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Cost-Output Relation, Technological Progress, and Clinical Activity Mix of US Hospital Pharmacies

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  • Albert Okunade

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Abstract

The fairly recent discovery and growing use of costly, revolutionary biotechnology drugs (e.g., GM-CSFs) in hospitals represent a major technical innovation in clinical pharmacy intervention. This paper models the translog production cost impacts of ten distinct clinical pharmacy tasks including pharmacokinetics, consultations with MDs, monitoring drug interactions,..., and presents results on decomposed technical change, economies of scope, scale economies, total factor productivity, and the alternatively defined pairwise factor substitution possibilities. The model was fitted to 1981–1990 time-series/cross-sectional data of US hospital pharmacies (source: Eli-Lilly Co.®). Zellner's ISURE (Iterative Seemingly Unrelated Regression Equations) system estimates reveal a non-homothetic underlying technology with biased and pure technical change effects dominating scale-augmentation. Certain clinical tasks increase costs but are cost-saving if jointly produced with selective others. One of the largest and statistically significant economies of scope estimates is between ‘monitoring drug interactions’ and ‘consultations with MDs’. Cost implications of findings are given in light of the recent trends in hospital pharmacy clinical activities, related professional health manpower, and piecemeal health policy reforms. Copyright Kluwer Academic Publishers 2001

Suggested Citation

  • Albert Okunade, 2001. "Cost-Output Relation, Technological Progress, and Clinical Activity Mix of US Hospital Pharmacies," Journal of Productivity Analysis, Springer, vol. 16(2), pages 167-193, September.
  • Handle: RePEc:kap:jproda:v:16:y:2001:i:2:p:167-193
    DOI: 10.1023/A:1011635411864
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    References listed on IDEAS

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    1. 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 470-481, August.
    2. Fournier, Gary M & Mitchell, Jean M, 1992. "Hospital Costs and Competition for Services: A Multiproduct Analysis," The Review of Economics and Statistics, MIT Press, vol. 74(4), pages 627-634, November.
    3. Given, Ruth S., 1996. "Economies of scale and scope as an explanation of merger and output diversification activities in the health maintenance organization industry," Journal of Health Economics, Elsevier, vol. 15(6), pages 685-713, December.
    4. Chalfant, James A. & Gallant, A. Ronald, 1985. "Estimating substitution elasticities with the Fourier cost function : Some Monte Carlo results," Journal of Econometrics, Elsevier, vol. 28(2), pages 205-222, May.
    5. Charnes, A. & Cooper, W. W. & Rhodes, E., 1978. "Measuring the efficiency of decision making units," European Journal of Operational Research, Elsevier, vol. 2(6), pages 429-444, November.
    6. Konstantinos Giannakas & Kien Tran & Vangelis Tzouvelekas, 2000. "Efficiency, technological change and output growth in Greek olive growing farms: a Box-Cox approach," Applied Economics, Taylor & Francis Journals, vol. 32(7), pages 909-916.
    7. W. Cooper & C. Lovell, 2000. "New Approaches to Measures of Efficiency in DEA: An Introduction," Journal of Productivity Analysis, Springer, vol. 13(2), pages 91-92, March.
    8. Gagne, Robert & Ouellette, Pierre, 1998. "On the Choice of Functional Forms: Summary of a Monte Carlo Experiment," Journal of Business & Economic Statistics, American Statistical Association, vol. 16(1), pages 118-124, January.
    9. Albert A. Okunade, 1999. "Will the real elasticity of substitution 'in Norwegian dentistry' please stand up?," Health Economics, John Wiley & Sons, Ltd., vol. 8(3), pages 221-232.
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    Cited by:

    1. Daniel L. Friesner & Matthew Q. McPherson & Robert Rosenman, 2010. "Are Hospital Pharmacies More Efficient if They Employ Nurses?," Economics Bulletin, AccessEcon, vol. 30(1), pages 139-156.
    2. Okunade, Albert A. & Murthy, Vasudeva N. R., 2002. "Technology as a 'major driver' of health care costs: a cointegration analysis of the Newhouse conjecture," Journal of Health Economics, Elsevier, vol. 21(1), pages 147-159, January.
    3. Blank, Jos L. T. & Vogelaar, Iris, 2004. "Specifying technical change: a research on the nature of technical change in Dutch hospital industry," The Quarterly Review of Economics and Finance, Elsevier, vol. 44(3), pages 448-463, July.
    4. Richard Cebula, 2006. "A Further Analysis of Determinants of Health Insurance Coverage," International Advances in Economic Research, Springer;International Atlantic Economic Society, vol. 12(3), pages 382-389, August.
    5. Suraratdecha, Chutima & Okunade, Albert A., 2006. "Measuring operational efficiency in a health care system: A case study from Thailand," Health Policy, Elsevier, vol. 77(1), pages 2-23, June.
    6. Okunade, Albert A. & Suraratdecha, Chutima, 2006. "The pervasiveness of pharmaceutical expenditure inertia in the OECD countries," Social Science & Medicine, Elsevier, vol. 63(1), pages 225-238, July.
    7. repec:kap:hcarem:v:22:y:2019:i:3:d:10.1007_s10729-019-09470-8 is not listed on IDEAS

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