IDEAS home Printed from https://ideas.repec.org/p/wsu/wpaper/rosenman-2.html
   My bibliography  Save this paper

Are Hospitals Seasonally Inefficient? Evidence from Washington State Hospitals

Author

Listed:
  • Daniel Friesner
  • Matthew McPherson
  • Robert Rosenman

    (School of Economic Sciences, Washington State University)

Abstract

Efficiency measurement has been one of the most extensively explored areas of health services research over the past two decades. Despite this attention, few studies have examined whether a provider’s efficiency varies on a monthly, quarterly or other, sub-annual basis. This paper presents an empirical study that looks for evidence of seasonal inefficiency. Using a quarterly panel of general, acute-care hospitals from Washington State, we find that hospital efficiency does vary over time; however, the nature of this dynamic inefficiency depends on the type of efficiency being measured. Our results suggest that technical and cost efficiency vary by quarter. Allocative and scale efficiency also vary on a quarterly basis, but only if the data are jointly disaggregated by quarter and another, firm-specific factor such as size or operating status. Thus, future research, corporate decisions and government policies designed to improve the efficiency of hospital care need to account for seasonal trends in hospital efficiency.

Suggested Citation

  • Daniel Friesner & Matthew McPherson & Robert Rosenman, 2006. "Are Hospitals Seasonally Inefficient? Evidence from Washington State Hospitals," Working Papers 2006-3, School of Economic Sciences, Washington State University.
    • Handle: RePEc:wsu:wpaper:rosenman-2
    as

    Download full text from publisher

    File URL: http://www.ses.wsu.edu/Research/rosenman_seasonal_efficiency%20_2_.pdf
    File Function: First version, 2005
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Leopold Simar & Paul Wilson, 2000. "A general methodology for bootstrapping in non-parametric frontier models," Journal of Applied Statistics, Taylor & Francis Journals, vol. 27(6), pages 779-802.
    2. Rodriguez-Alvarez, Ana & Fernandez-Blanco, Victor & Lovell, C. A. Knox, 2004. "Allocative inefficiency and its cost:: The case of Spanish public hospitals," International Journal of Production Economics, Elsevier, vol. 92(2), pages 99-111, November.
    3. Jati Sengupta, 1998. "Stochastic data envelopment analysis: a new approach," Applied Economics Letters, Taylor & Francis Journals, vol. 5(5), pages 287-290.
    4. Nikolaos Maniadakis & Emmanuel Thanassoulis, 2000. "Assessing productivity changes in UK hospitals reflecting technology and input prices," Applied Economics, Taylor & Francis Journals, vol. 32(12), pages 1575-1589.
    5. Bruce Hollingsworth & P.J. Dawson & N. Maniadakis, 1999. "Efficiency measurement of health care: a review of non‐parametric methods and applications," Health Care Management Science, Springer, vol. 2(3), pages 161-172, July.
    6. Sherman T. Folland & Richard A. Hofler, 2001. "How reliable are hospital efficiency estimates? Exploiting the dual to homothetic production," Health Economics, John Wiley & Sons, Ltd., vol. 10(8), pages 683-698, December.
    7. 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.
    8. Mickael Lothgren & Magnus Tambour, 1999. "Bootstrapping the data envelopment analysis Malmquist productivity index," Applied Economics, Taylor & Francis Journals, vol. 31(4), pages 417-425.
    9. Zuckerman, Stephen & Hadley, Jack & Iezzoni, Lisa, 1994. "Measuring hospital efficiency with frontier cost functions," Journal of Health Economics, Elsevier, vol. 13(3), pages 255-280, October.
    10. Simar, Leopold & Wilson, Paul W., 2007. "Estimation and inference in two-stage, semi-parametric models of production processes," Journal of Econometrics, Elsevier, vol. 136(1), pages 31-64, January.
    11. Valdmanis, Vivian, 1992. "Sensitivity analysis for DEA models : An empirical example using public vs. NFP hospitals," Journal of Public Economics, Elsevier, vol. 48(2), pages 185-205, July.
    12. Friedman, Bernard & Pauly, Mark, 1981. "Cost Functions for a Service Firm with Variable Quality and Stochastic Demand: The Case of Hospitals," The Review of Economics and Statistics, MIT Press, vol. 63(4), pages 620-624, November.
    13. Prior, Diego, 2003. "Long- and short-run non-parametric cost frontier efficiency: An application to Spanish savings banks," Journal of Banking & Finance, Elsevier, vol. 27(4), pages 655-671, April.
    14. Fare, R. & Grosskopf, S. & Roos, P., 1995. "Productivity and quality changes in Swedish pharmacies," International Journal of Production Economics, Elsevier, vol. 39(1-2), pages 137-144, April.
    15. Jati Sengupta, 1999. "Farrell-type efficiency under demand and price fluctuations," Applied Economics Letters, Taylor & Francis Journals, vol. 6(8), pages 505-507.
    16. Luis R. Murillo‐Zamorano, 2004. "Economic Efficiency and Frontier Techniques," Journal of Economic Surveys, Wiley Blackwell, vol. 18(1), pages 33-77, February.
    17. Mickael Lothgren, 1999. "Bootstrapping the Malmquist productivity index - a simulation study," Applied Economics Letters, Taylor & Francis Journals, vol. 6(11), pages 707-710.
    18. B. Golany & J. E. Storbeck, 1999. "A Data Envelopment Analysis of the Operational Efficiency of Bank Branches," Interfaces, INFORMS, vol. 29(3), pages 14-26, June.
    19. Rajiv D. Banker & Richard C. Morey, 1986. "Efficiency Analysis for Exogenously Fixed Inputs and Outputs," Operations Research, INFORMS, vol. 34(4), pages 513-521, August.
    20. Fare, Rolf & Grosskopf, Shawna & Kirkley, Jim, 2000. "Multi-output Capacity Measures and Their Relevance for Productivity," Bulletin of Economic Research, Wiley Blackwell, vol. 52(2), pages 101-112, April.
    21. Lisa C. DeFelice & W. David Bradford, 1997. "Relative inefficiencies in production between solo and group practice physicians," Health Economics, John Wiley & Sons, Ltd., vol. 6(5), pages 455-465, September.
    22. Rajiv D. Banker, 1993. "Maximum Likelihood, Consistency and Data Envelopment Analysis: A Statistical Foundation," Management Science, INFORMS, vol. 39(10), pages 1265-1273, October.
    23. Mickael Lothgren & Magnus Tambour, 1999. "Testing scale efficiency in DEA models: a bootstrapping approach," Applied Economics, Taylor & Francis Journals, vol. 31(10), pages 1231-1237.
    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. 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. repec:ebl:ecbull:v:30:y:2010:i:1:p:139-156 is not listed on IDEAS
    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, vol. 11(4), pages 319-338, December.

    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. Dan Friesner & Robert Roseman & Matthew McPherson, 2008. "Are hospitals seasonally inefficient? Evidence from Washington State," Applied Economics, Taylor & Francis Journals, vol. 40(6), pages 699-723.
    2. 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, vol. 11(4), pages 319-338, December.
    3. O'Neill, Liam & Rauner, Marion & Heidenberger, Kurt & Kraus, Markus, 2008. "A cross-national comparison and taxonomy of DEA-based hospital efficiency studies," Socio-Economic Planning Sciences, Elsevier, vol. 42(3), pages 158-189, September.
    4. Varabyova, Yauheniya & Schreyögg, Jonas, 2013. "International comparisons of the technical efficiency of the hospital sector: Panel data analysis of OECD countries using parametric and non-parametric approaches," Health Policy, Elsevier, vol. 112(1), pages 70-79.
    5. Valentin Zelenyuk, 2019. "Data Envelopment Analysis and Business Analytics: The Big Data Challenges and Some Solutions," CEPA Working Papers Series WP072019, School of Economics, University of Queensland, Australia.
    6. Fethi, Meryem Duygun & Pasiouras, Fotios, 2010. "Assessing bank efficiency and performance with operational research and artificial intelligence techniques: A survey," European Journal of Operational Research, Elsevier, vol. 204(2), pages 189-198, July.
    7. Essid, Hédi & Ouellette, Pierre & Vigeant, Stéphane, 2010. "Measuring efficiency of Tunisian schools in the presence of quasi-fixed inputs: A bootstrap data envelopment analysis approach," Economics of Education Review, Elsevier, vol. 29(4), pages 589-596, August.
    8. Léopold Simar & Paul W. Wilson, 2015. "Statistical Approaches for Non-parametric Frontier Models: A Guided Tour," International Statistical Review, International Statistical Institute, vol. 83(1), pages 77-110, April.
    9. Bao Hoang Nguyen & Robin C. Sickles & Valentin Zelenyuk, 2021. "What do we know from the vast literature on efficiency and productivity in healthcare? A Systematic Review and Bibliometric Analysis," CEPA Working Papers Series WP092021, School of Economics, University of Queensland, Australia.
    10. N. Maniadakis & N. Kotsopoulos & P. Prezerakos & J. Yfantopoulos, 2008. "Measuring Intra-Hospital Clinic Efficiency and Productivity: Application to a Greek University General Hospital," European Research Studies Journal, European Research Studies Journal, vol. 0(1-2), pages 95-110.
    11. Massimo Finocchiaro Castro & Calogero Guccio, 2014. "Searching for the source of technical inefficiency in Italian judicial districts: an empirical investigation," European Journal of Law and Economics, Springer, vol. 38(3), pages 369-391, December.
    12. N. Maniadakis & N. Kotsopoulos & P. Prezerakos & J. Yfantopoulos, 2009. "Health Care Services Performance Measurement: Theory, Methods and Empirical Evidence," European Research Studies Journal, European Research Studies Journal, vol. 0(3), pages 151-170.
    13. 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.
    14. Franz R. Hahn, 2007. "Determinants of Bank Efficiency in Europe. Assessing Bank Performance Across Markets," WIFO Studies, WIFO, number 31499, April.
    15. Forsund, Finn R. & Sarafoglou, Nikias, 2005. "The tale of two research communities: The diffusion of research on productive efficiency," International Journal of Production Economics, Elsevier, vol. 98(1), pages 17-40, October.
    16. Matthias Staat, 2011. "Estimating the efficiency of general practitioners controlling for case mix and outlier effects," Empirical Economics, Springer, vol. 40(2), pages 321-342, April.
    17. José M. Cordero & Agustín García-García & Enrique Lau-Cortés & Cristina Polo, 2021. "Efficiency and Productivity Change of Public Hospitals in Panama: Do Management Schemes Matter?," IJERPH, MDPI, vol. 18(16), pages 1-21, August.
    18. Nurhafiza Md Hamzah & Kok Fong See, 2019. "Technical efficiency and its influencing factors in Malaysian hospital pharmacy services," Health Care Management Science, Springer, vol. 22(3), pages 462-474, September.
    19. Wijesiri, Mahinda & Yaron, Jacob & Meoli, Michele, 2017. "Assessing the financial and outreach efficiency of microfinance institutions: Do age and size matter?," Journal of Multinational Financial Management, Elsevier, vol. 40(C), pages 63-76.
    20. 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.

    More about this item

    Keywords

    repeated auction; seasonality; efficiency; hospitals; data envelopment analysis;
    All these keywords.

    JEL classification:

    • I11 - Health, Education, and Welfare - - Health - - - Analysis of Health Care Markets
    • I18 - Health, Education, and Welfare - - Health - - - Government Policy; Regulation; Public Health

    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:wsu:wpaper:rosenman-2. 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: Danielle Engelhardt (email available below). General contact details of provider: https://edirc.repec.org/data/ecwsuus.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.