The impact of CON regulation on hospital efficiency.
In this paper we propose an empirically implementable measure of aggregate-level efficiency along the lines of Debreu's (1951) coefficient of resource utilization but restricted to the production side. The efficiency measure is based on directional distance functions, which allows the overall measure of efficiency to be decomposed into measures of technical and "structural" efficiency. The latter measure, which captures inefficiencies associated with the organization of production within an industry, is further decomposed into measures of scale and mix efficiency. The measures developed in the paper are illustrated using U.S. hospital data. The illustration sheds light on the efficacy of certificate of need (CON) regulations.
Ferrier
Gary D
GD
Department of Economics, University of Arkansas, Fayetteville, AR, USA.
Leleu
Hervé
H
Valdmanis
Vivian G
VG
D002567:Certificate of Need / Q000191:economics / Q000331:legislation & jurisprudence*; D004469:Economics, Hospital; D017598:Efficiency, Organizational; D005161:Facility Regulation and Control / Q000191:economics / Q000331:legislation & jurisprudence; D005102:Health Expenditures / Q000331:legislation & jurisprudence; D017722:Hospital Charges / Q000331:legislation & jurisprudence; D006761:Hospitals; D006801:Humans; D008962:Models, Theoretical; D011907:Rate Setting and Review / Q000331:legislation & jurisprudence; D014481:United States
J Health Polit Policy Law. 1997 Apr;22(2):315-38
9159707
Health Aff (Millwood). 2001 Jan-Feb;20(1):50-67
11194860
Health Serv Res. 2003 Feb;38(1 Pt 2):447-69
12650375
Health Matrix Clevel. 1999 Winter;9(1):1-35
10538189
Med Care Res Rev. 2006 Aug;63(4):499-524
16847075
J Health Polit Policy Law. 1998 Jun;23(3):455-81
9626641
J Health Polit Policy Law. 1997 Jun;22(3):721-88
9185017
Health Aff (Millwood). 2006 Sep-Oct;25(5):w337-43
16868008
Soc Sci Med. 2002 Jun;54(11):1677-84
12113449