title: Do primary care physicians or specialists provide more efficient care?
abstract: Sinusitis is a common health complaint and expenditures for its treatment are high; thus, it is necessary to promote efficient practice behaviours in managing patient care. This study compares resource utilization between primary care physicians and specialists in the treatment of Medicaid sinusitis patients in Virginia. Physician-level data from Virginia Medicaid claim files for 1993 were analysed. The efficiency frontier, representing the best achievable performance in the use of resources for treating sinusitis, is identified using Data Envelopment Analysis. Resource utilization (primary care physician visits, specialist visits, emergency room usage, prescriptions and laboratory tests) and corresponding costs are compared between generalists and otolaryngologists. It was concluded from this study that there are no discernible differences in technical efficiency between generalists and specialists in the treatment of sinusitis. Nevertheless, otolaryngologists are found to be more costly than generalists in treating sinusitis. Variation in both caseload and patient mix might explain variation in use of resources.
authors.affiliation: Department of Health Administration, Medical College of Virginia, Virginia Commonwealth University 23298-0203, USA. ozcan@hsc.vcu.edu
authors.forename: Y A
authors.initials: YA
authors.lastname: Ozcan
authors.forename: H J
authors.initials: HJ
authors.lastname: Jiang
authors.forename: C W
authors.initials: CW
authors.lastname: Pai
mesh_terms: D003657:Decision Making; D017598:Efficiency, Organizational; D005194:Family Practice / Q000592:standards*; D006302:Health Services Research; D006801:Humans; D008484:Medicaid; D010036:Otolaryngology / Q000592:standards*; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data*; D011320:Primary Health Care / Q000592:standards; D012852:Sinusitis / Q000628:therapy*; D014481:United States; D014768:Virginia