Output Efficiency of Health Maintenance Organizations in Florida

Rosenman, Robert; Siddharthan, Kris; Ahern, Melissa M.

doi:10.1002/(sici)1099-1050(199705)6:3<295::aid-hec265>3.0.co;2-#

Cited by 28 publications

(19 citation statements)

References 23 publications

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“…Concerning HMOs, a study found that HMOs with Medicaid patients are significantly less efficient than are other HMOs [59]. …”

Section: Resultsmentioning

confidence: 99%

“…One study (2%) focussed on the analysis of technical and scale efficiencies for a sample of 28 HMOs in Florida [59]. …”

Section: Resultsmentioning

confidence: 99%

“…Cautious conclusions are that public provision might be potentially more efficient than private hospitals in certain settings. Three articles performed analyses using a sample of private for-profit and not-for-profit hospitals [59, 61, 64]. One article estimated the scale and technical efficiency of a sample of hospitals to identified differences between public and private not-for-profit hospitals [72].…”

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Efficiency and optimal size of hospitals: Results of a systematic search

Giancotti¹,

Guglielmo²,

Mauro³

2017

PLoS ONE

122

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BackgroundNational Health Systems managers have been subject in recent years to considerable pressure to increase concentration and allow mergers. This pressure has been justified by a belief that larger hospitals lead to lower average costs and better clinical outcomes through the exploitation of economies of scale. In this context, the opportunity to measure scale efficiency is crucial to address the question of optimal productive size and to manage a fair allocation of resources.Methods and findingsThis paper analyses the stance of existing research on scale efficiency and optimal size of the hospital sector. We performed a systematic search of 45 past years (1969–2014) of research published in peer-reviewed scientific journals recorded by the Social Sciences Citation Index concerning this topic. We classified articles by the journal’s category, research topic, hospital setting, method and primary data analysis technique. Results showed that most of the studies were focussed on the analysis of technical and scale efficiency or on input / output ratio using Data Envelopment Analysis. We also find increasing interest concerning the effect of possible changes in hospital size on quality of care.ConclusionsStudies analysed in this review showed that economies of scale are present for merging hospitals. Results supported the current policy of expanding larger hospitals and restructuring/closing smaller hospitals. In terms of beds, studies reported consistent evidence of economies of scale for hospitals with 200–300 beds. Diseconomies of scale can be expected to occur below 200 beds and above 600 beds.

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“…Concerning HMOs, a study found that HMOs with Medicaid patients are significantly less efficient than are other HMOs [59]. …”

Section: Resultsmentioning

confidence: 99%

“…One study (2%) focussed on the analysis of technical and scale efficiencies for a sample of 28 HMOs in Florida [59]. …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 1 more Smart Citation

Efficiency and optimal size of hospitals: Results of a systematic search

Giancotti¹,

Guglielmo²,

Mauro³

2017

PLoS ONE

122

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“…For example, to assess the efficiency of the hospital sector DEA has been utilized by the studies like Grosskopf and Valdmanis (1987), Hollingsworth and Parkin (1995), Parkin and Hollingsworth (1997), McKillop, Glass, Kerr, and Mccallion (1999), Hollingsworth, Dawson, and Maniadakis (1999, and so on. Apart from the above, DEA models have been used to assess primary health care services (Salinas-Jiménez & Smith, 1996), to measure the efficiency of health maintenance organizations (Roseman, Siddharthan, & Ahern, 1997), to compare the provision of perinatal services across the United Kingdom (Thanassoulis, Boussofiane, & Dyson, 1995), to compare the education and health efficiency in Organisation for Economic Co-operation and Development (OECD) countries (Afonso & Aubyn, 2005), and to judge the efficiency of government expenditure in Africa (Gupta & Verhoeven, 2001). Spinks and Hollingsworth (2005) assessed health efficiency for OECD countries using DEA-based Malmquist Indexes.…”

Section: Introductionmentioning

confidence: 99%

Efficiency of Health Care System in India: An Inter-State Analysis using DEA Approach

Dhar

Bhattacharya

2012

Social Work in Public Health

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Since independence a massive personnel and public health infrastructure has been created in India. However, there is no competition and hardly any choice to the poor patients resulting in poor quality services leading to allocative and technical inefficiencies. This study uses the data envelopment analysis model to assess and compare the efficiency of health system within various states of India. It shows the inadequacy of health infrastructure and manpower in the inefficient states where poor people are concentrated. Among the determinants of efficiency female literacy, poverty level, institutional delivery, and full immunization of children are proved to be important factors in explaining efficiency of health system in India.

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“…Rosenman et al [34] studied the quarterly and annual reports of 28 HMOs operating in Florida in 1994. They measured outputs as commercial, Medicare, and Medicaid enrollment and inputs as total assets, medical expenditures, and administrative expenditures.…”

Section: Hmo Average Productivitymentioning

confidence: 99%

A descriptive analysis of average productivity among health maintenance organizations, 1985 to 2001

Wholey

Engberg

Bryce³

2006

Health Care Manage Sci

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This paper examines the evolution of average productivity among HMOs for 4,419 Health Maintenance Organizations (HMOs) from 1985 to 2001. For both IPA and non-IPA HMOs, HMO productivity increased from 1990 to 1996 and rapidly decreased from 1997 to 2001. In contrast to cost functions that show scale economies for IPA and non-IPA HMOs, production functions showed scale economies for IPA HMOs were constant and non-IPA HMOs having only slight scale economies. This suggests that much of the scale economies observed in cost functions are due to lower prices for resources used rather than improvements in production organization. Non-IPA HMOs and non-profit HMOs are more productive than IPA HMOs and for profit HMOs. Production organization for non-IPA HMOs appears to have improved over time, resulting in non-IPA HMOs being able to produce more member months of coverage with their production organization in 1997 to 2001 than they would have with their production organization in 1985 to 1990. Regulations requiring consumer involvement in HMO governance reduce productivity.

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Output Efficiency of Health Maintenance Organizations in Florida

Cited by 28 publications

References 23 publications

Efficiency and optimal size of hospitals: Results of a systematic search

Efficiency and optimal size of hospitals: Results of a systematic search

Efficiency of Health Care System in India: An Inter-State Analysis using DEA Approach

A descriptive analysis of average productivity among health maintenance organizations, 1985 to 2001

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