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Scale and scope efficiencies through hospital consolidations

机译：通过合并医院实现规模和范围效率

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The hospital sector in the Province of Ontario has recently completed a large scale restructuring marked by wide ranging hospital closures, mergers and program transfers. Given a generally inconclusive economics literature, regulators used an accounting, as opposed to an economic, approach when predicting gains to consolidations. This paper uses an economic cost function to examine economies of scale and scope in the years preceding restructuring, where there was little doubt that economies were possible. Issues relating to output aggregation, functional form, and scale and scope testing are addressed and an equilibrium cost function is derived from an estimated short run function to measure the cost concepts of interest. Using index and direct approaches, we examine a variety of potential reconfigurations and conclude that there were indeed large scale unexploited gains to strategic consolidation in the hospital sector. Furthermore, these gains may not have been detected using standard approaches in the literature.
机译：安大略省的医院部门最近完成了大规模的改组，其特点是广泛的医院关闭，合并和计划转移。鉴于经济学方面的文献普遍没有定论，监管者在预测合并收益时采用的是会计方法，而不是经济方法。本文使用经济成本函数来考察重组前几年的规模经济和范围经济，而毫无疑问，经济是可能的。解决了与输出汇总，功能形式以及规模和范围测试有关的问题，并从估计的短期函数中得出了均衡成本函数，以衡量所关注的成本概念。使用索引和直接方法，我们检查了各种潜在的重新配置，并得出结论，在医院领域的战略整合中确实存在着大量未开发的收益。此外，使用文献中的标准方法可能未检测到这些增益。

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