<oai_dc:dc xmlns:dc="http://purl.org/dc/elements/1.1/" xmlns:oai_dc="http://www.openarchives.org/OAI/2.0/oai_dc/" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xsi:schemaLocation="http://www.openarchives.org/OAI/2.0/oai_dc/ http://www.openarchives.org/OAI/2.0/oai_dc.xsd">
  <dc:contributor>Filippini, Massimo</dc:contributor>
  <dc:creator>Di Giorgio, Laura</dc:creator>
  <dc:date>2013-05-29</dc:date>
  <dc:description xmlns:ns0="xml" ns0:lang="en">Public provision of institutionalized long term care will pose an increasing  challenge to the sustainability of public finances. Population ageing has  been recognized as one of the main factors driving health care costs  increase in Europe and is expected to further raise the demand of  nursing home care. To ensure a sustainable system in the next  decades, policymakers need evidence on the determinants of nursing  care costs and how to best organize the sector to ensure efficient  provision of care. This thesis aims at investigating issues regarding the  cost structure of not-for profit nursing homes by using sound economic  theory and rigorous empirical methodologies. The analysis is performed  using a panel dataset of nursing homes located in a Swiss region. The  first chapter investigates the impact of different forms of organizations  on the cost efficiency of non-profit nursing homes. In particular, it uses  an improved specification of the cost frontier as compared to previous  studies based on Swiss data and sheds light on the issue of measuring  constant inefficiency in the presence of unobserved heterogeneity. The  second chapter analyses the impact of prospective payments on costs  of nursing home care services. To evaluate the impact of the recent  policy change - from retrospective to prospective payment - on nursing  home costs, we adopt two empirical approaches: i) we estimate a model  using a fixed-effects estimator (FE) with a time trend that is allowed to  change after the policy reform; ii) we use a counterfactual approach  (CF) where a fixed-effects model is used to predict costs for the years  after the reform, and calculate the impact of the reform as the difference  between observed- and predicted costs in each year. Finally, the third  chapter focuses on the relationship between costs and quality in non- profit nursing homes. We use data on the clinical indicators derived from  the Minimum Data Set. These quality indicators meet the taxonomy of the  Structure-Process-Outcome (SPO) framework to measure quality in  health care suggested by Donabedian (1988). As with respect to  previous studies, we control for unobserved characteristics that may  bias the relationship between costs and quality and address the issue  of potential endogeneity of the quality indicators.</dc:description>
  <dc:format>application/pdf</dc:format>
  <dc:identifier>https://localhost:5000/ark:/12658/srd1318532</dc:identifier>
  <dc:identifier>https://susi.usi.ch/global/documents/318532</dc:identifier>
  <dc:identifier>https://susi.usi.ch/documents/318532/files/2013ECO002.pdf</dc:identifier>
  <dc:language>eng</dc:language>
  <dc:relation>info:eu-repo/semantics/altIdentifier/urn/urn:nbn:ch:rero-006-111792</dc:relation>
  <dc:relation>info:eu-repo/semantics/altIdentifier/ark/12658/srd1318532</dc:relation>
  <dc:rights>info:eu-repo/semantics/openAccess</dc:rights>
  <dc:rights>License undefined</dc:rights>
  <dc:subject xmlns:ns1="xml" ns1:lang="en">Nursing home costs</dc:subject>
  <dc:subject xmlns:ns2="xml" ns2:lang="en">Nonprofit</dc:subject>
  <dc:subject xmlns:ns3="xml" ns3:lang="en">Institutional form</dc:subject>
  <dc:subject xmlns:ns4="xml" ns4:lang="en">Prospective payment system</dc:subject>
  <dc:subject xmlns:ns5="xml" ns5:lang="en">Quality</dc:subject>
  <dc:subject>info:eu-repo/classification/udc/33</dc:subject>
  <dc:title xmlns:ns6="xml" ns6:lang="en">Essays on the cost structure of nonprofit nursing homes</dc:title>
  <dc:type>http://purl.org/coar/resource_type/c_db06</dc:type>
</oai_dc:dc>