00010-1
  17. Christensen LR, Jorgenson DW, Lau LJ. Conjugate Duality and the Transcendental Logarithmic Production Function. Econometrica 1970;39(4):255-256
  18. Christensen LR, Jorgenson DW, Lau LJ. Transcendental Logarithmic Production Frontiers. Review of Economics and Statistics 1973;55:28-45 https://doi.org/10.2307/1927992
  19. Copeland TE, Weston JF. Financial Theory and Corporate Policy. 3rd ed. California:Addison-Wesley;1988
  20. Dranove D, Lindrooth R. Hospital Consolidation and Costs: Another look at the Evidence. Journal of H ealth Economics 2003;22:983-997 https://doi.org/10.1016/j.jhealeco.2003.05.001
  21. Gilligan WT, Smirlock ML, Marshall W. Scale and Scope Economies in the Multi-Product Banking Firm. Journal of Monetary Economies 1984;13:393-405 https://doi.org/10.1016/0304-3932(84)90041-2
  22. Given RS. Economies of Scale and Scope as an Explanation of Merger and Output Diversification Activities in the Health Maintenance Organization Industry. Journal of Health Economics 1996;15:685-713 https://doi.org/10.1016/S0167-6296(96)00500-0
  23. Greene WH. The Econometric Approach to Efficiency Measurement. Stern School of Business:New York University;1991
  24. Greene WH. Econometric Analysis. 2nd ed. New York:MaMillan;1993
  25. Greene WH. LIMDEP version 7.0 User's Manual. Economic Software;1995
  26. Gujarati DN. Basic Econometrics. 3rd ed. McGraw-Hill;1995
  27. Varian HR. Microeconomic Analysis. Norton & Company;1984:171-181
  28. Hunter WC, Timme SG. Technical Change, Organizational Form, and The Structure of Bank Production. Journal of Money, Credit, and Bnaking 1986;18:152-166 https://doi.org/10.2307/1992199
  29. Maurice SC, Thomas CR. Managerial Economics. 5th ed, 1995;382-383
  30. Preyra C, Pink G. Scale and Scope Efficiencies through Hospital Consolidations. Journal of Health Economics 2006;25(6):1049-1068 https://doi.org/10.1016/j.jhealeco.2005.12.006
  31. Pulley LB, Braunstein YM. A Composite Cost Function for Multiproduct Firms with an Application to Economies of Scope in Banking. The Review of Economics and Statistics 1992;221-230
  32. Shaffer S. Can Megamergers Improve Bank Efficiency?. Journal of Banking and Finance 1993;17:423-436 https://doi.org/10.1016/0378-4266(93)90042-C
  33. Silberberg E. The Structure of Economics. 2nd, McGraw-Hill;1990
  34. Zellner A. An Efficient Method of Estimating Seemingly Unrelated Regressions and Tests for Aggregation Bias. American Statistical Association Journal 1962;June:348-368