Factors affecting productive efficiency in primary care clinics

Abstract

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.

Efficiency of social sector expenditure in India: a case of health and education in selected Indian states

“…Likewise, with a focus on developing nations some notable studies include a report on district hospitals in Namibia, 28 37 Worthington, 38 Jamison and colleagues, 39 and Salomon and others 40 relating to inter country comparison, Schmacker and colleagues 41 relating to USA, Evans and others 42 for a cross country comparison and Greene, 43 Farsi and others 44 relating to Switzerland, Wang and others 45 for New South Wales, Kris and others4 6,47 9,54-56 These latter types of studies have deployed frontier efficiency measurement techniques which involve a production possibility frontier depicting a locus of potentially technical efficient output combination that an organization or health system is capable of producing at a point of time. An output combination below this frontier is termed as technically inefficient.…”

Investigation of factors affecting efficiency of primary healthcare in Turkey with two-stage data envelopment analysis

“…Similar to the results of this study, in the study conducted by Leng et al [50], on the institutions providing primary healthcare in China, it was found that the efficiency score decreased as the number of physicians and nurses increased. Unlike this study, Schmacker and McKay [51] conducted a study on 442 clinic providing primary healthcare in America concluding that there is a positive relationship between the numbers of physician and other healthcare personnel, and the efficiency scores, while there is not any relationship between the number of nurses and efficiency. Similarly, in the study conducted by Bobo et al [52] examined the efficiency of public health institutions in Ethiopia, a positive correlation was found between the number of health personnel and the efficiency scores.…”

Efficiency of Ontario primary care physicians across payment models: a stochastic frontier analysis

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