Efficiency and its measurement: what practitioners need to know.
OBJECTIVE
To help health professionals understand and evaluate the concept of efficiency and its measurement in practice.


METHODS
We reviewed conceptual and practical analyses of healthcare efficiency and its measurement and describe our findings.


METHODS
We searched the following 3 sources: the MEDLINE and EconLit databases for articles published from 1990 to 2008 using the keywords efficiency, inefficiency, productivity, and economic profiling; seminal economic studies of efficiency identified in MEDLINE or EconLit or in economics reference materials; and the "gray literature" on efficiency measures developed by private organizations.


RESULTS
An essential element of efficiency is that healthcare outputs are as large as possible given their inputs. An efficiency measure specifies outputs and inputs appropriate to the goals of the assessment. Participants in the healthcare system have differing perspectives about the goals of efficiency assessments, relevant outputs and inputs, and validity of measures.


CONCLUSIONS
The broad meaning and the value of healthcare efficiency seem uncontroversial, yet any particular application may be confronted with conflicting perspectives and with practical challenges.
Romley
John A
JA
RAND Corporation, Santa Monica, CA 90407-2138, USA. romley@rand.org
Hussey
Peter S
PS
de Vries
Han
H
Wang
Margaret C
MC
Shekelle
Paul G
PG
McGlynn
Elizabeth A
EA
D003365:Costs and Cost Analysis; D017598:Efficiency, Organizational; D006282:Health Personnel; D006801:Humans; D011787:Quality of Health Care