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Assessing overall, technical, and scale efficiency among home health care agencies

Author

Listed:
  • Vivian G. Valdmanis

    (Grand Valley State University
    CNRS, IÉSEG School of Management, Univ. Lille, UMR 9221-LEM Lille Economie Management)

  • Michael D. Rosko

    (Widener University
    University of St. Andrews)

  • Hervé Leleu

    (CNRS, IÉSEG School of Management, Univ. Lille, UMR 9221-LEM Lille Economie Management)

  • Dana B. Mukamel

    (University of California)

Abstract

While home health care agencies (HHAs) play a vital role in the production of health, little research has been performed gauging their efficiency. Employing a robust approach to data envelopment analysis (DEA) we assessed overall, technical, and scale efficiency on a nationwide sample of HHAs. After deriving the three efficiency measures, we regressed these scores on a variety of environmental factors. We found that HHAs, on average, could proportionally reduce inputs by 28 % (overall efficiency), 23 % (technical efficiency) and 6 % (scale efficiency). For-profit ownership was positively associated with improvements in overall efficiency and technical efficiency and chain ownership was positively associated with global efficiency. There were also state-by-state variations on all the efficiency measures. As home health becomes an increasingly important player in the health care system, and its share of national health expenditures increases, it has become important to understand the cost structure of the industry and the potential for efficiencies. Therefore, further research is recommended as this sector continues to grow.

Suggested Citation

  • Vivian G. Valdmanis & Michael D. Rosko & Hervé Leleu & Dana B. Mukamel, 2017. "Assessing overall, technical, and scale efficiency among home health care agencies," Health Care Management Science, Springer, vol. 20(2), pages 265-275, June.
  • Handle: RePEc:kap:hcarem:v:20:y:2017:i:2:d:10.1007_s10729-015-9351-1
    DOI: 10.1007/s10729-015-9351-1
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    1. Alois Kneip & Léopold Simar & Paul Wilson, 2011. "A Computationally Efficient, Consistent Bootstrap for Inference with Non-parametric DEA Estimators," Computational Economics, Springer;Society for Computational Economics, vol. 38(4), pages 483-515, November.
    2. Kneip, Alois & Simar, Léopold & Wilson, Paul W., 2008. "Asymptotics And Consistent Bootstraps For Dea Estimators In Nonparametric Frontier Models," Econometric Theory, Cambridge University Press, vol. 24(6), pages 1663-1697, December.
    3. Kass, David I., 1987. "Economics of scale and scope in the provision of home health services," Journal of Health Economics, Elsevier, vol. 6(2), pages 129-146, June.
    4. Léopold Simar & Paul Wilson, 2011. "Inference by the m out of n bootstrap in nonparametric frontier models," Journal of Productivity Analysis, Springer, vol. 36(1), pages 33-53, August.
    5. Simar, Leopold & Wilson, Paul W., 2007. "Estimation and inference in two-stage, semi-parametric models of production processes," Journal of Econometrics, Elsevier, vol. 136(1), pages 31-64, January.
    6. Valdmanis, Vivian, 1992. "Sensitivity analysis for DEA models : An empirical example using public vs. NFP hospitals," Journal of Public Economics, Elsevier, vol. 48(2), pages 185-205, July.
    7. Cynthia Dudzinski & O. Homer Erekson & Andrea Ziegert, 1998. "Estimating an hedonic translog cost function for the home health care industry," Applied Economics, Taylor & Francis Journals, vol. 30(9), pages 1259-1267.
    8. Yasar A. Ozcan, 2014. "Evaluation of Performance in Health Care," International Series in Operations Research & Management Science, in: Health Care Benchmarking and Performance Evaluation, edition 2, chapter 0, pages 3-14, Springer.
    9. Léopold Simar & Paul W. Wilson, 1998. "Sensitivity Analysis of Efficiency Scores: How to Bootstrap in Nonparametric Frontier Models," Management Science, INFORMS, vol. 44(1), pages 49-61, January.
    10. Grosskopf, S. & Valdmanis, V., 1987. "Measuring hospital performance : A non-parametric approach," Journal of Health Economics, Elsevier, vol. 6(2), pages 89-107, June.
    11. Nyman, John A. & Dowd, Bryan E., 1991. "Cost function analysis of Medicare policy: Are reimbursement limits for rural home health agencies sufficient?," Journal of Health Economics, Elsevier, vol. 10(3), pages 313-327, October.
    12. Yasar A. Ozcan, 2014. "Health Care Benchmarking and Performance Evaluation," International Series in Operations Research and Management Science, Springer, edition 2, number 978-1-4899-7472-3, September.
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    2. Onofrio Resta & Emanuela Resta & Alberto Costantiello & Angelo Leogrande, 2023. "Elderly People Treated in Integrated Home Care in Italian Regions: A Metric Approach," Working Papers hal-04367727, HAL.
    3. Habib Zare & Madjid Tavana & Abbas Mardani & Sepideh Masoudian & Mahyar Kamali Saraji, 2019. "A hybrid data envelopment analysis and game theory model for performance measurement in healthcare," Health Care Management Science, Springer, vol. 22(3), pages 475-488, September.
    4. Marouene Chaieb & Jaber Jemai & Khaled Mellouli, 2020. "A decomposition - construction approach for solving the home health care scheduling problem," Health Care Management Science, Springer, vol. 23(2), pages 264-286, June.
    5. Genave, Anna & Blancard, Stéphane & Garabedian, Sabine, 2020. "An assessment of energy vulnerability in Small Island Developing States," Ecological Economics, Elsevier, vol. 171(C).

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