Identifying, Categorizing, and Evaluating Health Care Efficiency Measures
Published 1 April 2008
Elizabeth A. McGlynn, Paul G Shekelle, Susan Chen, Dana P. Goldman, John A. Romley, Peter S. Hussey
Citations54
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TL;DR
Recognizing the importance of improving efficiency measurement of health care quality, the Agency for Healthcare Research and Quality has sponsored this systematic review and analysis of available measures.
Abstract
Recognizing the importance of improving efficiency measurement of health care quality, the Agency for Healthcare Research and Quality has sponsored this systematic review and analysis of available measures.
Keywords
Decision SciencesEconomics, Econometrics and Finance
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BMJComparative efficiency of national health systems: cross national econometric analysis
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Estimates of most productive output scale suggest that locally decreasing returns to scale set in at higher output levels for physicians who treat higher proportions of high severity patients.
Anesthesia & AnalgesiaSuccessful Strategies for Improving Operating Room Efficiency at Academic Institutions
263 Citations1998Frank J. Overdyk, Susan C. Harvey +2 more
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Journal of Health EconomicsFrontier estimation: How useful a tool for health economics?
262 Citations1994Joseph P. Newhouse
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European Journal of Operational ResearchPublic sector efficiency measurement applications of data envelopment analysis
251 Citations1993
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232 Citations2002Robert H. Miller, Harold S. Luft
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StrokeEfficiency, effectiveness, and duration of stroke rehabilitation.
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JONA The Journal of Nursing AdministrationThe Influence of Manager Behavior on Nurses' Job Satisfaction, Productivity, and Commitment
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The author discusses the findings of her study drawing comparisons to other studies and suggesting implications for improving managerial supervision, organizational performance and outcomes.
Journal of Health EconomicsNursing home care in The Netherlands: a nonparametric efficiency analysis
164 Citations1994Peter Kooreman
This paper analyzes the technical efficiency of Dutch nursing homes with respect to the use of labor inputs by means of Data Envelopment Analysis (DEA) and the determinants of the efficiency scores are investigated using censored regression analysis.
Journal of Health EconomicsMathematical programming for the efficient allocation of health care resources
163 Citations1996Aaron A. Stinnett, A. David Paltiel
This paper makes use of established optimization techniques to demonstrate that a general mathematical programming framework can accommodate much more complex information regarding returns to scale, partial and complete indivisibility and program interdependence.
Health EconomicsThe efficiency of health production: re‐estimating the WHO panel data using parametric and non‐parametric approaches to provide additional information
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The American Journal of SurgeryEfficiency of the operating room suite
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Annals of Internal MedicineThe Effect of Full-Time Faculty Hospitalists on the Efficiency of Care at a Community Teaching Hospital
156 Citations1998Herbert S. Diamond, Elliot Goldberg +1 more
The experience of a community teaching hospital during the initial year of a hospitalist program is reported, which can be determined only by studies that measure quality of care, patient satisfaction, and cost and efficiency of care in various settings.
Journal of Public EconomicsPublic insurance and child hospitalizations: access and efficiency effects
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The net impact of Medicaid expansions on hospitalizations during this period finds that total hospitalizations increased significantly, with each 10 percentage-point rise in eligibility leading to an 8.4% increase in hospitalizations; the access effect strongly outweighs any efficiency effect produced by expanded coverage.
PubMedMeasuring hospital efficiency: a comparison of two approaches.
155 Citations2000Thomas N. Chirikos, Alan M. Sear
Hospital policymakers should not be indifferent to the choice of the frontier model used to score efficiency relationships, but may be well advised to wait until additional research clarifies reasons why DEA and SFR models yield divergent results before they introduce these methods into the policy process.
Applied EconomicsMeasuring production efficiency of acute hospitals in Scotland, 1991-94: validity issues in data envelopment analysis
154 Citations1997David Parkin, Bruce Hollingsworth
A broad framework for assessing validity is suggested, which should be developed further, and illustrative examples of the problems in a real application within health care are given, finding a disturbing lack of concordance between the different results obtained.
Journal of Productivity AnalysisRural hospital performance and its correlates
151 Citations1996Gary D. Ferrier, Vivian Valdmanis
In general, for-profit hospitals are found to outperform not-for-profit and public hospitals and demand characteristics, quality of care, and the mix of services offered are also found to influence performance.
Annals of Emergency MedicineA 5-Year Time Study Analysis of Emergency Department Patient Care Efficiency
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Time studies are an effective method of identifying areas of patient care delay and targeted administrative interventions apparently reduced the total ED LOS and improved overall efficiency in the Los Angeles County hospital ED.
Health AffairsVariations In The Longitudinal Efficiency Of Academic Medical Centers
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The Review of Economics and StatisticsProfit Incentives and Technical Efficiency in the Production of Nursing Home Care
144 Citations1989John A. Nyman, Dennis L. Bricker
Health Services ResearchProfile of Medical Charges for Children by Health Status Group and Severity Level in a Washington State Health Plan
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To identify children and evaluate patterns of charges for pediatric medical care, by overall health status, severity of illness, and categories of medical service, a Washington State health plan was used.
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Journal of Public EconomicsDoes contracting out increase the efficiency of government programs? Evidence from Medicaid HMOs
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Journal of Health EconomicsCost and efficiency in nursing homes: a stochastic frontier approach
123 Citations1994Donald F. Vitaliano, Mark Toren
The stochastic frontier cost function is fit to the data utilizing the composed error model, wherein statistical noise and allocative and technical inefficiency are jointly estimated.
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An approach to identifying inefficient practice patterns is demonstrated in this pilot study of physicians treating heart shock patients using data envelopment analysis (DEA), a relatively new linear-program-based efficiency evaluation tool.
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Journal of the American College of CardiologyIdentification of variables needed to risk adjust outcomes of coronary interventions: evidence-based guidelines for efficient data collection
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The most powerful predictors of adverse outcome were measures of hemodynamic instability, disease severity, demographics and comorbid conditions in both univariate and multivariate analyses.
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European Journal of Operational ResearchA variable returns to scale data envelopment analysis model for the joint determination of efficiencies with an example of the UK health service
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A multi-activity DEA model for the joint determination of efficiencies with variable returns to scale is developed and it is found that apparent overall efficiency may hide scale inefficiency in individual activities.
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OECD Economics Department working papersHealth Care Reform Controlling Spending and Increasing Efficiency
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Journal of Medical SystemsPublic Sector Hospital Efficiency for Provincial Markets in Turkey
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Analysis of inefficient provinces suggests that in those 44 inefficient provinces are collectively overbedded, employ excessive number of specialists and other health labor, and spent approximately $70,000,000 from their revolving funds in excess compared to efficient provinces.
Medical CareOwnership and Technical Efficiency of Hospitals
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The findings in this paper revealed the sample public hospitals to be more efficient relative to the sample NFP hospitals, illustrating the applicability of the nonparametric technique in the measurement of relative technical productive performance between NFP and public hospitals.
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The results suggest caution regarding the use of frontier methods to rank individual hospitals, but they are robust when generating comparisons of hospital group mean inefficiencies, such as testing models that compare non-profits and for-profits by economic inefficiency.
INQUIRY The Journal of Health Care Organization Provision and FinancingHospital Cost Efficiency and System Membership
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Efficiency benefits from organization of physician and insurance activities at the system level, with discretion over the array of service offerings left to individual members are suggested.
The European Journal of Health EconomicsMeasuring and comparing the (in)efficiency of German and Swiss hospitals
85 Citations2004Lukas Steinmann, Gunnar Dittrich +2 more
The finding continues to be that hospitals of Saxony have higher efficiency scores than their Swiss counterparts and the finding proves robust with regard to modifications of DEA that are motivated by differences in hospital planning in Germany and Switzerland.
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85 Citations2004Robert Rosenman, Daniel Friesner
This paper looks at the efficiency of physician practices, focusing on scopes of service by comparing single specialty groups and multispecialty groups, and finds that larger practices are able to capture efficiencies of scope, but incur inefficiencies of scale.
Canadian Journal of Economics/Revue canadienne d économique"Behavioural" Cost Functions for Hospitals
85 Citations1971Robert G. Evans
Journal of Productivity AnalysisDecomposing hospital productivity changes, 1985–1988: A nonparametric Malmquist approach
84 Citations1995James Burgess, Paul W. Wilson
It is found that changes in technology dominate changes in inefficiency in determining changes in productivity.
Journal of Medical SystemsIntegration Mechanisms and Hospital Efficiency in Integrated Health Care Delivery Systems
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OmegaGreek hospitals: how well their resources are used
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Journal of EconometricsLargest size-efficient scale and size efficiencies of decision-making units in data envelopment analysis
78 Citations1990Ajay Maindiratta
The notion of size efficiency is introduced to measure this potential for further input reductions, and the existence of a largest radially size-efficient output scale is established as a ray property of the production frontier.
PubMedThe effects of medical group practice and physician payment methods on costs of care.
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South African Journal of EconomicsTECHNICAL EFFICIENCY AND PRODUCTIVITY OF PUBLIC SECTOR HOSPITALS IN THREE SOUTH AFRICAN PROVINCES*
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Evidence is found that the DRG payment system does appear to have had a positive impact on productivity and technical efficiency of some commonly employed diagnostic technologies in Portuguese hospitals during this time period, using both parametric and non‐parametric frontier models.
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75 Citations1999Antonio Giuffrida
The analysis of the efficiency of primary care provision in the English Family Health Service Authorities (FHSAs) over the period 1990/91–1994/95 suggests that there is very limited scope for productivity gains in this sector.
BMJImpact of the NHS reforms on English hospital productivity: an analysis of the first three years
74 Citations1997N. Söderlund, Iván Csaba +3 more
Gaining independent trust status was associated with significant productivity gains for NHS hospitals, although some of the effect may have been due to self selection; and at the end of the study period productivity differences between trust waves were non-significant.
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74 Citations1999Michael D. Rosko
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74 Citations2001Tong Li, Robert Rosenman
It is found that hospitals with higher casemix indices or more beds are less efficient while for-profit hospitals and those with higher proportion of Medicare patient days are more efficient.
AnesthesiologyIntroduction of Anesthesia Resident Trainees to the Operating Room Does Not Lead to Changes in Anesthesia-controlled Times for Efficiency Measures
72 Citations2004Sunil Eappen, Hugh Flanagan +1 more
The data strongly suggest that the initiation of anesthesia trainees to the operating room has no clinically or economically meaningful adverse effect on the anesthesia-controlled time component of operating room efficiency.
Analyzing Technical and Allocative Efficiency of Hospitals
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High health care costs in the United States and the effect of these costs on governmental budgets and private industry has stimulated cost consciousness among the purchasers of hospital care.
Academic MedicineA relative-value-based system for calculating faculty productivity in teaching, research, administration, and patient care
70 Citations1997Charles Hilton, William Fisher +2 more
This system provides a quantitative method for the equal recognition of faculty productivity in a number of areas, and it may be useful as a starting point for other academic units exploring similar issues.
Health Services ResearchA National Study of Efficiency for Dialysis Centers: An Examination of Market Competition and Facility Characteristics for Production of Multiple Dialysis Outputs
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The increasing inefficiency associated with membership in large chains suggests that the growing consolidation in the dialysis industry may not, in fact, be the strategy for attaining more technical efficiency in the production of multiple dialysis outputs.
Trauma Patients with Multiple Extremity Injuries
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The study emphasizes the need for injury scoring systems that better predict the needs of patients with MEI and that will serve as a basis for equitable funding of trauma centers.
Health EconomicsFinancial incentives and productive efficiency in Finnish health centres
68 Citations1996Kalevi Luoma, Maija‐Liisa Järviö +2 more
According to the results, a high percentage of funding coming from central government matching grants and high taxable income per inhabitant are significant predictors of inefficiency.
Journal of Medical SystemsThe Impact of the Prospective Payment System on the Technical Efficiency of Hospitals
67 Citations2000Jin-Yuan Chern, Thomas T. H. Wan
No significant difference in technical efficiency was found in each hospital peer group over the study period, which demonstrates that if hospital managers use this analytical tool appropriately, they may spot where any organizational weakness lies and how they can improve it.
Mathematical Medicine and Biology A Journal of the IMAThe efficiency of Scottish acute hospitals: An application of data envelopment analysis
67 Citations1995Bruce Hollingsworth, David Parkin
The results demonstrate the capacity of DEA to produce a user-friendly array of results, based on sound theoretical underpinnings, and suggest that, although still very much under development, DEA is usable and, given the weakness of current means of measuring efficiency in the National Health Service, that DEA has a strong claim for further consideration.
Journal of Accounting and Public PolicyAn assessment of the impact of diagnosis-related group (DRG)-based reimbursement on the technical efficiency of New Jersey hospitals using data envelopment analysis
67 Citations1988James P. Borden
It appears that New Jersey's “experiment” with diagnosis-related group (DRG)-based reimbursement on hospital efficiency has not had any positive effect on hospital efficiency, a goal of the program, and any pre-DRG efficiency differences among hospitals still exist under the DRG program.
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66 Citations2005Werner Brouwer, Willem‐Jan Meerding +2 more
The relationship between QOL and productivity is highlighted to stimulate debate and research in this area and may prove important, for instance in modelling productivity costs with use of information on QOL.
Health EconomicsA critique of the World Health Organisation's evaluation of health system performance
65 Citations2003Jeff Richardson, John Wildman +1 more
The World Health Organisation's approach to the measurement of health system efficiency is briefly described and the model for combining the different objectives into a single index of system performance is problematical and alternative models are shown to alter system rankings.
Critical Care MedicineSpecificity of computerized physician order entry has a significant effect on the efficiency of workflow for critically ill patients
65 Citations2005Nora’aini Ali, Hagop S. Mekhjian +5 more
Appropriate CPOE applications can improve the efficiency of care for critically ill patients and the workflow requirements of individual units must be analyzed before technologies like C POE can be properly developed and implemented.
Applied EconomicsAssessing productivity changes in UK hospitals reflecting technology and input prices
65 Citations2000N Maniadakis, Emmanuel Thanassoulis
Malmquist productivity indexes are used to evaluate the performance of acute hospitals in the UK over the period after the introduction of the internal market in the National Health Service in 1991 and it is found that productivity regressed in the year after the reforms but progressed thereafter.
Health EconomicsRelative inefficiencies in production between solo and group practice physicians
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Stochastic production frontier estimation is employed to address the issue of whether solo or group practice physicians are relatively more inefficient, and which is more efficient.
Journal of General Internal MedicineProductivity, quality, and patient satisfaction
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In these academic primary care practices, rates of patient satisfaction, compliance with screening guidelines, and resource utilization were similar for part- time PCPs compared to full-time PCPs.
PubMedImproving team structure and communication: a key to hospital efficiency.
63 Citations2004David M. Friedman, David L Berger
Restructuring the patient care team yielded a decreased mean length of stay while maintaining a high level of patient satisfaction, which helps validate a hospital-wide initiative to maintain a highlevel of patient care while increasing patient volume.
Medical Care Output and Productivity
63 Citations2001David Cutler, Ernst R. Berndt
A key finding suggests that growth in health care spending has coincided with an increase in products and services that together reduce mortality rates and promote additional health gains, so concerns over the apparent increase in unit prices of medical care may understate positive impacts on consumer welfare.
Emerald eBooksPublic provision and performance : contributions from efficiency and productivity measurement
63 Citations2000Jos L.T. Blank, C. A. Knox Lovell +1 more
Efficiency research in the public sector: some final considerations (J.T. Blank, E.L. Blank)
Health Care Management SciencePhysician benchmarking: measuring variation in practice behavior in treatment of otitis media
62 Citations1998Yaşar A. Özcan
By restricting particular inputs and outputs, and directing all physicians to treat otitis media through a balanced primary care model, physicians would be able to provide the same quality care at an average savings of 23.7% per efficient and 4.4% per inefficient provider.
Medical CareThe Impact of Prospective Reimbursement on Nursing Home Efficiency
62 Citations1989Thomas R. Sexton, Alan M. Leiken +2 more
It appears that a sudden increase in administrative hours in the final study year played a role in that year's lower average efficiency scores, but also that all input levels generally rose while output levels remained virtually constant.
Medical CareEvaluating Managerial Efficiency of Veterans Administration Medical Centers Using Data Envelopment Analysis
62 Citations1989Thomas R. Sexton, Alan M. Leiken +4 more
This study applied the methodology of Data Envelopment Analysis (DEA) to the set of VA medical centers to evaluate their relative managerial efficiencies and revealed that VAMCs affiliated with a university were generally less efficient than those without such an affiliation.
PubMedIntra-unit patient transports: time, motion, and cost impact on hospital efficiency.
62 Citations2005Ann Hendrich, Nelson Lee
Solid evidence to support the improvement of hospital and patient care efficiency through the identification and suggested elimination of waste patterns within the transport process is presented.
Eastern Economic JournalHOSPITAL COST AND EFFICIENCY IN A REGIME OF STRINGENT REGULATION
61 Citations2016Donald F. Vitaliano, Mark Toren
A stochastic frontier cost function is fitted to data for 219 New York hospitals and finds that Rochester area hospitals, where a system of monopsony reimbursement exists, are more efficient and unionized hospitals are less efficient.
Health EconomicsMeasuring the productive efficiency and clinical quality of institutional long‐term care for the elderly
60 Citations2004Juha Laine, Miika Linna +2 more
The results did not reveal systematic association between technical efficiency and clinical quality of care, however, the prevalence of pressure ulcers, indicating poorquality of care was associated with technical efficiency, a fact which highlights the importance of including quality measures in the assessment of efficiency in long-term care.
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60 Citations2000Roberto Cellini, Giacomo Pignataro +1 more
A general conclusion stemming out of the analysis is that competition is not a value per se and that its effects on hospitals' performance are affected by the rules governing the health system.
International Journal of Health Care Finance and EconomicsRegulation, Ownership and Efficiency in the Swiss Nursing Home Industry
59 Citations2002Luca Crivelli, Massimo Filippini +1 more
An econometric estimation of a stochastic cost frontier is presented using cross-section data for a sample of 886 Swiss nursing homes operating in 1998 to examine the relationship between cost efficiency, the alternative institutional forms and the different regulatory settings.
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59 Citations2003Sanjay Saint, Timothy P. Hofer +3 more
Although some pathways did reduce LOS or resource utilization or both, most pathways reduced neither and future efforts should be placed on further evaluating the effectiveness of critical pathways.
Socio-Economic Planning SciencesEfficiency of hospital service production in local markets: The balance sheet of U.S. medical armament
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PubMedThe effect of physician practice organization on efficient utilization of hospital resources.
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Doctor characteristics explain a significant amount of the variability in hospital charges and length of stay in the two maternity conditions, and hypotheses that efficiency is influenced by practice organization factors such as patient volume and managed care load are supported.
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57 Citations2005Juha Laine, Harriet Finne‐Soveri +4 more
The results suggest that an association may exist between technical efficiency and unwanted dimensions of quality in institutional long-term care wards for the elderly in Finland.
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