Work

What is the difference between specialisation and diversity in hospitals? Investigating their relationship with efficiency

Year: 2025

Type: article

Abstract: The relationship between hospital specialisation and efficiency is crucial for managing hospital services. We discuss hospital specialisation as a specific instance of the more general concept of diversity and the conceptual opposite of variety. Unlike prior studies that focus on specialisation measures without a theoretical background, we employ the Blau Index, based on the concept of variety, enabling us to assess diversification's impact on efficiency. We apply the non-parametric meta-frontier approach to a sample of Italian hospitals from 2000 to 2019 in a two-stage analysis. In the first phase, we employ Data Envelopment Analysis (DEA) to evaluate healthcare efficiency. In the second phase, we use bootstrap truncated regression to explore the impact of hospital specialisation and various organisational factors on efficiency. Our findings challenge the prevailing assumption that specialisation leads to higher efficiency, showing instead that hospitals with greater diversification tend to perform better. Hospital managers and regional decision makers can leverage this insight to make informed strategic decisions regarding strategic planning for service delivery.

Source: Socio-Economic Planning Sciences

DOI: 10.1016/j.seps.2025.102251

Authors: Ginevra Giuliani, Simone Gitto

Institution: University of Siena

Language: English

Topic: Efficiency Analysis Using DEA

Subfield: Management Science and Operations Research

Field: Decision Sciences

Domain: Social Sciences

Open Access status: hybrid

Estimated APC paid: $3,550

Funders: European Commission, Ministero dell'Istruzione e del Merito, NextGenerationEU