Appendix G (continued, 3): Characteristics of Health Care Efficiency Measures Published in Peer-Reviewed Literature [1982-2006]

Health Care Efficiency Measures: Identification, Categorization, and Evaluation

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

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: Nurses N=3

Author, year	Type of paper	Unit of observation	Sample size	Data source	Time frame	Years	Inputs	Outputs	PR	Method	Data on reliability, sensitivity analysis, validity reported?
Carter M et al., 2000¹³⁵	Descriptive	Nurse	4 Nurses	Primary data	Longitudinal	1997-1998	Nurse labor costs Financial	Hosp days Health services		Ratios	No /No /No
Dexter F et al., 1998¹³⁶	Descriptive	Nurse	NR	Not specified	N/A	Yrs N/R	Number of nurses Physical	Hosp discharge Health services		Ratios, Simulation	No /No /No
Chumbler NR et al., 2000¹³⁷	Research	Nurse	293 Nurses	Primary data	Cross-sectional	1998	Nurse time Physical	Non-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: Other N=20

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?
Skinner J et al., 2001¹³⁸	Research	Geographic region, Medicare program	306 Geographic regions	Secondary data	Cross-sectional	1995-1996	Total costs Financial	Health outcomes Health outcome		X X	X	Other regression-based approach	No /Yes/No
Ashby J et al., 2000¹³⁹	Descriptive	Medicare program	NR	Secondary data	Time series	1985-1996	Total costs Financial	Hosp discharge Health services			X	Ratios	No /No /No
							Hosp days Physical	Hosp discharge Health services			X	Ratios	No /No /No
Ozcan YA et al., 1994¹⁴⁰	Research	Area agency on aging	25 Area agencies on aging	Secondary data	Cross-sectional	1991	Total costs Financial	Meals, Supportive services Health services	X	X		DEA	No /No /No
Mansley EC et al., 2002¹⁴¹	Research	Cancer detection program	19 Cancer detection programs	Secondary data	Longitudinal	1991-1996	Total costs Financial	Covered lives Health services	X	X		Other regression-based approach	No /Yes/No
							Total costs Financial	Outpatient procedure Health services	X	X		Other regression-based approach	No /Yes/No
							Total costs Financial		X	X		Other regression-based approach	No /Yes/No
Tyler LH et al., 1995¹⁴²	Research	Community mental health center	39 Community mental health centers	Secondary data	Cross-sectional	1992-1993	Number of administrative staff(p), Number of other personnel(p), Operating cost(f) Physical Financial	Covered lives Health services	X			DEA	No /Yes/No
Yeh J et al., 1997¹⁴³	Research	Community-based youth service	40 Community-based youth services	Primary data	Cross-sectional	Yrs N/R	Administrative expenditures, Direct costs Financial	Services provided Health services		X		DEA	No /No /No
DiJerome L et al., 1999¹⁴⁴	Descriptive	Cost centers	NR	Data source N/A	N/A	Yrs N/A	Other time Physical	Inpatient procedure Health services				Ratios	No /No /No
							Other time Physical	Hosp discharge Health services				Ratios	No /No /No
							Number of other personnel Physical	Inpatient procedure Health services				Ratios	No /No /No
							Number of other personnel Physical	Hosp discharge Health services				Ratios	No /No /No
							Other time Physical	Week, month, or year of care provided Health services				Ratios	No /No /No
							Productive manhours Physical	Inpatient procedure Health services				Ratios	No /No /No
							Productive manhours Physical	Hosp discharge Health services				Ratios	No /No /No
Ozgen H et al., 2002¹⁴⁵	Research	Dialysis centers	791 Dialysis centers	Secondary data	Cross-sectional	1997	Number of physicians(p), Number of nurses(p), Number of other personnel(p), Equipment (counts)(p), Operating cost(f) Physical Financial	Outpatient procedure, Training, Home treatment Health services	X	X		DEA	No /No /No
Ozcan YA et al., 1996¹⁴⁶	Research	Geographic region	298 Geographic regions	Secondary data	Longitudinal	1989-1993	Number of physicians, Number of nurses, Number of administrative staff, Number of technical staff, Number of other personnel Physical	Physician visit, Hosp discharge Health services		X	X	DEA	No /No /No
Ozcan YA, 1995¹⁴⁷	Research	Geographic region	319 Geographic regions	Secondary data	Cross-sectional	1990	Number of other personnel(p), Beds (counts)(p), Other counts(p), Operating cost(f) Physical Financial	Physician visit, Hosp discharge Health services		X	X	DEA	No /Yes/No
Okunade AA, 2001¹⁴⁸	Research	Hospital pharmacy	NR	Primary data	Time series	1981-1990	Drug capital costs(f), Total costs(f), Wage rate/wages(p) Physical Financial	Hosp days Health services				Other regression-based approach	No /Yes/No
Wan TT et al., 2003¹⁴⁹	Research, Develop methodology	Integrated delivery systems	100 Integrated delivery systems	Secondary data	Longitudinal	1998-2000	Beds (counts), Number of outpatient surgical centers, Number of facilities in the network Physical	Outpatient procedure, Inpatient procedure, Hosp discharge Health services				DEA	No /No /No
							Hosp days Physical	Hosp discharge Health services				Ratios	No /No /No
							Beds (counts) Physical	Hosp days Health services				Ratios	No /No /No
Wan TT et al., 2002¹⁵⁰	Descriptive	Integrated delivery systems	973 Integrated delivery systems	Secondary data	Cross-sectional	1997-1998	Number of physicians, Beds (counts) Physical	Outpatient procedure, Inpatient procedure, Hosp discharge Health services	X			DEA	No /No /No
							Total costs Financial	Hosp discharge Health services	X		X	Ratios, Other regression-based approach	No /No /No
Andes S et al., 2002¹⁵¹	Research	Medical groups	115 Primary health centers	Secondary data	Cross-sectional	1999	Number of nurses, Number of administrative staff, Number of technical staff, Other counts Physical	Charges Health services				DEA	No /No /No
Schinnar AP et al., 1990¹⁵²	Research	Mental health care program	54 Mental health care programs	Secondary data	Cross-sectional	1984-1985	Other time Physical	Week, month, or year of care provided Health services	X			DEA, Other regression-based approach	No /No /No
							Other time Physical	Non-physician visit Health services	X			DEA, Other regression-based approach	No /No /No
							Other labor costs, Other costs Financial	Week, month, or year of care provided, Non-physician visit Health services	X			DEA, Other regression-based approach	No /No /No
							Other costs Financial	Non-physician visit Health services	X			DEA, Other regression-based approach	No /No /No
Ozcan YA et al., 1999¹⁵³	Research	Organ procurement organization	64 Organ procurement organizations	Secondary data	Cross-sectional	1995	Number of other personnel(p), Operating cost(f), "Hospital development formalization index"(p), Referrals(p) Physical Financial	Organs recovered Health services	X			DEA	No /Yes/No
Larson EH et al., 2001¹⁵⁴	Descriptive	Other clinician	2,921 Clinicians	Secondary data	Cross-sectional	1993-1994	Other time Physical	Non-physician visit Health services	X	X		Ratios	No /No /No
Boston DW, 1991¹⁵⁵	Descriptive	Other clinician	6 Clinicians	Primary data	Longitudinal	1986	Other time Physical	Non-physician visit Health services				Ratios	No /No /No
							Other time Physical	Charges Health services				Ratios	No /No /No
							Total charges Financial	Non-physician visit Health services				Ratios	No /No /No
Alexander JA et al., 1998¹⁵⁶	Research	Outpatient substance abuse treatment organizations	618 Outpatient substance abuse treatment organizations	Primary data	Cross-sectional	1995	Other time(p), Total costs(f) Physical Financial	Week, month, or year of care provided Health services	X	X		DEA, Other regression-based approach	No /Yes/No
Sinay T, 2001¹⁵⁷	Research	Primary health center	163 Primary health centers	Secondary data	Cross-sectional	1994	Number of physicians(p), Number of nurses(p), Number of other personnel(p), Other capital costs(f) Physical Financial	Physician visit, Non-physician visit Health services				DEA	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, 3): 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/hcemappg4.html