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Scope and scale inefficiencies in physician practices

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  • Robert Rosenman

    (Department of Economics, Washington State University, USA)

  • Daniel Friesner

    (School of Business Administration, Gonzaga University, USA)

Abstract

Using a national data set, this paper looks at the efficiency of physician practices, focusing on scopes of service by comparing single specialty groups and multispecialty groups. An analysis of efficiency using DEA indicates that there are scope inefficiencies from combining different types of providers into a single practice. Most of the inefficiency is due to technical rather than allocative reasons. In addition, we find that larger practices are able to capture efficiencies of scope, but incur inefficiencies of scale. Copyright © 2004 John Wiley & Sons, Ltd.

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File URL: http://hdl.handle.net/10.1002/hec.882
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Bibliographic Info

Article provided by John Wiley & Sons, Ltd. in its journal Health Economics.

Volume (Year): 13 (2004)
Issue (Month): 11 ()
Pages: 1091-1116

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Handle: RePEc:wly:hlthec:v:13:y:2004:i:11:p:1091-1116

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Web page: http://www3.interscience.wiley.com/cgi-bin/jhome/5749

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Cited by:
  1. Luis Murillo-Zamorano & Carmelo Petraglia, 2011. "Technical efficiency in primary health care: does quality matter?," The European Journal of Health Economics, Springer, Springer, vol. 12(2), pages 115-125, April.
  2. 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, Springer, vol. 17(2), pages 150-161, June.
  3. Rajitkanok Puenpatom & Robert Rosenman, 2008. "Efficiency of Thai provincial public hospitals during the introduction of universal health coverage using capitation," Health Care Management Science, Springer, Springer, vol. 11(4), pages 319-338, December.
  4. Cordero Ferrera, Jose Manuel & Alonso Morán, Edurne & Nuño Solís, Roberto & Orueta, Juan F. & Souto Arce, Regina, 2013. "Efficiency assessment of primary care providers: A conditional nonparametric approach," MPRA Paper 51926, University Library of Munich, Germany.
  5. Daniel Friesner & Ron Mittelhammer & Robert Rosenmane, 2006. "Inferring the Latent Incidence of Inefficiency from DEA Estimates and Bayesian Priors," Working Papers, School of Economic Sciences, Washington State University 2006-8, School of Economic Sciences, Washington State University.
  6. Heimeshoff, Mareike & Schreyögg, Jonas, 2013. "Estimation of a physician practice cost function," hche Research Papers 2013/07, Hamburg Center for Health Economics (hche), University of Hamburg.
  7. Friesner, Daniel & Mittelhammer, Ron & Rosenman, Robert, 2013. "Inferring the incidence of industry inefficiency from DEA estimates," European Journal of Operational Research, Elsevier, Elsevier, vol. 224(2), pages 414-424.
  8. Eila Kankaanpää & Ismo Linnosmaa & Hannu Valtonen, 2011. "Public health care providers and market competition: the case of Finnish occupational health services," The European Journal of Health Economics, Springer, Springer, vol. 12(1), pages 3-16, February.
  9. King, Robyn & Green, Peter, 2012. "Governance of primary healthcare practices: Australian insights," Business Horizons, Elsevier, Elsevier, vol. 55(6), pages 593-608.
  10. Amado, Carla Alexandra da Encarnação Filipe & Santos, Sérgio Pereira dos, 2009. "Challenges for performance assessment and improvement in primary health care: The case of the Portuguese health centres," Health Policy, Elsevier, Elsevier, vol. 91(1), pages 43-56, June.
  11. Daniel Friesner & Matthew McPherson & Robert Rosenman, 2006. "Are Hospitals Seasonally Inefficient? Evidence from Washington State Hospitals," Working Papers, School of Economic Sciences, Washington State University 2006-3, School of Economic Sciences, Washington State University.
  12. 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, Springer, vol. 15(3), pages 289-302, April.
  13. Olga Milliken & Rose Anne Devlin & Vicky Barham & William Hogg & Simone Dahrouge & Grant Russell, 2008. "Comparative Efficiency Assessment of Primary Care Models Using Data Envelopment Analysis," Working Papers, University of Ottawa, Department of Economics 0802E, University of Ottawa, Department of Economics.
  14. John Schneider & Pengxiang Li & Donald Klepser & N. Peterson & Timothy Brown & Richard Scheffler, 2008. "The effect of physician and health plan market concentration on prices in commercial health insurance markets," International Journal of Health Care Finance and Economics, Springer, Springer, vol. 8(1), pages 13-26, March.
  15. Pelone, Ferruccio & Kringos, Dionne Sofia & Valerio, Luca & Romaniello, Alessandro & Lazzari, Agnese & Ricciardi, Walter & de Belvis, Antonio Giulio, 2012. "The measurement of relative efficiency of general practice and the implications for policy makers," Health Policy, Elsevier, Elsevier, vol. 107(2), pages 258-268.
  16. Matthias Staat, 2011. "Estimating the efficiency of general practitioners controlling for case mix and outlier effects," Empirical Economics, Springer, Springer, vol. 40(2), pages 321-342, April.
  17. Grace Lordan, 2007. "Measuring efficiency in health care: an application to out of hours primary care services in the island of Ireland," Health, Econometrics and Data Group (HEDG) Working Papers, HEDG, c/o Department of Economics, University of York 07/08, HEDG, c/o Department of Economics, University of York.

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