{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:17:20Z","timestamp":1760059040589,"version":"build-2065373602"},"reference-count":33,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T00:00:00Z","timestamp":1747353600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World"],"abstract":"<jats:p>This study analyses the effects of public hospital mergers in Portugal, particularly the creation of hospital centers, 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\u20132015 period show no statistically significant difference in productivity levels between merged hospitals (hospital centers) and non-merged hospitals (hospital units). However, for hospitals merged in 2007, there is evidence of significant productivity gains in the post-merger period (2008\u20132014). These findings partially support the assumptions of New Public Management and Efficiency Theory concerning efficiency improvements through hospital mergers in the public sector.<\/jats:p>","DOI":"10.3390\/world6020069","type":"journal-article","created":{"date-parts":[[2025,5,16]],"date-time":"2025-05-16T10:24:02Z","timestamp":1747391042000},"page":"69","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Accounting for Efficiency: Productivity Assessment of Merged Hospitals in Portugal Using DEA\u2013Malmquist Analysis"],"prefix":"10.3390","volume":"6","author":[{"given":"Nat\u00e1lia Maria Pereira","family":"Macedo","sequence":"first","affiliation":[{"name":"School of Economics and Management, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0197-9914","authenticated-orcid":false,"given":"Anabela Martins","family":"Silva","sequence":"additional","affiliation":[{"name":"School of Economics and Management, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8366-9863","authenticated-orcid":false,"given":"Am\u00e9lia","family":"Silva","sequence":"additional","affiliation":[{"name":"CEOS.PP, Instituto Superior de Contabilidade e Administra\u00e7\u00e3o do Porto, Polytechnic of Porto, Rua Jaime Lopes Amorim, s\/n, 4465-004 Matosinhos, Portugal"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,16]]},"reference":[{"key":"ref_1","first-page":"94","article-title":"Pol\u00edtica de fus\u00e3o de entidades hospitalares em Portugal: Avalia\u00e7\u00e3o da produtividade","volume":"15","author":"Nunes","year":"2018","journal-title":"Rev. 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