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Analysis of uncompensated hospital care using a DEA model of output congestion

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  • Gary Ferrier
  • Michael Rosko
  • Vivian Valdmanis

    ()

Abstract

Uncompensated care can create financial difficulties for hospitals. The problem is likely to worsen as the number of individuals lacking health insurance continues to grow. The objective of this study is to measure how uncompensated care affects hospitals' ability to provide the services for which they do receive compensation. Applying output-based data envelopment analysis (DEA) under various assumptions on the disposability of outputs to a sample of Pennsylvania hospitals, we find that, on average, hospitals could have produced 7% more output if they had all operated on the best-practice frontier and that uncompensated care reduced the production of other hospital outputs by 2%. Thus, even if hospitals were to operate efficiently, they might still face financial distress as a result of providing uncompensated care. The findings in our study suggest that policy makers should continue looking at ways to increase funding to hospitals providing uncompensated care while not distorting economic incentives to reduce excessive costs. Copyright Springer Science + Business Media, Inc. 2006

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File URL: http://hdl.handle.net/10.1007/s10729-006-7665-8
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Bibliographic Info

Article provided by Springer in its journal Health Care Management Science.

Volume (Year): 9 (2006)
Issue (Month): 2 (May)
Pages: 181-188

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Handle: RePEc:kap:hcarem:v:9:y:2006:i:2:p:181-188

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Web page: http://www.springerlink.com/link.asp?id=101767

Related research

Keywords: Uncompensated care; Hospital efficiency; Congestion; DEA;

References

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  1. Simar, L. & Wilson, P.W., 1999. "Statistical Inference in Nonparametric Frontier Models: the State of the Art," Papers 9904, Catholique de Louvain - Institut de statistique.
  2. 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.
  3. Fare, Rolf, et al, 1989. "Multilateral Productivity Comparisons When Some Outputs Are Undesirable: A Nonparametric Approach," The Review of Economics and Statistics, MIT Press, vol. 71(1), pages 90-98, February.
  4. Fare, Rolf & Grosskopf, Shawna, 2000. "Slacks and congestion: a comment," Socio-Economic Planning Sciences, Elsevier, vol. 34(1), pages 27-33, March.
  5. Guan Zhengfei & Alfons Oude Lansink, 2003. "Input Disposability and Efficiency in Dutch Arable Farming," Journal of Agricultural Economics, Wiley Blackwell, vol. 54(3), pages 467-478.
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Citations

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Cited by:
  1. Leleu, Hervé, 2013. "Shadow pricing of undesirable outputs in nonparametric analysis," European Journal of Operational Research, Elsevier, vol. 231(2), pages 474-480.
  2. Simões, Pedro & Cunha Marques, Rui, 2009. "Performance and Congestion Analysis of the Portuguese Hospital Services," MPRA Paper 16940, University Library of Munich, Germany.
  3. Barros, Carlos Pestana & Menezes, Antonio & Vieira, José A. Cabral & Peypoch, Nicolas & Solonandrasana, Bernardin, 2007. "An Analysis of Hospital Efficiency and Productivity Growth Using the Luenberger Productivity Indicator," IZA Discussion Papers 2689, Institute for the Study of Labor (IZA).
  4. : Álvaro Almeida & José Pedro Fique, 2011. "Evaluating Hospital Efficiency Adjusting for Quality Indicators: an Application to Portuguese NHS Hospitals," FEP Working Papers 435, Universidade do Porto, Faculdade de Economia do Porto.
  5. Carlos Barros & António Gomes de Menezes & Nicolas Peypoch & Bernardin Solonandrasana & José Vieira, 2008. "An analysis of hospital efficiency and productivity growth using the Luenberger indicator," Health Care Management Science, Springer, vol. 11(4), pages 373-381, December.
  6. Ananda, Jayanath & Gitto, Simone & Mancuso, Paolo, 2013. "Ownership, Productivity Change in the Australian Urban Water Sector: a Bootstrap Malmquist indices approach," MPRA Paper 50384, University Library of Munich, Germany.
  7. Bruce Hollingsworth, 2008. "The measurement of efficiency and productivity of health care delivery," Health Economics, John Wiley & Sons, Ltd., vol. 17(10), pages 1107-1128.
  8. Jan Clement & Vivian Valdmanis & Gloria Bazzoli & Mei Zhao & Askar Chukmaitov, 2008. "Is more better? An analysis of hospital outcomes and efficiency with a DEA model of output congestion," Health Care Management Science, Springer, vol. 11(1), pages 67-77, March.
  9. Ng, Ying Chu, 2011. "The productive efficiency of Chinese hospitals," China Economic Review, Elsevier, vol. 22(3), pages 428-439, September.

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