[New management models or traditional hospital management? Transition of a hospital-foundation in a Euroregion].

Abstract

Background: This study aims to assess the impact of transitioning a hospital/foundation from indirect management to direct management on the efficiency of hospital resource management.

Methodology: Until 2010, the Virxe da Xunqueira hospital/foundation, located in the Galicia-North Portugal Euroregion, operated under indirect management. In 2010, it transitioned to direct management as a health centre within the Galician Health Service (Spain). Public management of hospital resources was compared using data development analysis for two periods: indirect management (2005-2009) and direct management (2011-2015). Inputs included labour (number of workers) and capital (number of beds), while outputs were measured by the number of consultations, emergencies, interventions, admissions (inpatients), hospital stays, patients on waiting the list, average length of stay, waiting times, and hospital occupancy rate. The synthetic index used was the basic care units.

Results: Virxe da Xunqueira demonstrated greater efficiency as a hospital/foundation in terms of the number of consultations, emergencies, admissions, inpatients, and indicators related to patient stay (including number and average length of stay). After transitioning to direct management, the hospital showed improved efficiency in average waiting times, the number of patients on the waiting list, and the number of surgical interventions. The production factors exhibited decreasing returns to scale in both types of governance.

Conclusions: Both type of management show greater efficiency in certain inputs. However, there is insufficient evidence to conclude that the previous management model (indirect management) is more efficient than direct management.