Economic Thought and Practice, , 2026.
Original scientific paper
https://doi.org/10.17818/EMIP/2026/22
DETERMINANTS OF TECHNICAL EFFICIENCY IN CROATIAN HOSPITALS
Simona Prijaković
orcid.org/0000-0001-7835-582X
; Institute of Public Finance
Romario Marijanović
orcid.org/0009-0001-8622-5563
; Institute of Public Finance; University of Rijeka, Faculty of Economics and Business
*
Mihaela Bronić
orcid.org/0000-0002-0863-2040
; Institut za javne financije
* Corresponding author.
Abstract
This paper evaluates the technical efficiency of 26 Croatian general hospitals, clinical hospitals, and clinical hospital centres, and examines its determinants across the pre-pandemic (2015–2016) and pandemic (2021–2022) periods. Technical efficiency is defined as a hospital’s ability to maximise outputs from given inputs relative to the best-performing peers. An input-oriented Data Envelopment Analysis (DEA) with a BCC model and variable returns to scale is applied, using total expenditures (excluding investments in facilities) as the input and three outputs: weighted inpatient, day hospital, and outpatient cases. In the second stage, the Simar–Wilson bootstrap model assesses organisational and socioeconomic determinants. Population density and unemployment are negatively associated with efficiency, while bed occupancy, the share of disabled residents, and the share of the population under 15 show positive associations. The findings support more regionally adjusted resource allocation, improved bed management, and better data on treatment quality and complexity.
Keywords
technical efficiency determinants; Croatia; public hospitals; data envelopment analysis; Simar-Wilson
Hrčak ID:
347091
URI
Publication date:
11.5.2026.
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