Chapter 6 Innovations and Productivity: An Empirical Investigation in Dutch Hospital Industry

There is a large body of literature on the efficiency and productivity of hospitals. Most studies focus on the effects of environmental pressures on hospital efficiency, such as payment systems (Dismuke & Sena, 1999; Sommersguter-Reichmann, 2000), competition (Rosko, 1999, 2004), Sari, 2003), and property rights (Gruca & Nath, 2001). Other studies pinpoint their attention to economic phenomena, such as economies of scale (Lindrooth, Lo Sasso, & Bazzoli, 2003; Dranove & Lindrooth, 2003), economies of scope (Prior & Sola, 2000; Grosskopf, Margaritis, & Valdmanis, 2001; Li & Rosenman, 2001), chain membership (Menke, 1997), economic behavior (Blank & Merkies, 2004), and expense preference (Rodriguez-Alvarez & Lovell, 2004).