Common Efficiency Measures

Measuring efficiency is a difficult business. As AHRQ,  “In most cases, individuals and firms will define efficiency as a relationship between what it costs them and what service or outcome they receive, rather than as a trait inherent in the provider.” Further, efficiency can be measured as either production efficiency or allocative efficiency.  “For example,…

Measuring Hospital Efficiency

Efficiency in the field of economics increases when either 1) outputs are increased for a given level of inputs, or 2) inputs are decreased for a given level of output. Estimating efficiency in the medical field is more difficult, however, since the output (marginal health improvement) is difficult to measure. In the area of hospitals,…

Characterisitcs of High Quality Clinics

In his healthcare speech, President Obama cited Intermountain Healthcare in Utah and the Geisinger Health System in rural Pennsylvania as two healthcare organizations that offer high-quality care at costs below average.  In Medicare’s Physician Group Practice demonstration project, Forsyth Medical Group in North Carolina and St. John’s Health System in Missouri were able to meet…

Certificate of Need Laws and Cardiac Surgery

Certificate of Need (CON) were enacted in order to try to stem the wave of increasing health care costs. In order for hospitals or other providers to expand or build a new facility, CON requires these organizations to get prior government approval. The logic was that when providers expanded medical facilities, supplier-induced demand would increase…

Health Care Efficiency: Academic vs. Vendor Measures

Measuring efficiency in health care is extremely difficult.  If there was an accurate scientific measure of patient health (e.g., a 1-100 scale) before and after treatment.  That way, one could measure changes in health before and after treatment per every dollar spent.  However, measuring health outcomes is very difficult.  In the academic literature, hospital efficiency most commonly…

Medical procedures: What proportion met quality standards?

According the a 2008 Leapfrog Hospital Survey, below are the proportion of each type of medical procedure that met quality standards: Coronary artery bypass graft: 43% Percutaneous coronary interventions: 35% High-risk deliveries: 32% Pancreatic resection: 23% Bariatric surgery: 16% Esophagectomy: 15% Aortic valve replacement: 7% Aortic abdominal aneurysm repair: 5% Source: Binder and Rudolph (HSR…

Front-Line Staff Perspectives

As an economist, I conduct most of my analysis based on the quantitative data.  However, qualitative data should not be overlooked.  A paper by Tucker et al. (2008) looks at how the front-line hospital staff evaluates quality issues.  Some examples of their findings are: The largest number of operational failures occurred in the equipment/supply category.…