title: Evaluating the Impact of Hospital Efficiency on Wellness in the Military Health System.
abstract: Like all health care delivery systems, the U.S. Department of Defense Military Health System (MHS) strives to achieve top preventative care and population health outcomes for its members while operating at an efficient level and containing costs. The objective of this study is to understand the overall efficiency performance of military hospitals and investigate the relationship between efficiency and wellness. This study uses data envelopment analysis and stochastic frontier analysis to compare the efficiency of 128 military treatment facilities from the Army, Navy, and Air Force during the period of 2011 to 2013. Fixed effects panel regression is used to determine the association between the hospital efficiency and wellness scores. The results indicate that data envelopment analysis and stochastic frontier analysis efficiency scores are congruent in direction. Both results indicate that the majority of the MHS hospitals and clinics can potentially improve their productive efficiency by managing their input resources better. When comparing the performance of the three military branches of service, Army hospitals as a group outperformed their Navy and Air Force counterparts; thus, best practices from the Army should be shared across service components. The findings also suggest no statistically significant, positive association between efficiency and wellness over time in the MHS.
authors.affiliation: Center for Integrated Healthcare Delivery Systems, Department of Industrial and Manufacturing Engineering, Pennsylvania State University, 362 Leonhard Building, University Park, PA 16802.
authors.forename: Nathaniel D
authors.initials: ND
authors.lastname: Bastian
authors.affiliation: Department of Systems and Information Engineering, University of Virginia, 151 Engineer's Way, Olsson 113D, Charlottesville, VA 22904.
authors.forename: Hyojung
authors.initials: H
authors.lastname: Kang
authors.affiliation: Center for Integrated Healthcare Delivery Systems, Department of Industrial and Manufacturing Engineering, Pennsylvania State University, 362 Leonhard Building, University Park, PA 16802.
authors.forename: Eric R
authors.initials: ER
authors.lastname: Swenson
authors.affiliation: Center for Healthcare Innovation, Education and Research, Department of Health Organization Management, Rawls College of Business, Texas Tech University, 703 Flint Avenue, Lubbock, TX 79410.
authors.forename: Lawrence V
authors.initials: LV
authors.lastname: Fulton
authors.affiliation: Center for Health and Humanitarian Systems, School of Industrial and Systems Engineering, Georgia Institute of Technology, 755 Ferst Drive, Northwest, Atlanta, GA 30332.
authors.forename: Paul M
authors.initials: PM
authors.lastname: Griffin
mesh_terms: D003695:Delivery of Health Care / Q000639:trends*; D017598:Efficiency, Organizational / Q000592:standards*; D006772:Hospitals, Military / Q000592:standards*; D006801:Humans; D008137:Longitudinal Studies; D008889:Military Personnel / Q000706:statistics & numerical data*; D012044:Regression Analysis; D012189:Retrospective Studies; D014481:United States; D014493:United States Department of Veterans Affairs / Q000458:organization & administration