Public Hospital Mergers and Productivity: Evidence from the Portuguese NHS Using DEA-Malmquist Analysis

This study analyses the effects of public hospital mergers in Portugal, particularly the creation of hospital centres, on productivity levels. Grounded in the theoretical frameworks of New Public Management and Efficiency Theory, a Data Envelopment Analysis (DEA) approach, combined with the Malmquist Productivity Index, was used to evaluate performance. Results for the 2013–2015 period show that merged hospitals (hospital centres) generally had lower productivity levels than non-merged hospitals (hospital units), although the differences were not statistically significant. However, for hospitals merged in 2007, there is evidence of significant productivity gains in the post-merger period (2008–2014). These findings partially support the assumptions of New Public Management and Efficiency Theory concerning efficiency improvements through hospital mergers in the public sector.