Due to the wave of mergers that have taken place in the USA, the early 1990s could be labelled as a restructuring era for health care systems. The question of whether mergers have an impact on organizational performance is still an area of interest for health services researchers. In this study, we examined the impacts of horizontal mergers of US hospital's technical efficiency before and after merger using longitudinal Data Envelopment Analysis (DEA). The findings of our study illustrate that mergers do increase a hospital's level of efficiency. Constant returns-to-scale model indicated an overall reduction in input utilisation after merger, compared to variable returns-to-scale model. This indicates the role of scale efficiency as a dominant source of improvement in inefficiency of hospitals involved in horizontal mergers, but not for technical efficiency. Suggestions for future study are provided.
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