An Analysis of the Optimal Use of Inputs in the Production of Medical Services

Smith, Kenneth R.; Miller, Marianne McInnes; Golladay, Fredrick L.

doi:10.2307/145184

Cited by 24 publications

(8 citation statements)

References 3 publications

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“…But in cases where there exists information on the task structure of medical care, to adopt that aggregate production function methodology is to preclude the opportunity for studying the effects of alternative treatments on patient outcomes. As the work of Smith et al (1972) and Lipscomb and Scheffier (1975) indicate, it is possible to construct activity analysis models which capture the diverse processes of medical care, yet yield readily interpretable solutions.…”

Section: T2m0 In=0mentioning

confidence: 99%

Health resource allocation and quality of care measurement in a social policy framework

Lipscomb

1978

Policy Sci

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An activity analysis production function, linking the structure, process, and outcome of medical care, is introduced. The model, based on a semi-Markovian conception of the disease process, is designed to determine that allocation of inputs among programs which maximizes expected improvement in population health status. Reflected in such prescriptions are the expected efficacy of alternative treatments and population preferences among program outcomes. Based on the model, two system-oriented indexes of the quality of medical care are defined. This allocation methodology represents a particular application of a more general "social policy model," a potentially useful paradigm for the evaluation of public programs generally.

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Section: T2m0 In=0mentioning

confidence: 99%

Health resource allocation and quality of care measurement in a social policy framework

Lipscomb

1978

Policy Sci

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“…Unit costs will exhibit discontinuities at each switching point, and between switching points may be represented as segments of an appropriate rectangular hyperbola in which the constant represents total cost of staff. 4 A comparison of the total cost and total revenue functions under the assumption that prices are constant will reveal that there are certain quantities of output which the physician will find it unprofitable to produce and costs will exceed revenues at those quantities. For very small practices-practices unable to fully occupy a single unaided physician-the argument is familiar: There is not enough activity to insure the provider an income comparable to his alternatives.…”

Section: The Requirement That All Inputs Of Labor Be Employed For Normentioning

confidence: 99%

“…The model builds upon previous research by two of the authors in which they constructed an activity analysis model of the physician's office practice [4]. The present effort is designed to increase the realism of that model by acknowledging institutional restrictions on the hiring of nonphysician labor inputs.…”

Section: Introductionmentioning

confidence: 99%

Scale Economies in the Delivery of Medical Care: A Mixed Integer Programming Analysis of Efficient Manpower Utilization

Golladay¹,

Manser²,

Smith³

1974

The Journal of Human Resources

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JSTOR is a not-for-profit service that helps scholars, researchers, and students discover, use, and build upon a wide range of content in a trusted digital archive. We use information technology and tools to increase productivity and facilitate new forms of scholarship. For more information about JSTOR, please contact support@jstor.org.. University of Wisconsin Press andThe Board of Regents of the University of Wisconsin System are collaborating with JSTOR to digitize, preserve and extend access to The Journal of Human Resources. ABSTRACT This paper presents an activity analysis model of primary medical care which, through the use of integer constraints, captures both the technology of ambulatory care and the institutional restriction that labor inputs must be employed in discrete units. The result is that staffing patterns and optimal choice of techniques depend on the scale of practice. Empirical experiments demonstrate this relationship and, furthermore, reveal that introduction of physician extenders into the medical care system increases the scale at which economies o f staffing are obtained and raises the diseconomies of suboptimal practice.

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“…Despite the wealth of literature in recent years focusing variously upon the productivity (actual or potential), quality of care, and acceptability of nurse practitioners, physician associates, and dental auxiliaries, the hard evidence on cost savings is remarkably thin. True, some productivity studies have looked necessarily at the mirrorimage question of how unit production costs vary with auxiliary usage (e.g., Smith, Miller, and Golladay, 1972; Kilpatrick, Mackenzie, and Delaney, 1972;Reinhardt, 1973;and Lipscomb and Scheffler, 1975). But these were based, by and large, either on experimental, laboratory-like data or else historical information from cross-sectional surveys that contained only a few practice observations from each medical market area.…”

Section: Introductionmentioning

confidence: 99%

Deregulation of Paraprofessionals and Health Care Cost Containment: The Case of Dentistry

Lipscomb

1982

Review of Policy Research

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The author argues that the development of satisfactory market models in dentistry and other health care areas is crucial to a realistic examination of various deregulation proposals. He argues that such examinations cannot rely on the logic of economics alone, but must be rooted in empirical analyses well-founded in theory. Using expanded function dental auxiliaries as an example, the author demonstrates the complexities of the issues involved and the relevance of political economy models. Copyright 1982 by The Policy Studies Organization.

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An Analysis of the Optimal Use of Inputs in the Production of Medical Services

Cited by 24 publications

References 3 publications

Health resource allocation and quality of care measurement in a social policy framework

Health resource allocation and quality of care measurement in a social policy framework

Scale Economies in the Delivery of Medical Care: A Mixed Integer Programming Analysis of Efficient Manpower Utilization

Deregulation of Paraprofessionals and Health Care Cost Containment: The Case of Dentistry

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