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Measuring performance in the presence of stochastic demand for hospital services: an analysis of Belgian general care hospitals

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Mike Smet ()

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Abstract

Since demand for hospital services is subject to substantial variability, the relationship between uncertain demand, excess capacity, hospital costs and performance should be investigated thoroughly. In this paper a waiting time indicator to proxy hospital standby capacity is incorporated into a multi-product translog cost function for Belgian general care hospitals. The indicator is derived from queuing theory and improves on the conventionally used (inverse of the) occupancy rate. The multi-product stochastic frontier specification allows calculation of cost elasticities and marginal cost of seven hospital departments, as well as the degree of economies of scale and scope and enables identification of differences in efficiency. Copyright Springer Science+Business Media, LLC 2007

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File URL: http://hdl.handle.net/10.1007/s11123-006-0021-7
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Publisher Info
Article provided by Springer in its journal Journal of Productivity Analysis.

Volume (Year): 27 (2007)
Issue (Month): 1 (February)
Pages: 13-29
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Handle: RePEc:kap:jproda:v:27:y:2007:i:1:p:13-29

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Web page: http://www.springerlink.com/link.asp?id=100296

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Related research
Keywords: Hospital costs; Stochastic demand; Efficiency; Productivity; Stochastic frontier analysis; Econometrics; Queuing theory; Multi-product cost function; C01; C13; C21; D24; H51; l11; l12;

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  1. Street, Andrew & Jacobs, Rowena, 2002. "Relative Performance Evaluation of the English Acute Hospital Sector," Applied Economics, Taylor and Francis Journals, vol. 34(9), pages 1109-19, June. [Downloadable!] (restricted)
  2. Caves, Douglas W & Christensen, Laurits R & Tretheway, Michael W, 1980. "Flexible Cost Functions for Multiproduct Firms," The Review of Economics and Statistics, MIT Press, vol. 62(3), pages 477-81, August. [Downloadable!] (restricted)
  3. Keeler, Theodore E & Ying, John S, 1996. "Hospital Costs and Excess Bed Capacity: A Statistical Analysis," The Review of Economics and Statistics, MIT Press, vol. 78(3), pages 470-81, August. [Downloadable!] (restricted)
  4. Martin Gaynor & Gerard F. Anderson, 1995. "Uncertain Demand, The Structure of Hospital Costs, and the Cost of EmptyHospital Beds," NBER Working Papers 4460, National Bureau of Economic Research, Inc. [Downloadable!] (restricted)
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  5. Daniel Bilodeau & Pierre-Yves Crémieux & Pierre Ouellette, 2000. "Hospital Cost Function In A Non-Market Health Care System," The Review of Economics and Statistics, MIT Press, vol. 82(3), pages 489-498, August. [Downloadable!] (restricted)
  6. Mulligan, James G., 1985. "The stochastic determinants of hospital-bed supply," Journal of Health Economics, Elsevier, vol. 4(2), pages 177-181, June. [Downloadable!] (restricted)
  7. Conrad, Robert F & Strauss, Robert P, 1983. "A Multiple-Output Multiple-Input Model of the Hospital Industry in North Carolina," Applied Economics, Taylor and Francis Journals, vol. 15(3), pages 341-52, June.
  8. Dawson, Diane & Goddard, Maria & Street, Andrew, 2001. "Improving performance in public hospitals: a role for comparative costs?," Health Policy, Elsevier, vol. 57(3), pages 235-248, September. [Downloadable!] (restricted)
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