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DEA and primary care physician report cards: Deriving preferred practice cones from managed care service concepts and operating strategies

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  • Jon Chilingerian
  • H. David Sherman

Abstract

Evaluating the practice patterns of the newly dominant force in managed care, the primary care gatekeeper, will be one of the toughest challenges facing health reformers in the United States. This paper introduces DEA as a tool to profile and evaluate practice patterns of primary care physicians. To illustrate these ideas, the practice behavior of 326 primary care physicians in a large Health Maintenance Organization were studied for one year. When two DEA models were compared, a cone ratio DEA model projected the excess utilization of more hospital days and fewer office visits than a DEA model without defined preferred practice regions. The application demonstrates how a cone ratio DEA model can incorporate strategic thinking and executive accountability when establishing clinical benchmarks. Copyright Kluwer Academic Publishers 1997

Suggested Citation

  • Jon Chilingerian & H. David Sherman, 1997. "DEA and primary care physician report cards: Deriving preferred practice cones from managed care service concepts and operating strategies," Annals of Operations Research, Springer, vol. 73(0), pages 35-66, October.
    • Handle: RePEc:spr:annopr:v:73:y:1997:i:0:p:35-66:10.1023/a:1018993515090
    DOI: 10.1023/A:1018993515090
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    Cited by:

    1. Richter, Magnus, 2017. "Time and quality efficiency of Scotch single malt whisky production: An empirical two-model DEA approach," Ilmenauer Schriften zur Betriebswirtschaftslehre, Technische Universität Ilmenau, Institut für Betriebswirtschaftslehre, volume 2, number 22017.
    2. Dino Rizzi & Vincenzo Rebba, 2006. "Measuring Hospital Efficiency through Data Envelopment Analysis when Policy-makers� Preferences Matter. An Application to a sample of Italian NHS hospitals," Working Papers 2006_13, Department of Economics, University of Venice "Ca' Foscari".
    3. Q Feng & J Antony, 2010. "Integrating DEA into Six Sigma methodology for measuring health service efficiency," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 61(7), pages 1112-1121, July.
    4. Antonio Giuffrida & Hugh Gravelle, 2001. "Measuring performance in primary care: econometric analysis and DEA," Applied Economics, Taylor & Francis Journals, vol. 33(2), pages 163-175.
    5. Luis Murillo-Zamorano & Carmelo Petraglia, 2011. "Technical efficiency in primary health care: does quality matter?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 12(2), pages 115-125, April.
    6. Filipe Amado, Carla Alexandra & Dyson, Robert G., 2008. "On comparing the performance of primary care providers," European Journal of Operational Research, Elsevier, vol. 185(3), pages 915-932, March.
    7. Cordero, José Manuel & Alonso-Morán, Edurne & Nuño-Solinis, Roberto & Orueta, Juan F. & Arce, Regina Sauto, 2015. "Efficiency assessment of primary care providers: A conditional nonparametric approach," European Journal of Operational Research, Elsevier, vol. 240(1), pages 235-244.
    8. José Cordero Ferrera & Eva Cebada & Luis Murillo Zamorano, 2014. "The effect of quality and socio-demographic variables on efficiency measures in primary health care," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(3), pages 289-302, April.
    9. Mareike Heimeshoff & Jonas Schreyögg & Lukas Kwietniewski, 2014. "Cost and technical efficiency of physician practices: a stochastic frontier approach using panel data," Health Care Management Science, Springer, vol. 17(2), pages 150-161, June.
    10. Robert Rosenman & Daniel Friesner, 2004. "Scope and scale inefficiencies in physician practices," Health Economics, John Wiley & Sons, Ltd., vol. 13(11), pages 1091-1116, November.
    11. Giannis Karagiannis & Panagiotis Ravanos, 2023. "On Value Efficiency Analysis and Cone-Ratio Data Envelopment Analysis models," Discussion Paper Series 2023_03, Department of Economics, University of Macedonia, revised Mar 2023.
    12. Fang Wu & Mingyao Gu & Chenming Zhu & Yingna Qu, 2023. "Temporal-Spatial Evolution and Trend Prediction of the Supply Efficiency of Primary Medical Health Service—An Empirical Study Based on Central and Western Regions of China," IJERPH, MDPI, vol. 20(3), pages 1-23, January.
    13. C A F Amado & R G Dyson, 2009. "Exploring the use of DEA for formative evaluation in primary diabetes care: An application to compare English practices," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 60(11), pages 1469-1482, November.
    14. Thanassoulis, Emmanuel & Silva Portela, Maria C.A. & Graveney, Mike, 2012. "Estimating the scope for savings in referrals and drug prescription costs in the general Practice units of a UK primary care trust," European Journal of Operational Research, Elsevier, vol. 221(2), pages 432-444.
    15. Matthias Staat, 2003. "The efficiency of treatment strategies of general practitioners," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 4(3), pages 232-238, September.

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