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Estabelecimento de Benchmarks para os custos de utilização dos edifícios hospitalares portugueses; Benchmarks establishment for running costs of portuguese hospital facilities

Lemos, Leonel Fernandes
Fonte: Universidade do Minho Publicador: Universidade do Minho
Tipo: Trabalho de Conclusão de Curso
Publicado em //2013 POR
Relevância na Pesquisa
46.09%
Dissertação de mestrado integrado em Engenharia Civil (área de especialização em Perfil de Construções); O Serviço Nacional de Saúde (SNS) contribui para a proteção da saúde dos portugueses, contudo a sua gestão tem-se revelado, por vezes, pouco eficiente, uma vez que não é possível controlar a procura, assim como os custos. Os edifícios hospitalares têm uma grande e complexa variedade de recursos e exigências nos seus diversos campos de atuação, que juntamente com o aumento da esperança média de vida e o avanço científico e tecnológico, tornam o estudo desta tipologia de edifícios um desafio aliciante. A gestão hospitalar rapidamente se apercebeu que: para o SNS se tornar uma estrutura financeira estável, seria necessário melhorar o desempenho, tornando-se assim o benchmarking a palavra do momento. A avaliação do desempenho não cria somente os benchmarks, como fornece também informação em falta às instituições e organizações e demonstra como melhorar o desempenho. Através da metodologia benchmarking espera-se obter o valor das melhores práticas exercidas pelos edifícios hospitalares e assim fornecer aos gestores hospitalares e projetistas a possibilidade de identificação de pontos de melhoria com vista à redução de custos de utilização e aumento da sua eficiência. Desta forma...

Do hospital mergers improve the performance of hospital efficiency?; Quão eficiente é o desempenho hospitalar pós-fusões?: o caso português

Condeixa, Inês Silvestre
Fonte: Universidade de Aveiro Publicador: Universidade de Aveiro
Tipo: Dissertação de Mestrado
ENG
Relevância na Pesquisa
36.11%
Atualmente cada vez mais empresas se juntam para aumentar o seu mercado, obter economias de escala, melhorar as estruturas de custos fixos e, consequentemente, aumentar o lucro. Os hospitais não são exceção. No entanto, a reestruturação de um hospital deve considerar a eficiência do desempenho. A criação dos Centros de Hospitalares (HCʼs) afecta a eficiência dos mesmos, sendo esta a nossa questão fulcral. Para responder a esta questão medimos o impacto das fusões horizontais na eficiência dos hospitais portugueses, utilizando o método Data Envelopment Analysis (DEA). Os resultados empíricos do nosso estudo mostram que as fusões não resultam necessariamente num aumento da eficiência técnica. Algumas fusões hospitalares podem alcançar uma dimensão excessiva, criando deseconomias de escala. A análise sugere, assim, que existem diferenças de acordo com áreas geográficas e estruturas hospitalares. Foram notórias diferenças entre as unidades hospitalares de pequena e grande dimensão, que pensamos que pode ser explicadas pelas necessidades de mercado e problema dos "picos de afluência”. O desempenho das fusões mais antigas, parece permanecer estável nos anos seguintes.; Nowadays, more and more firms come together to gain size...

Opções políticas em saúde: Efeitos sobre a eficiência hospitalar

Harfouche, Ana Paula de Jesus
Fonte: Instituto Superior de Ciências Sociais e Políticas Publicador: Instituto Superior de Ciências Sociais e Políticas
Tipo: Tese de Doutorado
Publicado em //2010 POR
Relevância na Pesquisa
36.09%
Tese de Doutoramento em Ciências Sociais na especialidade de Administração Pública; Nesta investigação foram estudadas duas Opções Políticas em Saúde, no período 2002- 2008, em Portugal. A primeira, importou as linhas de conduta da New Public Management para o Sector da Saúde, no período 2002-2004, sob a acção do XV e XVI Governos Constitucionais Ministro da Saúde Luís Filipe Pereira, com a empresarialização dos hospitais. A segunda, no período 2005-2007/8, sob a acção do XVII Governo Constitucional - Ministro da Saúde António Correia de Campos, que deu continuidade à empresarialização com tónica para a fusão dos hospitais em centros hospitalares. As Opções foram combinadas com o estudo da eficiência técnica hospitalar. Esta combinação permitiu avaliar o efeito potencialmente induzido por cada uma das Opções Políticas adoptadas, na eficiência. Ambas as Opções Políticas foram indutoras de ganhos de eficiência nos hospitais empresarializados, de forma individualizada ou por fusão. Sublinha-se o efeito contaminação do grupo de hospitais não empresarializados, mas por operarem no mesmo ambiente e clima competitivo obtiveram, também, ganhos de eficiência. Assinala-se, ainda...

Análise da eficiência dos hospitais SA e SPA segundo uma abordagem de fronteira de eficiência

Gonçalves, Luís F. Melo
Fonte: Instituto Universitário de Lisboa Publicador: Instituto Universitário de Lisboa
Tipo: Tese de Doutorado
Publicado em //2008 POR
Relevância na Pesquisa
36.11%
Doutoramento em Gestão. Especialidade de Métodos Quantitativos de Gestão / Classificação JEL: I18, C02; Os hospitais são unidades complexas que produzem múltiplos outputs através da utilização de múltiplos inputs (Fare et al., 1994b). A par da sua complexidade, colocam-se questões relevantes relativas ao seu funcionamento, à sua eficiência pelos recursos envolvidos no seu funcionamento. Estima-se que cerca de metade dos recursos aplicados no sector da saúde dizem respeito ao funcionamento dos hospitais A conjugação desta situação, com a necessidade de combater as despesas da administração pública, esteve na base da onda reformista conhecida por New Public Management (NPM). A NPM teve origem, e conheceu grande impulso, nos países anglo-saxónico, nomeadamente, no Reino Unido. Nesta onda reformista que se assistiu, o sector da saúde foi onde, provavelmente, maiores alterações foram ensaiadas, como por exemplo a criação dos chamados quase-mercados ou mercado interno da saúde. Neste contexto, parte significativa dos hospitais do National Health Service (NHS) foram transformados em hospitais trusts. Em Portugal, na linha deste movimento reformista, foram ensaiadas algumas experiências no sector hospitalar...

Hospital Efficiency: Directed internship: Deloitte & NOVA SBE

Castro, Pedro Sucena e
Fonte: NSBE - UNL Publicador: NSBE - UNL
Tipo: Dissertação de Mestrado
Publicado em /06/2012 ENG
Relevância na Pesquisa
46.1%
A Work Project, presented as part of the requirements for the Award of a Masters Degree in Economics from the NOVA – School of Business and Economics; In a context of economic recession, where resource scarcity follows every manager, efficiency is the only way out. Health Care is no exception. Continuous budgetary cuts from central authorities led to increasing pressures in hospital managers to achieve efficient results. In light of being able to quantify efficiency, this work project has the aim of identifying the best of two frontier based analysis (Stochastic Frontier Analysis and Data Envelopment Analysis) by performing efficiency estimations for a single year using variables from the Portuguese reality, allowing the identification of inefficiency sources. Efficiency scores will be obtained to compare hospitals for efficiency ranks and several efficiency-seeking suggestions will be stated in the end. The scores obtained from the estimations show that some hospitals still have a rough path to endure if they are to achieve economic efficiency. From the analysis we can see that efficient hospitals vary for each model. (8 in SFA [hospitals with a score higher than 0.95] and 17 in DEA). Estimation outputs suggest that changes in hospital size or services provided should occur in order to achieve higher efficiency...

A national study of the efficiency of hospitals in urban markets.

Ozcan, Y A; Luke, R D
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /02/1993 EN
Relevância na Pesquisa
36.09%
Using a sample of 3,000 urban hospitals, this article examines the contributions of selected hospital characteristics to variations in hospital technical efficiencies, while it accounts for multiple products and inputs, and controls for local environmental variations. Four hospital characteristics are examined: hospital size, membership in a multihospital system, ownership, and payer mix (managed care contracts, percent Medicare, and percent Medicaid). Ownership and percent Medicare are consistently found to be related significantly to hospital efficiency. Within the ownership variable, government hospitals tend to be more efficient and for-profit hospitals less efficient than other hospitals. Higher percentages of Medicare payment are negatively related to efficiency. While not consistently significant across all five of the MSA size categories in which the analyses are conducted, possession of managed care contracts, membership in a multihospital system, and size all are consistently related positively to hospital technical efficiency. These variables are also all significant when the hospitals are examined in a combined analysis. Percent Medicaid was not significant in any of the analyses. Implications for policy and the need for methodological work are discussed.

Measuring hospital efficiency: a comparison of two approaches.

Chirikos, T N; Sear, A M
Fonte: PubMed Publicador: PubMed
Tipo: Artigo de Revista Científica
Publicado em /02/2000 EN
Relevância na Pesquisa
46.09%
OBJECTIVE: To compare the results of scoring hospital efficiency by means of two new types of frontier models, Data Envelopment Analysis (DEA) and stochastic frontier regression (SFR). STUDY SETTING: Financial records of Florida acute care hospitals in continuous operation over the period 1982-1993. STUDY DESIGN: Comparable DEA and SFR models are specified, and these models are then estimated to obtain the efficiency indexes yielded by each. The empirical results are subsequently examined to ascertain the extent to which they serve the needs of hospital policymakers. DATA COLLECTION: A longitudinal or panel data set is assembled, and a common set of output, input, and cost indicators is constructed to support the estimation of comparable DEA and SFR models. PRINCIPAL FINDINGS: DEA and SFR models yield convergent evidence about hospital efficiency at the industry level, but divergent portraits of the individual characteristics of the most and least efficient facilities. CONCLUSIONS: Hospital policymakers should not be indifferent to the choice of the frontier model used to score efficiency relationships. They may be well advised to wait until additional research clarifies reasons why DEA and SFR models yield divergent results before they introduce these methods into the policy process.

Changes in hospital efficiency after privatization

Tiemann, Oliver; Schreyögg, Jonas
Fonte: Springer US Publicador: Springer US
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.08%
We investigated the effects of privatization on hospital efficiency in Germany. To do so, we obtained bootstrapped data envelopment analysis (DEA) efficiency scores in the first stage of our analysis and subsequently employed a difference-in-difference matching approach within a panel regression framework. Our findings show that conversions from public to private for-profit status were associated with an increase in efficiency of between 2.9 and 4.9%. We defined four alternative post-privatization periods and found that the increase in efficiency after a conversion to private for-profit status appeared to be permanent. We also observed an increase in efficiency for the first three years after hospitals were converted to private non-profit status, but our estimations suggest that this effect was rather transitory. Our findings also show that the efficiency gains after a conversion to private for-profit status were achieved through substantial decreases in staffing ratios in all analyzed staff categories with the exception of physicians and administrative staff. It was also striking that the efficiency gains of hospitals converted to for-profit status were significantly lower in the diagnosis-related groups (DRG) era than in the pre-DRG era. Altogether...

The Classic: A Study in Hospital Efficiency: As Demonstrated by the Case Report of First Five Years of Private Hospital

Codman, Ernest Amory
Fonte: Springer-Verlag Publicador: Springer-Verlag
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
56.06%
This is an abridged version of the Classic Article by E.A. Codman, A Study in Hospital Efficiency: As Demonstrated by the Case Report of the First Five Years of a Private Hospital. The full article is available as supplemental material for the abridged version in the online version of CORR®. An accompanying biographical sketch of E.A. Codman is available at DOI 10.1007/s11999-012-2750-4. The Classic Article is © 1918 and is reprinted courtesy of Thomas Todd Co. from E.A. Codman. A Study in Hospital Efficiency: As Demonstrated by the Case Report of the First Five Years of a Private Hospital. Boston: Thomas Todd Co.; 1918: 4–10,108,162.

Serbia - Baseline Survey on Cost and Efficiency in Primary Health Care Centers Before Provider Payment Reforms

World Bank
Fonte: World Bank Publicador: World Bank
Relevância na Pesquisa
36.18%
The purpose of this study is to conduct a baseline survey on the cost and efficiency in Primary Health Care (PHC) Centers in Serbia before the implementation of the payment reforms. Results can be used to inform the payment reform and to establish a baseline on health sector performance including utilization, quality, cost, and efficiency against which the impact of the reforms can be assessed in a follow-up survey. Recommendations about payment system design and capitation formula are beyond the scope of this report and have been undertaken as a separate activity. This study was conducted with the support of World Bank health sector strategy funds. The rest of this report is organized is follows. Chapter two presents the data and methodology used in this survey to evaluate the cost and efficiency performance in Dom Zdravlja (DZs). Results are presented and discussed in chapter three. Based on findings, chapter four concludes and proposes several reform measures to support the effect of the provider payment reform. The annex contains additional information including a technical annex with an overview on the literature on cost and efficiency analysis...

The Impacts of Public Hospital Autonomization : Evidence from a Quasi-Natural Experiment

Wagstaff, Adam; Bales, Sarah
Fonte: World Bank, Washington, DC Publicador: World Bank, Washington, DC
EN_US
Relevância na Pesquisa
46.06%
This paper exploits the staggered rollout of Vietnam s hospital autonomization policy to estimate its impacts on several key health sector outcomes including hospital efficiency, use of hospital care, and out-of-pocket spending. The authors use six years of panel data covering all Vietnam s public hospitals, and three stacked cross-sections of household data. Autonomization probably led to more hospital admissions and outpatient department visits, although the effects are not large. It did not, however, affect bed stocks or bed-occupancy rates. Nor did it increase hospital efficiency. Oddly, despite the volume effects and the unchanged cost structure, the analysis does not find any evidence of autonomization leading to higher total costs. It does, however, find some evidence that autonomization led to higher out-of-pocket spending on hospital care, and higher spending per treatment episode; the effects vary in size depending on the data source and hospital type, but some are quite large -- around 20 percent. Autonomy did not apparently affect in-hospital death rates or complications...

Three essays on hospital efficiency

Rodriguez, Alfonso
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica
EN
Relevância na Pesquisa
46.17%
This dissertation analyzes hospital efficiency using various econometric techniques. The first essay provides additional and recent evidence to the presence of contract management behavior in the U.S. hospital industry. Unlike previous studies, which focus on either an input-demand equation or the cost function of the firm, this paper estimates the two jointly using a system of nonlinear equations. Moreover, it addresses the longitudinal problem of institutions adopting contract management in different years, by creating a matched control group of non-adopters with the same longitudinal distribution as the group under study. The estimation procedure then finds that labor, and not capital, is the preferred input in U.S. hospitals regardless of managerial contract status. With institutions that adopt contract management benefiting from lower labor inefficiencies than the simulated non-contract adopters. These results suggest that while there is a propensity for expense preference behavior towards the labor input, contract managed firms are able to introduce efficiencies over conventional, owner controlled, firms. ^ Using data for the years 1998 through 2007, the second essay investigates the production technology and cost efficiency faced by Florida hospitals. A stochastic frontier multiproduct cost function is estimated in order to test for economies of scale...

Efficiency measurement for hospitals owned by the Iranian Social Security organisation

Hajiali Afzali, H.; Moss, J.; Mahmood, M.
Fonte: Kluwer Academic/plenum Publ Publicador: Kluwer Academic/plenum Publ
Tipo: Artigo de Revista Científica
Publicado em //2007 EN
Relevância na Pesquisa
46.01%
This study used Data Envelopment Analysis (DEA) to examine the relative efficiency of hospitals owned by the Iranian Social Security Organization, which is the second largest institutional source of hospital care in that country. Using data for the year 2002, 26 of the 53 hospitals were deemed to be efficient. Inefficient hospitals had an average score of 90%, implying a potential reduction in all inputs on average by about 10% with no impact on output levels. In addition to the conventional DEA measurement, efficient hospitals were ranked by calculating super-efficiency scores, by identifying weak efficient hospitals, and by determining the frequency of peers. The study provides useful information for improving hospital management, rationalizing resource allocation, and improving services provided by hospitals.; Hossein Hajialiafzali, J. R. Moss and M. A. Mahmood; The original publication is available at www.springerlink.com

Efficiency in hospitals owned by the Iranian Social Security Organisation: measurement, determinants, and remedial actions.

Afzali, Hossein Haji Ali
Fonte: Universidade de Adelaide Publicador: Universidade de Adelaide
Tipo: Tese de Doutorado
Publicado em //2007
Relevância na Pesquisa
46.27%
Given the need to ensure the best use of scarce resources, increasing emphasis is being placed on hospital efficiency measurement. In the literature about hospital efficiency measurement, there is an absence of a well-defined framework to select the most appropriate set of input and output variables. Variables used in hospital efficiency studies predominantly reflect a narrow view of hospital functions with a little attention to quality variables. This implies that the hospital goal and its full range of functions in efficiency measurement are poorly understood. While numerous studies have been undertaken in developed countries, there have been only a few attempts at measuring hospital efficiency in developing countries. However, there has so far been no systematic attempt, using frontier-based techniques, to measure the efficiency of Iranian hospitals, and to identify factors affecting efficiency and remedial actions to improve efficiency. By focusing on the above two issues, this thesis makes three arguments. First, by undertaking an in-depth investigation regarding the multi-product nature of hospitals, considering a fuller range of hospital functions, and the values of various stakeholders including patient, staff, and community...

A conceptual framework for selecting the most appropriate variables for measuring hospital efficiency with a focus on Iranian public hospitals

Hajiali Afzali, H.; Moss, J.; Mahmood, M.
Fonte: Royal Society of Medicine Press Ltd. Publicador: Royal Society of Medicine Press Ltd.
Tipo: Artigo de Revista Científica
Publicado em //2009 EN
Relevância na Pesquisa
56.2%
Over the past few decades, there has been an increasing interest in the measurement of hospital efficiency in developing countries and in Iran. While the choice of measurement methods in hospital efficiency assessment has been widely argued in the literature, few authors have offered a framework to specify variables that reflect different hospital functions, the quality of the process of care and the effectiveness of hospital services. However, without the knowledge of hospital objectives and all relevant functions, efficiency studies run the risk of making biased comparisons, particularly against hospitals that provide higher quality services requiring the use of more resources. Undertaking an in-depth investigation regarding the multi-product nature of hospitals, various hospital functions and the values of various stakeholders (patient, staff and community) with a focus on the Iranian public hospitals, this study has proposed a conceptual framework to select the most appropriate variables for measuring hospital efficiency using frontier-based techniques. This paper contributes to hospital efficiency studies by proposing a conceptual framework and incorporating a broader set of variables in Iran. This can enhance the validity of hospital efficiency studies using frontier-based methods in developing countries.; Hossein Haji Ali Afzali...

Exploring health professionals' perspectives on factors affecting Iranian hospital efficiency and suggestions for improvement

Hajiali Afzali, H.; Moss, J.; Mahmood, M.
Fonte: John Wiley & Sons Ltd Publicador: John Wiley & Sons Ltd
Tipo: Artigo de Revista Científica
Publicado em //2011 EN
Relevância na Pesquisa
56.19%
While numerous studies have been undertaken in many developed countries and in a few developing countries, there has so far been no systematic attempt to identify factors affecting efficiency in the Iranian hospitals. This study was designed to elicit the perspectives of a group of health professionals and managers so as to analyse factors affecting the efficiency of hospitals owned by the Iranian Social Security Organization (SSO), which is the second largest institutional source of hospital care in that country. This study also aimed to identify actions that would improve efficiency. Using purposive sampling (to identify key informants), interviews with seventeen health professionals and hospital managers involved in the SSO health system were conducted. The respondents identified a number of organizational factors affecting efficiency, particularly the hospital budgeting and payment system used to fund physicians, and the lack of the managerial skills needed to manage complex facilities such as hospitals. The interviewees stressed the necessity for reforms of the regulatory framework to improve efficiency. A few participants recommended the concept of a funder-provider split. The results of this exploratory study have provided meaningful insight into Iranian health professionals views of factors affecting efficiency...

Three Essays on Hospital Efficiency

Rodriguez, Alfonso
Fonte: FIU Digital Commons Publicador: FIU Digital Commons
Tipo: Artigo de Revista Científica Formato: application/pdf
Relevância na Pesquisa
66.2%
This dissertation analyzes hospital efficiency using various econometric techniques. The first essay provides additional and recent evidence to the presence of contract management behavior in the U.S. hospital industry. Unlike previous studies, which focus on either an input-demand equation or the cost function of the firm, this paper estimates the two jointly using a system of nonlinear equations. Moreover, it addresses the longitudinal problem of institutions adopting contract management in different years, by creating a matched control group of non-adopters with the same longitudinal distribution as the group under study. The estimation procedure then finds that labor, and not capital, is the preferred input in U.S. hospitals regardless of managerial contract status. With institutions that adopt contract management benefiting from lower labor inefficiencies than the simulated non-contract adopters. These results suggest that while there is a propensity for expense preference behavior towards the labor input, contract managed firms are able to introduce efficiencies over conventional, owner controlled, firms. Using data for the years 1998 through 2007, the second essay investigates the production technology and cost efficiency faced by Florida hospitals. A stochastic frontier multiproduct cost function is estimated in order to test for economies of scale...

Impact of Hospital Provider Payment Reforms in Croatia

Bogut, Martina; Voncina, Luka; Yeh, Ethan
Fonte: Banco Mundial Publicador: Banco Mundial
Tipo: Publications & Research :: Policy Research Working Paper
ENGLISH
Relevância na Pesquisa
36.09%
Croatia began to implement case-based provider payment reforms in hospitals beginning in 2002, starting with broad-based categories according to therapeutic procedures. In 2009, formal diagnostic related groups were introduced, known locally as dijagnosticko terapijske skupine. This study examines the efficiency and quality impacts of these provider payment reforms globally on the Croatian health system by analyzing data on five procedures in acute health care for 10 years, between January 2000 and December 2009. The five procedures are cataracts, pneumonia, coronary bypass, appendectomy, and hip replacement. Using data from the Croatian Institute for Health Insurance, this study finds that both broad-based and detailed case-based payment systems have improved efficiency as measured by a reduction in average length of stay, with little impact on the number of cases. These provider payment reforms have had no adverse impact on quality as measured by readmissions. While it is still too early to quantify the impact of Croatia's introduction of formal diagnostic related groups...

Análisis predictivo de los eventos adversos relacionados con los indicadores de eficiencia hospitalaria de una IPS de Bogotá

Salamanca, Lucia; Mora, Sandra
Fonte: Facultad de administración Publicador: Facultad de administración
Tipo: info:eu-repo/semantics/masterThesis; info:eu-repo/semantics/acceptedVersion Formato: application/pdf
Publicado em 09/06/2015 SPA
Relevância na Pesquisa
46.2%
En este estudio se realizó un análisis predictivo de la aparición de eventos adversos de los pacientes de una IPS de Bogotá, Mederi Hospital Universitario de Barrios Unidos (HUBU) durante el año 2013; relacionados con los indicadores de eficiencia hospitalaria (Porcentaje de ocupación hospitalaria, número de egresos hospitalarios, promedio de estancia hospitalaria, número de egresos de urgencias, promedio de estancia en urgencias). Los datos fueron exportados a una matriz de análisis de las variables cualitativas; fueron presentadas con frecuencias absolutas y relativas, las variables cuantitativas (edad, tiempos de estancia) fueron presentadas con media, desviaciones estándar. Se agruparon los datos de eventos adversos y de eficiencia hospitalaria en una nueva matriz que permitiera el análisis predictivo la nueva matriz fue exportada al software de modelación estadístico Eviews 6.5; se especificaron modelos predictivos multivariados para la variable número de eventos adversos, respecto de los indicadores de eficiencia hospitalaria y se estimaron las probabilidades de ocurrencia, análisis de correlación y multicolinealidad; los resultados se presentaron en tablas de estimación para cada modelo, se restringieron los eventos adversos prevenibles y no prevenibles información obtenida a través de un sistema de información que registra los factores relacionados con la ocurrencia de eventos adversos en salud...

Análisis de los determinantes de la eficiencia hospitalaria: el caso de Chile

Santelices C,Emilio; Ormeño C,Héctor; Delgado S,Magdalena; Lui M,Christopher; Valdés V,Raúl; Durán C,Lorena
Fonte: Sociedad Médica de Santiago Publicador: Sociedad Médica de Santiago
Tipo: Artigo de Revista Científica Formato: text/html
Publicado em 01/04/2013 ES
Relevância na Pesquisa
36.13%
Background: The knowledge of variables influencing hospital efficiency is of paramount importance to carry out initiatives of management improvement and optimization. Aim: To explore on the hospital technical efficiency factors. Material and Methods: Data from 255,439 hospital discharges from 28 hospitals from May to October 2011 were analyzed. The efficiency index developed by Santelices et al was calculated. Proxy variables of hospital practices, human resource productivity, strategic performance, financing mechanisms, geographical territory and specialization, were considered. The analysis was carried out estimating econometric models. Results: The most significant variables to explain efficiency are the length of stay adjusted by complexity, the discharges per nurse and midwife and the performance of the Hospital Balancea Score Card. Conclusions: The suggested analysis contributes to identify hospital efficiency causes. The results suggest ways to improve performance of hospitals.