Facoltà di scienze economiche

Effizienz der Pflegeheime in der Schweiz

Crivelli, Luca ; Filippini, Massimo ; Lunati, Diego

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    Switzerland (7.2 million inhabitants) is a federal State composed of 26 Cantons. Article 3 of the Federal Constitution grants large autonomy to the single cantons in the sectors which are not regulated directly by the constitution itself, among others the health and social care sector. The decision-making autonomy of the cantons in the field of health and social care for the elderly creates a strong heterogeneity in the regulations and organization in the various cantons. Moreover, the long-term care for the elderly is supplied by private for-profit nursing homes, private non-profit nursing homes and public nursing homes, respectively. This mixed economy and heterogeneity of regulation between the cantons, which characterizes the long-term care market in Switzerland, raises the interesting issue of the effects on scale and cost efficiency of the different institutional organization forms and regulation structures. In the first part of this paper we present the organization and regulation procedures of the Swiss nursing home industry. In the second part of the paper we estimate a translog cost frontier function for a sample of 835 Swiss nursing homes.The results of this analysis are used to examine the relationship between cost efficiency and the alternative institutional and regulation forms.