Appendix G (continued): Characteristics of Health Care Efficiency Measures Published in Peer-Reviewed Literature [1982-2006]

Health Care Efficiency Measures: Identification, Categorization, and Evaluation

Contents
United States Only - Unit of Observation: Hospital
Unit of Observation: Hospital (Continued)
United States Only - Unit of Observation: Physician
United States Only - Unit of Observation: Health Plans
United States Only - Unit of Observation: Nurses
United States Only - Unit of Observation: Other

United States Only - Unit of Observation: Hospital N=93 (Continued)

Author, year	Type of paper	Unit of observation	Sample size	Data source	Time frame	Years	Inputs	Outputs	PR	AC	PT	CM	Method	Data on reliability, sensitivity analysis, validity reported?
Rosko MD, 1999⁵¹	Research	Hospital	3,262 Hospitals	Secondary data	Cross-sectional	1994	Other capital costs(f), Total costs(f), Wage rate/wages(p) Physical Financial	Physician visit, Hosp discharge, Hosp days Health services	X	X		X	SFA	No /Yes/No
Chern JY et al., 2000⁵²	Research	Hospital	80 Hospitals	Secondary data	Longitudinal	1984-1993	Number of other personnel(p), Beds (counts)(p), Other counts(p), Other costs(f) Physical Financial	Physician visit, Hosp discharge Health services	X			X	DEA	No /No /No

Frech HE et al., 2000⁵³	Research	Hospital	378 Hospitals	Secondary data	Longitudinal	1983-1984-1990-1991	Number of physicians(p), Operating cost(f), Total assets(p) Physical Financial	Physician visit, Hosp discharge, Training Health services	X	X			SFA, Other regression-based approach	No /Yes/No
Harris J et al., 2000⁵⁴	Research	Hospital	20 Hospitals	Secondary data	Cross-sectional	1991-1993	Number of other personnel(p), Beds (counts)(p), Other counts(p), Operating cost(f) Physical Financial	Physician visit, Hosp discharge Health services				X	DEA	No /Yes/No
100 Top Hospitals, 2001⁵⁵	Descriptive	Hospital	887,172 Patients, 707 Hospitals	Secondary data	Cross-sectional	1998	Hosp days Physical	Hosp discharge Health services	X		X	X	Ratios	No /No /No
							Total costs Financial	Hosp discharge Health services	X		X	X	Ratios	No /No /No
							ICU-related ancillary cost Financial	ICU days Health services	X		X	X	Ratios	No /No /No
Brown HS, 2001⁵⁶	Research	Hospital	613 Hospitals	Secondary data	Longitudinal	1992-1996	Other capital costs(f), Beds (counts)(p) personnel(p), Number of other Physical Financial	Hosp discharge Health services	X	X	X	X	SFA	No /Yes/No
Folland ST et al., 2001⁵⁷	Research, Develop methodology	Hospital	2,007 Hospitals	Secondary data	Cross-sectional	1985	Other capital costs(f), Total costs(f), Wage rate/wages(p) Physical Financial	Physician visit, Hosp days Health services	X	X			SFA	Yes/Yes/No
Li T et al., 2001⁵⁸	Research	Hospital	90 Hospitals	Secondary data	Longitudinal	1988-1993	Other capital costs(f), Total costs(f), Wage rate/wages(p) Physical Financial	Physician visit, Hosp days Health services	X			X	SFA	No /Yes/No
Rosko MD, 2001⁵⁹	Research	Hospital	1,966 Hospitals	Secondary data	Cross-sectional	1997	Other capital costs(f), Total costs(f), Wage rate/wages(p) Physical Financial	Physician visit, Hosp discharge Health services	X	X		X	SFA	No /Yes/No
Brown HS, 2003⁶⁰	Research	Hospital	613 Hospitals	Secondary data	Longitudinal	1992-1996	Number of other personnel(p), Other capital costs(f), Beds (counts)(p) Physical Financial	Hosp discharge Health services	X			X	SFA	No /Yes/No
100 Top Hospitals, 2003⁶¹	Descriptive	Hospital	NR	Not specified	Longitudinal	Yrs N/R	Other labor costs, Total costs Financial	Hosp discharge Health services			X		Ratios	No /No /No
							Beds (counts) Physical	Hosp discharge Health services					Ratios	No /No /No
							Number of other personnel Physical	Hosp discharge Health services				X	Ratios	No /No /No
Chu HL et al., 2004⁶²	Research	Hospital	246 Hospitals	Secondary data	Longitudinal	1997-1999	Number of other personnel(p), Nurse time(p), Other time(p), Equipment capital costs(f), Other capital costs(f), Supplies (counts)(p) Physical Financial	Inpatient procedure, Physician visit, Hosp discharge, Hosp days Health services	X	X		X	DEA	No /No /No
Jordan SD, 1994⁶³	Descriptive	Hospital	160 Patients, 2 Hospitals	Primary data	Cross-sectional	Yrs N/R	Nurse labor costs, Other labor costs Financial	Charges Health services					Ratios	No /No /No
Young ST, 1992⁶⁴	Research	Hospital	22 Hospitals	Not specified	Cross-sectional	Yrs N/R	Other time Physical	Fill rate, Inventory turns, Purchase price index Other					Ratios, DEA	No /No /No
Bellin E et al., 2004⁶⁵	Descriptive, Develop methodology	Hospital department	1,733 Patients	Primary data	Longitudinal	2001-2002	Hosp days Physical	Hosp discharge Health services			X		Other regression-based approach	No /Yes/No
Mathiasen RA et al., 2001⁶⁶	Descriptive	Hospital department	57 Patients	Primary data, Secondary data	Longitudinal	1997-1998	Hosp days Physical	Hosp discharge Health services			X	X	Ratios	No /No /No
							Total costs Financial	Hosp discharge Health services			X	X	Ratios	No /No /No
Kyriacou DN et al., 1999⁶⁷	Descriptive	Hospital department	826 Patients	Primary data	Longitudinal	1993-1998	Hosp days Physical	Emergency visit Health services					Ratios	No /No /No
Finkler MD et al., 1993⁶⁸	Research	Hospital department	9 Hospital depts	Primary data	Cross-sectional	Yrs N/R	Physician time, Nurse time Physical	Inpatient procedure Health services				X	DEA	No /Yes/No
Wilson GW et al., 1982⁶⁹	Research	Hospital department	922 Hospital depts	Secondary data	Cross-sectional	Yrs N/R	Number of technical staff(p), Equipment capital costs(f) Physical Financial	Procedure Health services	X	X			DEA, Other regression-based approach	No /Yes/No
Seltzer SE et al., 1998⁷⁰	Descriptive	Hospital department	2 Hospital depts	Primary data	Longitudinal	1992-1996	Total costs Financial	Inpatient procedure Health services					Ratios	No /No /No
							Total costs Financial	Relative value unit Health services					Ratios	No /No /No
							Number of other personnel Physical	Inpatient procedure Health services					Ratios	No /No /No
							Number of other personnel Physical	Relative value unit Health services					Ratios	No /No /No
Sternick E, 1990⁷¹	Descriptive	Hospital department	NR	Not specified	Cross-sectional	Yrs NR	Other labor costs, Other capital costs, Total costs Financial	Charges Health services					Ratios	No /No /No
Ozgen H et al., 2004⁷²	Research	Hospital department, Dialysis centers	140 Dialysis centers	Secondary data	Longitudinal	1994-2000	Number of physicians(p), Number of nurses(p), Number of technical staff(p), Number of other personnel(p), Equipment capital costs(f), Drug capital costs(f), Supply capital costs(f), Other capital costs(f), Equipment (counts)(p) Physical Financial	Outpatient procedure(s), Training(other), Home dialysis treatments(s) Health services Other					Malmquist or other index numbers, DEA	No /No /No
Starfield B et al., 1994⁷³	Descriptive	Hospital department, Primary health center	135 Primary health centers	Secondary data	Cross-sectional	1998	Total costs Financial	Week, month, or year of care provided Health services				X	Ratios	No /No /No
Wang BB et al., 1999⁷⁴	Research	Hospital, Geographic region	6,010 Hospitals, 314 Geographic regions	Secondary data	Longitudinal	1989-1993	Number of other personnel(p), Beds (counts)(p), Total costs(f) Physical Financial	Physician visit, Hosp discharge Health services	X	X		X	DEA	No /No /No
Goodman DC et al., 2006⁷⁵	Descriptive	Hospital, Geographic region	306 Geographic regions, 97 Hospitals	Secondary data	Longitudinal	1999-2001	Number of physicians Physical	Covered lives Health services					Ratios	No /No /No
Dewar DM et al., 2000⁷⁶	Research	Hospital, Health plan	39,697 Patients	Secondary data	Longitudinal	1992-1996	Total costs Financial	Health outcome Health outcomes			X	X	Ratios	No /No /No
Conrad D et al., 1996⁷⁷	Research	Hospital, Health plan	44,397 Patients, 37 Hospitals	Secondary data	Longitudinal	1991-1992	Total costs Financial	Hosp discharge Health services	X	X	X	X	Other regression-based approach	No /No /No
Broyles RW, 1990⁷⁸	Research	Hospital, Hospital department	81 Hospitals	Secondary data	Longitudinal	1979-1982	Direct costs Financial	Hosp discharge Health services	X X			X	Other regression-based approach	No /No /No
							Direct costs Financial	Hosp days Health services	X	X		X	Other regression-based approach	No /No /No
							Service volume Physical	Hosp discharge Health services	X	X		X	Other regression-based approach	No /No /No
							Service volume Physical	Hosp days Health services	X	X		X	Other regression-based approach	No /No /No
DeLia D et al., 2002⁷⁹	Research	Hospital, Primary health center	155 Hospitals	Secondary data	Longitudinal	1997-1999	Number of physicians, Number of nurses, Number of other personnel, Other counts Physical	Physician visit Health services					Other regression-based approach	No /Yes/No
Burgess,James FJr et al., 1993⁸⁰	Research	Hospital, Veterans Affairs	89 Hospitals	Secondary data	Longitudinal	1985-1987	Number of nurses, Number of other personnel, Physician time, Beds (counts) Physical	Outpatient procedure, Inpatient procedure, Physician visit, Hosp discharge, Hosp days Health services					DEA	No /No /No
Hao S et al., 1994⁸¹	Research	Hospital, Veterans Affairs	93 Hospitals	Not specified	Cross-sectional	1988	Number of physicians, Number of nurses, Beds (counts) Physical	Inpatient procedure, Physician visit, Hosp discharge, Emergency visit Health services	X				DEA	No /No /No
							Beds (counts) Physical	Hosp discharge Health services	X				Ratios	No /No /No
							Beds (counts) Physical	Inpatient procedure Health services	X				Ratios	No /No /No
							Beds (counts) Physical	Physician visit Health services	X				Ratios	No /No /No
							Number of nurses Physical	Hosp discharge Health services	X				Ratios	No /No /No
							Number of nurses Physical	Inpatient procedure Health services	X				Ratios	No /No /No
							Number of nurses Physical	Physician visit Health services	X				Ratios	No /No /No
							Number of physicians Physical	Hosp discharge Health services	X				Ratios	No /No /No
							Number of physicians Physical	Inpatient procedure Health services	X				Ratios	No /No /No
							Number of physicians Physical	Physician visit Health services	X				Ratios	No /No /No
Burgess JF et al., 1995⁸²	Research	Hospital, Veterans Affairs	1,545 Hospitals	Primary data, Secondary data	Longitudinal	1984-1988	Number of nurses, Number of technical staff, Number of other personnel, Beds (counts), Other counts Physical	Outpatient procedure, Inpatient procedure, Physician visit, Hosp discharge, Hosp days Health services	X			X	Malmquist or other index numbers	No /No /No
Burgess JF et al., 1996⁸³	Research	Hospital, Veterans Affairs	2,246 Hospitals	Secondary data	Cross-sectional	1987-1988	Number of nurses, Number of other personnel, Beds (counts) Physical	Outpatient procedure, Inpatient procedure, Physician visit, Hosp discharge, Hosp days Health services				X	DEA	No /No /No
Burgess JF et al., 1998⁸⁴	Research	Hospital, Veterans Affairs	1,545 Hospitals	Secondary data	Longitudinal	1984-1988	Number of nurses, Number of other personnel, Beds (counts) Physical	Outpatient procedure, Inpatient procedure, Physician visit, Hosp discharge, Hosp days Health services				X	DEA	No /No /No
Bannick RR et al., 1995⁸⁵	Research	Hospital, Veterans Affairs	284 Hospitals	Secondary data	Cross-sectional	1989	Number of physicians(p), Number of nurses(p), Number of other personnel(p), Beds (counts)(p), Other counts(p), Operating cost(f) Physical Financial	Physician visit, Hosp days Health services					DEA	No /No /No
Harrison JP et al., 2005⁸⁶	Research	Hospital, Veterans Affairs	121 Hospitals	Secondary data	Longitudinal	1998-2001	Number of other personnel(p), Beds (counts)(p), Total costs(f) Physical Financial	Inpatient procedure, Physician visit, Hosp days Health services					DEA	No /No /No
Sexton TR et al., 1989⁸⁷	Research	Hospital, Veterans Affairs	159 Hospitals	Secondary data	Cross-sectional	1985	Number of physicians(p), Number of nurses(p), Number of technical staff(p), Equipment capital costs(f), Other capital costs(f) Physical Financial	Relative value unit Health services	X				DEA	No /No /No
Eastaugh SR, 2002⁸⁸	Research	Nurse, Hospital	37 Hospitals	Primary data	Longitudinal	1997-2000	Other capital costs(f) Other time(p), Nurse time(p), Physical Financial	Relative value unit Health services					SFA	No /No /No
Weingarten SR et al., 2002⁸⁹	Research	Physician, Hospital	301 Physicians	Primary data	Cross-sectional	1997	Hosp days Physical	Hosp discharge Health services				X	Ratios	No /No /No
Auerbach AD et al., 2002⁹⁰	Research	Physician, Hospital	5,308 Patients	Secondary data	Longitudinal	1997-1999	Hosp days Physical	Hosp discharge Health services					Ratios	No /No /No
							Total costs Financial	Hosp discharge Health services					Ratios	No /No /No
Ghosh D et al., 2003⁹¹	Research, Develop methodology	Physician, Hospital department	1 Hospital depts	Primary data	Cross-sectional	1997	Total costs Financial	Physician visit Health services					Ratios	No /No /No
							Total charges Financial	Physician visit Health services					Ratios	No /No /No
Brenn BR et al., 2003⁹²	Descriptive	Physician, Hospital department	2,226 Patients	Primary data	Longitudinal	2000	Physician time Physical	Inpatient procedure Health services					Ratios	No /No /No
Ozcan YA et al., 1996⁹³	Research	Psychiatric hospital	85 Psychiatric hospitals	Secondary data	Cross-sectional	1990	Number of other personnel(p), Supply capital costs(f), Beds (counts)(p) Physical Financial	Physician visit, Hosp discharge Health services	X	X		X	DEA	No /No /No

*Explanatory variables: PR=Provider characteristics, AC=Area characteristics, PT=Patient characteristics, CM=Case mix adjustment, PM=Payment method

Page last reviewed April 2008

Internet Citation: Appendix G (continued): Characteristics of Health Care Efficiency Measures Published in Peer-Reviewed Literature [1982-2006]: Health Care Efficiency Measures: Identification, Categorization, and Evaluation. April 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://archive.ahrq.gov/research/findings/final-reports/efficiency/hcemappg2.html