Skip to main content
Log in

Reimbursing for the costs of teaching and research in finnish hospitals: A stochastic frontier analysis

  • Published:
International Journal of Health Care Finance and Economics Aims and scope Submit manuscript

Abstract

In this study stochastic frontier cost function was used to estimate the teaching and research costs of Finnish hospitals. Predicted efficiency adjusted costs were calculated and compared to evaluate the current level of teaching and research reimbursement. The efficiency adjustment had significant impact on the marginal and average cost estimates of the teaching and research output.

The results suggest that the average rate of teaching and research reimbursement should be approximately 14.6% of the total operating costs in university teaching hospitals. The main finding was that the university teaching hospitals were underfunded with respect to both research and teaching output.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Anderson, G. and J. Lave. (1986). “Financing Graduate Medical Education Using Multiple Regression to Set Payment Rates.” Inquiry 23, 191–199.

    Google Scholar 

  • Battese, G. and T. Coelli. (1995). “A Model for Technical Inefficiency Effects in a Stochastic Frontier Production Function for Panel Data.” Empirical Economics 20, 325–332.

    Article  Google Scholar 

  • Culyer, A., J. Wiseman, and M. Drummond. (1978). “What Accounts for the Higher Cost of Teaching Hospitals?” Social and Economic Administration 12, 20–29.

    Google Scholar 

  • Dalton, K. and E. Norton (2000). “Revisiting Rogowski and Newhouse on the Indirect Costs of Teaching: A Note on Functional Form and Retransformation in Medicare’s Payment Formulas.” Journal of Health Economics 19, 1027–1046.

    Article  Google Scholar 

  • Garfield, E. (1996). “How Can Impact Factors be Improved.” British Medical Journal 313, 411–413.

    Google Scholar 

  • Gong, B. and R. Sicles. (1989). “Finite Sample Evidence on the Performance of Stochastic Frontier Models Using Panel Data.” The Journal of Productivity Analysis 1, 229–261.

    Google Scholar 

  • Grannemann, T., R. Brown, and M. Pauly. (1986). “Estimating Hospital Cost, A Multiple-Output Analysis.” Journal of Health Economics 5, 7–127.

    Article  Google Scholar 

  • Hadley, J. (1983). “Teaching, and Hospital Costs.” Journal of Health Economics 2, 75–79.

    Article  Google Scholar 

  • Huttin, C. and G. Pouvoirville. (2001). “The Impact of Teaching and Research on Hospital Costs.” The European Journal of Health Economics 2(2), 47–53.

    Google Scholar 

  • Kittelsen, S., F. Piro, and J. Magnussen. (2002). “Hva Betyr Forskning, Utdanning of Reisetid for Sykehusenes Kostnader?” (How does reseach, teaching and travel time affect hospital costs?). HERO Skriftserie 2002:18. OSLO: University of Oslo.

  • Linna, M., U. Häkkinen, and E. Linnakko. (1998). “An Econometric Study of Costs of Teaching and Research in Finnish Hospitals.” Health Economics 7(4), 291–305.

    Article  Google Scholar 

  • Linna, M. and U. Häkkinen. (1996). “Ekonometrinen Tutkimus Yliopistosairaaloiden Erityisvaltionosuuden Korvausperusteista” (An Econometric Study on the Teaching and Research Reimbursement for Teaching Hospitals): Stakes Aiheita working paper series, Helsinki.

  • Lopez-Casanovas, G. and M. Saez. (1999). “The Impact of Teaching Status on Average Costs in Spanish Hospitals.” Health Economics (6), 641–651.

  • Milne, R., A. Abebe, and B. Torsney. (1989). “The Impact of Teaching on Hospital Costs: A Budgetary Approach to Non-market Institutions.” Journal of Operational Research Society 40, 1089–1098.

    Google Scholar 

  • Nicholson, S. and D. Song. (2001). “The Incentive Effects of the Medicare Indirect Medical Education Policy.” Journal of Health Economics 20, 909–933.

    Article  Google Scholar 

  • Rogowski, J. and J. Newhouse. (1992). “Estimating the Indirect Costs of Teaching.” Journal of Health Economics 11, 153–171.

    Article  Google Scholar 

  • Sheingold, SH. (1990). “Alternatives for Using Multivariate Regression to Adjust Prospective Payment Rates.” Health Care Financing Review 11 (3), 31–41.

    Google Scholar 

  • Sloan, F., R. Feldman, and A. Steinwald. (1983). “Effects of Teaching on Hospital Costs.” Journal of Health Economics 2, 1–28.

    Article  Google Scholar 

  • The Ministry of Social Welfare, and Health (Sosiaali- ja terveysministeriö). (1996). “Yliopistosairaaloiden erityisvaltionosuusjärjestelmän kehittäminen.” Sosiaali- ja terveysministeriön työryhmämuistioita. Helsinki 1996:3.

  • Thorpe, K. (1988). “The Use of Regression Analysis to Determine Hospital Payment: The Case of Medicare’s Indirect Teaching Adjustment.” Inquiry 25, 219–231.

    Google Scholar 

  • Welch, WP. (1987). “Do All Teaching Hospitals Deserve an Add-On Payment Under the Prospective Payment System?” Inquiry 24, 221–232.

  • Zuckerman, S., J. Hadley, and L. Iezzoni. (1994). “Measuring Hospital Efficiency with Frontier Cost Functions.” Journal of Health Economics 13, 255–280.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Miika Linna.

Additional information

JEL Code C14 . C23 . D24 . I10

Rights and permissions

Reprints and permissions

About this article

Cite this article

Linna, M., Häkkinen, U. Reimbursing for the costs of teaching and research in finnish hospitals: A stochastic frontier analysis. Int J Health Care Finance Econ 6, 83–97 (2006). https://doi.org/10.1007/s10754-006-6256-z

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10754-006-6256-z

Keywords

Navigation