This study examines factors affecting the productive efficiency of primary care clinics. The empirical analysis uses a single-stage stochastic frontier regression model, in which factors affecting productive efficiency are specified as part of the inefficiency error component and estimated simultaneously with the production function. The study population includes primary care clinics in the US Military Health System from 1999 through 2003; the analytical data set is an unbalanced panel of 442 observations. The study's main results were that primary care clinics not associated with medical centres had significantly higher levels of productive efficiency than those associated with medical centres and that having proportionately more civilian staff (and thus less turnover) had a positive impact on productive efficiency. Due to their nature, these findings would be expected to also be applicable to the production of primary care in other settings. A key implication of the results is that improvements in productive efficiency should be a top priority, given the possibility for providing more primary care visits without increases in cost.
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Number of Pages 40Efficiency, 2
AbstractThe survivability of any health care system is largely dependent upon its ability to use resources efficiently. In the Military Health System efficiency is especially important because of the implementation of TRICARE, and the eventual, but uncertain form, of enrollment based capitation. This capitated managed care model will force Military Treatment Facility (MTF) leaders to make tough decisions regarding the health care services provided based on the limited resources available. Therefore, it is critical that MTF leaders are able to measure and track how efficiently they are able to deliver health care service. Purpose: The purpose of this study is to Results: According to the EEF metric, the Department of Primary Care at Keller ACH is operating very efficiently. Furthermore, Keller ACH ranks high in efficiency compared to homogeneous and like-sized facilities within the MEDCOM. Conclusions: This study demonstrates how the EEF metric can be used to evaluate the efficiency of specific service lines or overall hospital operations. The usefulness of the information yielded by performing this study is virtually unlimited. The Keller ACH leadership can make better management decisions by using the EEF study to identify trends, to compare Keller ACH to other MTFs, to establish goals and benchmarks, to identify possible outsourcing of services, and to educate staff. Ultimately, by using the EEF metric, MTFs will be better prepared for the capitated managed care environment.
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