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Measuring the Relative Performance of Providers of a Health Service

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Author Info
Daniel A. Ackerberg
Matilde P. Machado
Michael H. Riordan

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Abstract

A methodology is developed and applied to compare the performance of publicly funded agencies providing treatment for alcohol abuse in Maine. The methodology estimates a Wiener process that determines the duration of completed treatments, while allowing for agency differences in the effectiveness of treatment, standards for completion of treatment, patient attrition, and the characteristics of patient populations. Notably, the Wiener process model separately identifies agency fixed effects that describe differences in the effectiveness of treatment ('treatment effects'), and effects that describe differences in the unobservable characteristics of patients ('population effects'). The estimated model enables hypothetical comparisons of how different agencies would treat the same populations. The policy experiment of transferring the treatment practices of more cost-effective agencies suggests that Maine could have significantly reduced treatment costs without compromising health outcomes by identifying and transferring best practices.

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Paper provided by National Bureau of Economic Research, Inc in its series NBER Working Papers with number 8385.

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Date of creation: Jul 2001
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Handle: RePEc:nbr:nberwo:8385

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Find related papers by JEL classification:
L22 - Industrial Organization - - Firm Objectives, Organization, and Behavior - - - Firm Organization and Market Structure
I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets

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Please report citation or reference errors to , or , if you are the registered author of the cited work, log in to your RePEc Author Service profile, click on "citations" and make appropriate adjustments.:
  1. Imbens, Guido W & Angrist, Joshua D, 1994. "Identification and Estimation of Local Average Treatment Effects," Econometrica, Econometric Society, vol. 62(2), pages 467-75, March. [Downloadable!] (restricted)
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  2. Keane, Michael P & Wolpin, Kenneth I, 1997. "The Career Decisions of Young Men," Journal of Political Economy, University of Chicago Press, vol. 105(3), pages 473-522, June.
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  3. Machado, Matilde P., 2001. "Dollars and performance: treating alcohol misuse in Maine," Journal of Health Economics, Elsevier, vol. 20(4), pages 639-666, July. [Downloadable!] (restricted)
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  1. Matilde P. Machado, 2003. "Substance Abuse Treatment: What Do We Know? An Economist’S Perspective," Economics Working Papers we035621, Universidad Carlos III, Departamento de Economía. [Downloadable!]
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