IDEAS home Printed from https://ideas.repec.org/p/nbr/nberwo/8385.html

Measuring the Relative Performance of Providers of a Health Service

Author

Listed:
  • Daniel A. Ackerberg
  • Matilde P. Machado
  • Michael H. Riordan

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.

Suggested Citation

  • Daniel A. Ackerberg & Matilde P. Machado & Michael H. Riordan, 2001. "Measuring the Relative Performance of Providers of a Health Service," NBER Working Papers 8385, National Bureau of Economic Research, Inc.
    • Handle: RePEc:nbr:nberwo:8385
    Note: EH
    as

    Download full text from publisher

    File URL: http://www.nber.org/papers/w8385.pdf
    Download Restriction: no
    ---><---

    References listed on IDEAS

    as
    1. Donald W. K. Andrews, 2002. "Higher-Order Improvements of a Computationally Attractive "k"-Step Bootstrap for Extremum Estimators," Econometrica, Econometric Society, vol. 70(1), pages 119-162, January.
    2. Butler, J S, 1987. "Measurement Error in Self-reported Health Variables," The Review of Economics and Statistics, MIT Press, vol. 69(4), pages 644-650, November.
    3. Mingshan Lu & Thomas G. McGuire, 2002. "The Productivity of Outpatient Treatment for Substance Abuse," Journal of Human Resources, University of Wisconsin Press, vol. 37(2), pages 309-335.
    4. Charles F. Manski, 1996. "Learning about Treatment Effects from Experiments with Random Assignment of Treatments," Journal of Human Resources, University of Wisconsin Press, vol. 31(4), pages 709-733.
    5. Olley, G Steven & Pakes, Ariel, 1996. "The Dynamics of Productivity in the Telecommunications Equipment Industry," Econometrica, Econometric Society, vol. 64(6), pages 1263-1297, November.
    6. James J. Heckman & Jeffrey A. Smith, 1995. "Assessing the Case for Social Experiments," Journal of Economic Perspectives, American Economic Association, vol. 9(2), pages 85-110, Spring.
    7. Mingshan Lu, 1999. "Separating the True Effect from Gaming in Incentive‐Based Contracts in Health Care," Journal of Economics & Management Strategy, Wiley Blackwell, vol. 8(3), pages 383-431, September.
    8. 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.
    9. Machado, Matilde P., 2001. "Dollars and performance: treating alcohol misuse in Maine," Journal of Health Economics, Elsevier, vol. 20(4), pages 639-666, July.
    10. French, M.T. & Zarkin, G.A. & Hubbard, R.L. & Rachal, J.V., 1991. "The impact of time in treatment on the employment and earnings of drug abusers," American Journal of Public Health, American Public Health Association, vol. 81(7), pages 904-907.
    11. James Heckman, 1997. "Instrumental Variables: A Study of Implicit Behavioral Assumptions Used in Making Program Evaluations," Journal of Human Resources, University of Wisconsin Press, vol. 32(3), pages 441-462.
    12. Zvi Eckstein & Kenneth I. Wolpin, 1999. "Why Youths Drop Out of High School: The Impact of Preferences, Opportunities, and Abilities," Econometrica, Econometric Society, vol. 67(6), pages 1295-1340, November.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Lindelow, Magnus & Wagstaff, Adam, 2003. "Health facility surveys : an introduction," Policy Research Working Paper Series 2953, The World Bank.
    2. Machado, Matilde P., 2003. "Substance abuse treatment: what do we know? an economist's perspective," UC3M Working papers. Economics we035621, Universidad Carlos III de Madrid. Departamento de Economía.
    3. Lien, Hsien-Ming & Albert Ma, Ching-To & McGuire, Thomas G., 2004. "Provider-client interactions and quantity of health care use," Journal of Health Economics, Elsevier, vol. 23(6), pages 1261-1283, November.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Machado, Matilde P., 2003. "Substance abuse treatment: what do we know? an economist's perspective," UC3M Working papers. Economics we035621, Universidad Carlos III de Madrid. Departamento de Economía.
    2. Matilde Machado, 2005. "Substance abuse treatment, what do we know?," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 6(1), pages 53-64, March.
    3. James J. Heckman, 2005. "Micro Data, Heterogeneity and the Evaluation of Public Policy Part 2," The American Economist, Sage Publications, vol. 49(1), pages 16-44, March.
    4. Sebastian Galiani & Juan Pantano, 2021. "Structural Models: Inception and Frontier," NBER Working Papers 28698, National Bureau of Economic Research, Inc.
    5. Kasahara, Hiroyuki & Shimotsu, Katsumi, 2008. "Pseudo-likelihood estimation and bootstrap inference for structural discrete Markov decision models," Journal of Econometrics, Elsevier, vol. 146(1), pages 92-106, September.
    6. Jaap H. Abbring, 2010. "Identification of Dynamic Discrete Choice Models," Annual Review of Economics, Annual Reviews, vol. 2(1), pages 367-394, September.
    7. Angus Deaton, 2010. "Instruments, Randomization, and Learning about Development," Journal of Economic Literature, American Economic Association, vol. 48(2), pages 424-455, June.
    8. Hiroyuki Kasahara & Katsumi Shimotsu, 2006. "Nested Pseudo-likelihood Estimation And Bootstrap-based Inference For Structural Discrete Markov Decision Models," Working Paper 1063, Economics Department, Queen's University.
    9. Angus Deaton, 2009. "Instruments of development: Randomization in the tropics, and the search for the elusive keys to economic development," Working Papers 1128, Princeton University, Woodrow Wilson School of Public and International Affairs, Center for Health and Wellbeing..
    10. Victor Aguirregabiria, 2006. "Another Look at the Identification of Dynamic Discrete Decision Processes: With an Application to Retirement Behavior," 2006 Meeting Papers 169, Society for Economic Dynamics.
    11. Dionissi Aliprantis, 2013. "Covariates and causal effects: the problem of context," Working Papers (Old Series) 1310, Federal Reserve Bank of Cleveland.
    12. Pamela Giustinelli & Charles F. Manski, 2018. "Survey Measures Of Family Decision Processes For Econometric Analysis Of Schooling Decisions," Economic Inquiry, Western Economic Association International, vol. 56(1), pages 81-99, January.
    13. Peter Arcidiacono & Holger Sieg & Frank Sloan, 2007. "Living Rationally Under The Volcano? An Empirical Analysis Of Heavy Drinking And Smoking," International Economic Review, Department of Economics, University of Pennsylvania and Osaka University Institute of Social and Economic Research Association, vol. 48(1), pages 37-65, February.
    14. Thomas J. Holmes, 2010. "Structural, Experimentalist, And Descriptive Approaches To Empirical Work In Regional Economics," Journal of Regional Science, Wiley Blackwell, vol. 50(1), pages 5-22, February.
    15. Fernández, Raquel & Wong, Joyce Cheng, 2011. "The Disappearing Gender Gap: The Impact of Divorce, Wages, and Preferences on Education Choices and Women's Work," IZA Discussion Papers 6046, IZA Network @ LISER.
    16. Christian Belzil & Jörgen Hansen, 2020. "Reconciling Changes in Wage Inequality With Changes in College Selectivity Using a Behavioral Model," CIRANO Working Papers 2020s-36, CIRANO.
    17. Fabien Postel-Vinay & Hélène Turon, 2007. "The Public Pay Gap in Britain: Small Differences That (Don't?) Matter," Economic Journal, Royal Economic Society, vol. 117(523), pages 1460-1503, October.
    18. Kalouptsidi, Myrto & Scott, Paul & Souza-Rodrigues, Eduardo, 2015. "Identification of Counterfactuals and Payoffs in Dynamic Discrete Choice with an Application to Land Use," TSE Working Papers 15-596, Toulouse School of Economics (TSE).
    19. John V. Pepper, 2003. "Using Experiments to Evaluate Performance Standards: What Do Welfare-to-Work Demonstrations Reveal to Welfare Reformers?," Journal of Human Resources, University of Wisconsin Press, vol. 38(4).
    20. Aguirregabiria, Victor & Mira, Pedro, 2010. "Dynamic discrete choice structural models: A survey," Journal of Econometrics, Elsevier, vol. 156(1), pages 38-67, May.

    More about this item

    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

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:nbr:nberwo:8385. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: the person in charge (email available below). General contact details of provider: https://edirc.repec.org/data/nberrus.html .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.