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Health care spending usually contributes to a large part of a developed country's economy. In 2011, the U.S. consumed about 17.7% of its GDP on health care. As one of the most significant components of the health care industry, the hospital sector plays a key role to provide healthcare services. Healthcare services industry can be affected by many factors, of which economic downturn is a crucial one. As a result, it is worth investigating the condition and state of hospital management when economic downturn occurs. This paper aims to analyze how the Great Recession affects hospital performance in Pennsylvania during the period 2005–2012 by using data envelopment analysis (DEA). Specifically, we measure efficiency for hospitals in Pennsylvania, and use several DEA models to calculate the global Malmquist index (GMI). We find that: (1) 15.4% hospitals are always efficient while 36.9% hospitals are always inefficient for all years in 2005–2012; (2) The relative distance for a group of hospitals to the frontier is almost unchanged post-recession and pre-recession; (3) The average efficiency/GMI decreases by 2.43%/3.07% from pre-recession to post-recession. The analysis indicates that hospital performance slightly decreased due to the economic downturn in Pennsylvania. [ABSTRACT FROM AUTHOR]