Appendix G (continued, 2): 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: Physician N=32

Author, year	Type of paper	Unit of observation	Sample size	Data source	Time frame	Years	Inputs	Outputs	PR	AC	PT	CM	PM	Method	Data on reliability, sensitivity analysis, validity reported?
Thomas JW, 2006⁹⁴	Research	Physician	104,744 Patients	Primary data	Longitudinal	1999-2002	Total costs Financial	Episode of care Health services	X			X		Other regression-based approach	No /Yes/No
Pope GC, 1990⁹⁵	Descriptive	Physician	NR	Secondary data	Time series	1976-1986	Number of physicians Physical	Week, month, or year of care provided Health services						Ratios	No /No /No
							Number of physicians Physical	Physician visit Health services						Ratios	No /No /No
							Physician time Physical	Physician visit Health services						Ratios	No /No /No
							Number of physicians Physical	Charges Health services						Ratios	No /No /No
							Physician time Physical	Charges Health services						Ratios	No /No /No
							Number of physicians, Number of other personnel Physical	Charges Health services						Ratios	No /No /No
Chilingerian JA et al., 1997⁹⁶	Research	Physician	326 Physicians	Primary data	Cross-sectional	1990	Other counts, Hosp days, Physician visits Physical	Week, month, or year of care provided Health services	X		X			DEA	No /No /No
Ozcan YA, 1998⁹⁷	Research	Physician	160 Physicians	Secondary data	Cross-sectional	1993	Drugs (counts), Physician visits, Number of lab/diagnostic tests, Discharges Physical	Episode of care Health services	X			X DEA			No /Yes/No
Ozcan YA et al., 2000⁹⁸	Research	Physician	178 Physicians	Secondary data	Cross-sectional	1993	Drugs (counts), Physician visits, Emergency visit, Number of lab/diagnostic tests Physical Other counts,	Hosp discharge, Episode of care Health services	X					DEA	No /No /No
Abouleish AE et al., 2000⁹⁹	Descriptive	Physician	26 Physicians	Primary data	Cross-sectional	1997-1998	Number of physicians Physical	Week, month, or year of care provided Health services						Ratios	No /No /No
							Number of physicians Physical	Relative value unit Health services						Ratios	No /No /No
Chilingerian JA et al., 1996¹⁰⁰	Research	Physician	326 Physicians	Primary data	Cross-sectional	1990	Other capital costs(f), Other counts(p), Physician visits(p), Hosp days(p) Physical Financial	Week, month, or year of care provided Health services	X		X			DEA, Other regression-based approach	No /Yes/No
Pai CW et al., 2000¹⁰¹	Research	Physician	176 Physicians	Secondary data	Cross-sectional	1993	Drugs (counts)(p), Total costs(f), Physician visits(p), Number of lab/diagnostic tests(p), Emergency visit(p) Physical Financial	Episode of care Health services						DEA	No /No /No
Chilingerian JA, 1989¹⁰²	Research	Physician	36 Physicians, 1,992 Patients	Primary data	Cross-sectional	1987	Ancillary cost(f), Hosp days(p) Physical Financial	Hosp discharge Health services	X		X	X		DEA	No /Yes/No
Chilingerian JA et al., 1990¹⁰³	Research	Physician	15 Physicians	Primary data	Cross-sectional	Yrs N/R	Ancillary cost(f), Hosp days(p) Physical Financial	Hosp discharge Health services				X		DEA	No /No /No
Burns LR et al., 1994¹⁰⁴	Research	Physician	43,625 Patients	Secondary data	Cross-sectional	1989-1990	Hosp days Physical	Hosp discharge Health services	X	X	X	X		Other regression-based approach	No /Yes/No
							Total charges Financial	Hosp discharge Health services	X	X	X	X		Other regression-based approach	No /Yes/No
Chilingerian JA, 1995¹⁰⁵	Research	Physician	36 Physicians	Secondary data	Cross-sectional	Yrs N/R	Hosp days(p), Ancillary cost(f) Physical Financial	Hosp discharge Health services	X			X		DEA	No /Yes/No
Diamond HS et al., 1998¹⁰⁶	Descriptive	Physician	9,935 Patients	Primary data	Longitudinal	1994-1995	Hosp days Physical	Hosp discharge Health services						Ratios	No /No /No
							Total costs Financial	Hosp discharge Health services						Ratios	No /No /No
Garg ML et al., 1991¹⁰⁷	Descriptive	Physician	130 Physicians	Primary data	Longitudinal	1985-1986	Number of physicians Physical	Physician visit Health services						Ratios	No /No /No
Camasso MJ et al., 1994¹⁰⁸	Research	Physician	1,424 Patients, 64 Physicians	Primary data	Cross-sectional	1985	Physician time Physical	Physician visit Health services	X					Ratios	No /Yes/No
Defelice LC et al., 1997¹⁰⁹	Research	Physician	924 Physicians	Secondary data	Cross-sectional	1984-1985	Physician time, Nurse time, Administrative staff time, Other counts Physical	Physician visit Health services	X	X				SFA	No /No /No
Weeks WB et al., 2003¹¹⁰	Descriptive	Physician	1,930 Physicians	Secondary data	Longitudinal	1987-1998	Physician time Physical	Physician visit Health services	X					Ratios	No /No /No
							Number of physicians Physical	Physician visit Health services	X					Ratios	No /No /No
Editor, 2002¹¹¹	Descriptive	Physician	NR	Secondary data	Cross-sectional	2002	Total charges Financial	Relative value unit Health services						Ratios	No /No /No
Albritton TA et al., 1997¹¹²	Descriptive	Physician	4,987 Patients, 11 Physicians	Primary data	Cross-sectional	1996	Number of physicians Physical	Relative value unit Health services						Ratios	No /No /No
							Physician visits Physical	Relative value unit Health services						Ratios	No /No /No
Hilton C et al., 1997¹¹³	Descriptive	Physician	17 Physicians	Primary data	Cross-sectional	1996	Number of physicians Physical	Relative value unit Health services						Ratios	No /No /No
Cramer JS et al., 2000¹¹⁴	Descriptive	Physician	21 Physicians	Primary data	Longitudinal	1997-1999	Number of physicians Physical	Relative value unit Health services						Ratios	No /No /No
Melzer SM et al., 2001¹¹⁵	Descriptive	Physician	1,738 Patients, 28 Physicians	Primary data	Cross-sectional	1997-1998	Number of physicians Physical	Relative value unit Health services						Ratios	No /No /No
Andreae MC et al., 2002¹¹⁶	Descriptive	Physician	35 Physicians	Primary data, Secondary data	Longitudinal	1999-2000	Physician time Physical	Relative value unit Health services						Ratios	No /No /No
American Medical Group Association, 2002¹¹⁷	Descriptive	Physician	NR	Secondary data	Cross-sectional	2002	Number of physicians Physical	Relative value unit Health services	X					Ratios	No /No /No
Coleman DL et al., 2003¹¹⁸	Research, Descriptive, Develop methodology	Physician	NR	Not specified	Cross-sectional	Yrs N/A	Number of physicians Physical	Relative value unit(s), Training(other), Research(other) Health services Other						Ratios	No /No /No
Fairchild DG et al., 2001¹¹⁹	Descriptive	Physician	132 Physicians	Primary data	Cross-sectional	1996-1997	Physician time Physical	Relative value unit Health services	X			X		Ratios	No /No /No
							Total costs Financial	Covered lives Health services	X			X		Ratios	No /No /No
Thomas JW et al., 2004¹²⁰	Descriptive	Physician	100,755 Patients, 804 Physicians	Secondary data	Cross-sectional	1997-1998	Total costs Financial	Covered lives Health services	X		X	X		Ratios	No /Yes/Yes
Gaynor M et al., 1990¹²¹	Research	Physician, Medical groups	957 Medical groups, 6,353 Physicians	Secondary data	Cross-sectional	1978	Physician time, Nurse time, Administrative staff time Physical	Physician visit Health services	X	X				SFA	No /Yes/No
Conrad DA et al., 2002¹²²	Research	Physician, Medical groups	383 Medical groups, 6,129 Physicians	Secondary data	Cross-sectional	1997	Number of nurses(p), Number of administrative staff(p), Physician time(p), Other capital costs(f) Physical Financial	Charges Health services	X	X				Other regression-based approach	No /Yes/No
							Number of nurses(p), Number of administrative staff(p), Physician time(p), Other capital costs(f) Physical Financial	Relative value unit Health services	X	X					No /Yes/No
Rosenman R et al., 2004¹²³	Research	Physician, Medical groups	502 Medical groups	Secondary data	Cross-sectional	1998	Number of physicians(p), Number of other personnel(p), Other capital costs(f), Other counts(p), Wage rate/wages(p) Physical Financial	Outpatient procedure, Inpatient procedure Health services	X	X				DEA, Other regression-based approach	No /Yes/No
Kralewski JE et al., 2000¹²⁴	Research	Physician, Medical groups	86 Medical groups, 57,123 Patients	Primary data	Cross-sectional	1995	Total costs Financial	Covered lives Health services	X		X	X	X	Ratios, Other regression-based approach	No /No /No
Blunt E, 1998¹²⁵	Descriptive	Physician, Nurse	6 Physicians, 2 Nurses	Primary data	Cross-sectional	1996-1997	Number of other personnel Physical	Physician visit Health services				X		Ratios	No /No /No

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

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United States Only - Unit of Observation: Health Plans N=9

Author, year	Type of paper	Unit of observation	Sample size	Data source	Time frame	Years	Inputs	Outputs	PR	AC	CM	Method	Data on reliability, sensitivity analysis, validity reported?
Cutler,David M et al., 1998¹²⁶	Research	Health plan	908 Patients, 4,243 Patients	Primary data, Secondary data	Cross-sectional	1993/ 1995	Total costs Financial	Episode of care Health services	X			Other regression-based approach	No /No /No
Cutler DM et al., 2000¹²⁷	Research	Health plan	6,965 Patients	Secondary data	Cross-sectional	1993-1995	Total costs Financial	Episode of care Health services				Ratios	No /No /No
Ahern M et al., 1996¹²⁸	Research	Health plan	20 Health plans	Secondary data	Longitudinal	1991-1993	Total costs Financial	Physician visit, Covered lives, Hosp days, Non-physician visit Health services	X	X		Other regression-based approach	No /No /No
Rollins J et al., 2001¹²⁹	Research	Health plan	36 Health plans	Secondary data	Longitudinal	1993-1997	Physician labor costs, Other labor costs, Administrative expenditures, Inpatient expenses Financial	Physician visit, Hosp days, Non-physician visit Health services	X			DEA	No /No /No
Brockett PL et al., 2004¹³⁰	Research	Health plan	108 Health plans	Secondary data	Cross-sectional	1995	Total premiums Financial	Physician visit, Hosp days Health services		X		DEA	No /Yes/No
							Total costs Financial	Physician visit, Covered lives, Hosp days Health services		X		DEA	No /Yes/No
Siddharthan K et al., 2000¹³¹	Research	Health plan	125 Health plans	Secondary data	Cross-sectional	1994	Operating cost Financial	Covered lives Health services	X	X		SFA	No /Yes/No
Siddharthan K et al., 2000¹³²	Research	Health plan	164 Health plans	Secondary data	Cross-sectional	1995	Hosp days, Physician visits, Emergency room visits, Outpatient procedure performed Physical	Covered lives Health services				DEA	No /No /No
Rosenman R et al., 1997¹³³	Research	Health plan	28 Health plans	Secondary data	Cross-sectional	1994	Total assets(p), Administrative expenditures(f), Medical cost(f) Physical Financial	Covered lives Health services	X			DEA	No /No /No
Bryce CL et al., 2000¹³⁴	Research, Develop methodology	Health plan	585 Health plans	Secondary data	Longitudinal	1985-1994	Hosp days(p), Physician visits(p), Administrative expenditures(f), Other costs(f) Physical Financial	Covered lives Health services	X	X	X	DEA, SFA, Other regression-based approach	No /Yes/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, 2): 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/hcemappg3.html