Appendix G: Characteristics of Health Care Efficiency Measures Published in Peer-Reviewed Literature [1982-2006]

Health Care Efficiency Measures: Identification, Categorization, and Evaluation

Contents
United States Only - Unit of Observation: Hospital
    Unit of Observation: Hospital (Continued)
United States Only - Unit of Observation: Physician
United States Only - Unit of Observation: Health Plans
United States Only - Unit of Observation: Nurses

United States Only - Unit of Observation: Other

United States Only - Unit of Observation: Hospital N=93

Author,
year
Type of
paper
Unit of
observation
Sample
size
Data
source
Time frameYearsInputsOutputsPRACPTCMPMMethodData on
reliability,
sensitivity
analysis,
validity
reported?
Kessler DP et al., 20021ResearchHospital1,661,674 PatientsSecondary dataLongitudinal1985-1996Total costs
Financial
Episode of care
Health services
XXXX Other regression-based approachNo /Yes/No
       Episode of care
Physical
Health outcome
Health outcomes
XXXX Other regression-based approachNo /Yes/No
Carey K, 20032ResearchHospital1,209 HospitalsSecondary dataCross-sectional1998Other labor costs(f), Beds (counts)(p), Total costs(f)
Physical
Financial
Hosp discharge(s), Health outcome(o), Hosp days(s)
Health services
Health outcomes
XX X SFANo /No /No
Nunamaker TR, 19833ResearchHospital17 HospitalsSecondary dataLongitudinal1978-1979Total costs
Financial
Hosp days
Health services
     Ratios, DEANo /Yes/No
Maindiratta A, 19904ResearchHospital55 HospitalsNot specifiedCross-sectionalYrs N/RNurse labor costs, Administrative staff labor costs, Ancillary cost
Financial
Hosp days
Health services
     DEANo /No /No
Alexander JA et al., 19945ResearchHospital333 HospitalsSecondary dataCross-sectional1981Other labor costs
Financial
Hosp days
Health services
XX   RatiosNo /Yes/No
       Operating cost
Financial
Hosp days
Health services
XX   RatiosNo /Yes/No
Chirikos TN et al., 19946ResearchHospital189 HospitalsSecondary dataCross-sectional1989Other labor costs, Operating cost
Financial
Hosp days
Health services
XX X DEANo /No /No
Bradford WD et al., 19967ResearchHospital379 HospitalsSecondary dataCross-sectional1986Other labor costs, Other capital costs
Financial
Hosp days
Health services
XX   Other regression-based approachNo /No /No
Rosko MD et al., 19998ResearchHospital195 HospitalsSecondary dataCross-sectional1989Other labor costs, Other capital costs, Total costs
Financial
Physician visit, Hosp discharge
Health services
XX X SFANo /Yes/No
Morey RC et al., 20009DescriptiveHospital27 HospitalsSecondary dataCross-sectional1987-1988Total costs
Financial
Hosp discharge
Health services
XX X DEANo /No /No
Chirikos TN et al., 200010ResearchHospital186 HospitalsSecondary dataLongitudinal1982-1993Administrative staff labor costs, Other labor costs, Equipment capital costs, Other capital costs, Other costs
Financial
Outpatient procedure, Hosp discharge, Hosp days
Health services
X  X DEA, SFANo /Yes/No
Rosko MD, 200111ResearchHospital1,631 HospitalsSecondary dataLongitudinal1990-1996Other labor costs, Other capital costs, Total expenses minus physician expenses
Financial
Physician visit, Hosp discharge
Health services
XX X SFANo /Yes/No
Cleverley WO, 200212Descriptive, Develop methodologyHospital1 HospitalNot specifiedN/AYrs N/ATotal costs
Financial
Hosp discharge
Health services
 X X RatiosNo /No /No
       Total costs
Financial
Outpatient procedure
Health services
   X RatiosNo /No /No
       Total costs
Financial
Outpatient procedure, Hosp discharge
Health services
 X X RatiosNo /No /No
O'Neal PV et al., 200213ResearchHospital69 Hospitals, 7,961 PatientsSecondary dataCross-sectional1997Drug capital costs, Other capital costs FinancialHosp days
Health services
     DEANo /No /No
       Drug capital costs, Other capital costs
Financial
Hosp discharge
Health services
     DEANo /No /No
Sari N, 200314ResearchHospital125 HospitalsSecondary dataLongitudinal1990-1992-1994-1997Other labor costs, Total costs
Financial
Physician visit, Hosp discharge
Health services
XXXX SFA, Other regression-based approachNo /Yes/No
Rosko MD, 200415ResearchHospital616 HospitalsSecondary dataLongitudinal1990-1999Total costs
Financial
Physician visit, Hosp discharge
Health services
XX X SFANo /Yes/No
Rosko MD et al., 200516ResearchHospital1,368 HospitalsSecondary dataCross-sectional1998Other labor costs, Other capital costs, Total costs
Financial
Outpatient procedure, Physician visit, Hosp discharge, Emergency visit
Health services
XX X SFANo /Yes/No
Grosskopf S et al., 198717ResearchHospital82 HospitalsSecondary dataCross-sectional1982Number of physicians, Number of other personnel, Total assets, Discharges
Physical
Outpatient procedure, Inpatient procedure, Physician visit, Emergency visit, Hosp days
Health services
     DEANo /Yes/No
Byrnes P et al., 198918ResearchHospital123 HospitalsSecondary dataCross-sectional1983Number of physicians, Nurse time, Administrative staff time, Technical staff time, Beds (counts)
Physical
Hosp discharge
Health services
     DEANo /No /No
Ashby JL et al., 199219Descriptive, Develop methodologyHospitalNRSecondary dataLongitudinal1980-1989Number of other personnel
Physical
Hosp discharge
Health services
X  X RatiosNo /No /No
       Number of other personnel
Physical
Inpatient procedure
Health services
X  X RatiosNo /No /No
Valdmanis V, 199220ResearchHospital41 HospitalsSecondary dataCross-sectional1982Number of physicians, Number of nurses, Number of other personnel, Discharges, Total assets
Physical
Hosp days
Health services
X    DEANo /No /No
       Number of physicians, Number of nurses, Number of other personnel, Beds (counts), Discharges
Physical
Hosp days
Health services
X    DEANo /No /No
       Number of physicians, Number of nurses, Number of other personnel, Beds (counts)
Physical
Hosp days
Health services
X    DEANo /No /No
       Number of physicians, Number of nurses, Number of other personnel, Total assets, Discharges
Physical
Inpatient procedure, Physician visit, Emergency visit, Hosp days
Health services
X    DEANo /No /No
       Number of physicians, Number of other personnel, Discharges, Total assets
Physical
Inpatient procedure, Hosp days, ICU days
Health services
X    DEANo /No /No
       Number of physicians, Number of other personnel, Discharges, Total assets
Physical
Inpatient procedure, Hosp days, ICU days
Health services
X    DEANo /No /No
       Number of nurses, Number of other personnel, Discharges, Total assets
Physical
Inpatient procedure, Hosp days, ICU days
Health services
X    DEANo /No /No
       Number of other personnel, Nurse time, Discharges, Total assets
Physical
Inpatient procedure, Hosp days, ICU days
Health services
X    DEANo /No /No
       Number of other personnel, Discharges, Total assets
Physical
Inpatient procedure(s), Hosp days(s), ICU days(s), House staff(other)
Health services
Other
X    DEANo /No /No
       Number of other personnel, Discharges, Total assets
Physical
Inpatient procedure(s), Hosp days(s), ICU days(s), House staff(other)
Health services
Other
X    DEANo /No /No
Grosskopf S et al., 199321ResearchHospital108 HospitalsSecondary dataCross-sectional1982Number of physicians, Number of other personnel, Total assets
Physical
Outpatient procedure, Inpatient procedure, Physician visit, Emergency visit, Hosp days
Health services
   X DEANo /Yes/No
Ferrier GD et al., 199622ResearchHospital360 HospitalsSecondary dataCross-sectional1989Number of other personnel, Beds (counts), Wage rate/wages, Total assets
Physical
Inpatient procedure, Physician visit, Hosp discharge, Hosp days
Health services
XX X DEANo /Yes/No
Phillips JF, 199923DescriptiveHospital39 HospitalsSecondary dataCross-sectional1992-1996Beds (counts)
Physical
Hosp days
Health services
     RatiosNo /No /No
       Hosp days
Physical
Hosp discharge
Health services
     RatiosNo /No /No
Grosskopf S et al., 200124ResearchHospital792 HospitalsSecondary dataCross-sectional1994Number of physicians, Number of nurses, Number of other personnel, Beds (counts)
Physical
Outpatient procedure, Inpatient procedure, Physician visit, Hosp discharge, Emergency visit
Health services
X    DEANo /Yes/No
Mobley LR et al., 200225ResearchHospital348 HospitalsSecondary dataCross-sectional1998Number of physicians, Number of nurses, Number of administrative staff, Number of technical staff, Beds (counts)
Physical
Physician visit, Hosp discharge, Hosp days, Ancillary care
Health services
XX X DEANo /Yes/No
Saint S et al., 200326DescriptiveHospital1 HospitalPrimary dataCross-sectional1993-1996Hosp days
Physical
Hosp discharge
Health services
   X RatiosNo /No /No
       RVU
Physical
Hosp discharge
Health services
   X RatiosNo /No /No
Sherman HD, 198427ResearchHospital7 HospitalsPrimary dataCross-sectional1976Number of other personnel(p), Supply capital costs(f), Beds (counts)(p) Physical FinancialHosp days(s), Training(other)
Health services
Other
  X  DEANo /Yes/Yes
       Total costs
Financial
Hosp days
Health services
     RatiosNo /No /Yes
Banker RD et al., 198628ResearchHospital114 HospitalsSecondary dataCross-sectional1978Nurse labor costs(f), Administrative staff labor costs(f), Beds (counts)(p), Ancillary cost(f) Physical
Financial
Hosp days
Health services
  X  DEA, Other regression-based approachNo /Yes/No
Bitran GR et al., 198729ResearchHospital160 HospitalsPrimary dataCross-sectional1983Number of other personnel(p), Physician labor costs(f), Other costs(f)
Physical
Financial
Hosp discharge
Health services
     DEA, Other regression-based approachNo /Yes/No
Borden JP, 198830ResearchHospital52 HospitalsSecondary dataLongitudinal1979-1984Number of nurses(p), Number of other personnel(p), Other capital costs(f), Beds (counts)(p)
Physical
Financial
Hosp discharge
Health services
   X DEANo /No /No
       Total costs
Financial
Hosp discharge
Health services
     RatiosNo /No /No
       Total costs
Financial
Hosp discharge
Health services
   X Other regression-based approachNo /No /No
Valdmanis VG, 199031ResearchHospital41 HospitalsSecondary dataCross-sectional1982Number of physicians(p), Number of other personnel(p), Other capital costs(f)
Physical
Financial
Inpatient procedure, Physician visit, Emergency visit, Hosp days, ICU days
Health services
X    DEANo /Yes/No
Sear AM, 199132DescriptiveHospital142 HospitalsSecondary dataLongitudinal1982-1988Number of other personnel
Physical
Beds
Other
X    RatiosNo /No /No
       Number of other personnel
Physical
Hosp days
Health services
X    RatiosNo /No /No
       Other labor costs
Financial
Hosp days
Health services
X    RatiosNo /No /No
DesHarnais S et al., 199133ResearchHospital245 HospitalsSecondary dataLongitudinal1983-1984Number of physicians(p), Number of nurses(p), Number of administrative staff(p), Number of technical staff(p), Other capital costs(f), Beds (counts)(p), Other counts(p)
Physical
Financial
Outpatient procedure(s), Physician visit(s), Hosp discharge(s), Emergency visit(s), Sub-acute/long-term patients(s), Trainees (FTEs)(other)
Health services
Other
  XX DEANo /No /No
Dittman DA et al., 199134ResearchHospital105 HospitalsSecondary dataCross-sectional1981Nurse time(p), Beds (counts)(p), Other costs(f), Hosp days(p)
Physical
Financial
Hosp discharge, Charges
Health services
     DEANo /No /No
       Nurse time(p), Beds (counts)(p), Other costs(f), Number of outpatient surgical centers(p), Wage rate/wages(p)
Physical
Financial
Hosp discharge, Charges
Health services
     DEANo /No /No
       Nurse time(p), Beds (counts)(p), Other costs(f)
Physical
Financial
Hosp discharge, Hosp days
Health services
     DEANo /No /No
Ozcan YA, 199235ResearchHospital40 HospitalsSecondary dataCross-sectional1989Number of nurses(p), Number of administrative staff(p), Number of other personnel(p), Beds (counts)(p), Operating cost(f), Total assets(p)
Physical
Financial
Physician visit(s), Hosp discharge(s), Hosp days(s), Trainees (FTEs)(other)
Health services
Other
   X DEANo /Yes/No
Bradbury RC et al., 199336ResearchHospital10 HospitalsSecondary dataLongitudinal1988-1989Total costs
Financial
Hosp discharge
Health services
  XX Other regression-based approachNo /No /No
       Other costs
Financial
Hosp discharge
Health services
  XX Other regression-based approachNo /No /No
       Hosp days
Financial
Hosp discharge
Health services
  XX Other regression-based approachNo /No /No
McCue MJ et al., 199337DescriptiveHospital84 HospitalsSecondary dataCross-sectional1986-1990Beds (counts)
Physical
Hosp days
Health services
X    RatiosNo /No /No
       Hosp days
Physical
Hosp discharge
Health services
X X  RatiosNo /No /No
       Beds (counts)
Physical
Hosp discharge
Health services
X X  RatiosNo /No /No
       Number of other personnel
Physical
Hosp days
Health services
X X  RatiosNo /No /No
       Total costs
Financial
Hosp days
Health services
X X  RatiosNo /No /No
       Total costs
Financial
Hosp discharge
Health services
X X  RatiosNo /No /No
       Routine expenses
Financial
Hosp days
Health services
X X  RatiosNo /No /No
       Routine expenses
Financial
Hosp discharge
Health services
X X  RatiosNo /No /No
       Other labor costs
Financial
Hosp days
Health services
X X  RatiosNo /No /No
       Other labor costs
Financial
Hosp discharge
Health services
X X  RatiosNo /No /No
Hogan AJ et al., 199338ResearchHospital300 HospitalsSecondary dataCross-sectional1983-1984Number of physicians(p), Number of nurses(p), Number of administrative staff(p), Number of other personnel(p), Supply capital costs(f), Other capital costs(f), Beds (counts)(p), Other counts(p)
Physical
Financial
Outpatient procedure, Physician visit, Hosp discharge, Emergency visit, Hosp days, Training
Health services
XX X DEANo /Yes/No
Ozcan YA et al., 199439ResearchHospital124 HospitalsSecondary dataLongitudinal1988-1990Hosp days
Physical
Hosp discharge
Health services
     RatiosNo /No /No
       Number of physicians(p), Number of nurses(p), Number of other personnel(p), Supply capital costs(f), Beds (counts)(p), Other counts(p)
Physical
Financial
Physician visit, Hosp days
Health services
     DEANo /No /No
       Beds (counts)
Physical
Hosp discharge
Health services
     RatiosNo /No /No
       Beds (counts)
Physical
Hosp days
Health services
     RatiosNo /No /No
       Number of other personnel
Physical
Physician visit
Health services
     RatiosNo /No /No
Byrnes, Patricia et al., 199440ResearchHospital123 HospitalsSecondary dataCross-sectional1983Number of nurses(p), Number of administrative staff(p), Number of technical staff(p), Number of other personnel(p), Other capital costs(f), Beds (counts)(p)
Physical
Financial
Hosp discharge
Health services
     DEANo /No /No
Zuckerman S et al., 199441ResearchHospital4,149 HospitalsSecondary dataCross-sectional1986-1987Other capital costs(f), Total costs(f), Wage rate/wages(p)
Physical
Financial
Physician visit, Hosp discharge, Hosp days
Health services
XXXX SFANo /No /No
Vitaliano DF et al., 199642ResearchHospital219 HospitalsSecondary dataCross-sectional1991Nurse labor costs(f), Technical staff labor costs(f), Other counts(p), Total costs(f)
Physical
Financial
Physician visit, Emergency visit, Hosp days
Health services
X  X SFANo /No /Yes
White KR et al., 199643ResearchHospital170 HospitalsSecondary dataCross-sectional1992Number of other personnel(p), Beds (counts)(p), Service volume(p), Operating cost(f)
Physical
Financial
Physician visit, Hosp discharge
Health services
X  X DEANo /No /No
Morey RC et al., 199644ResearchHospital105 HospitalsSecondary dataCross-sectional1978Nurse labor costs(f), Administrative staff labor costs(f), Beds (counts)(p), Total costs(f), Total assets(p), Ancillary cost(f)
Physical
Financial
Hosp days
Health services
X    DEANo /No /No
Koop G et al., 199745ResearchHospital382 HospitalsSecondary dataLongitudinal1987-1991Other labor costs(f), Other capital costs(f), Beds (counts)(p), Operating cost(f), Total assets(p)
Physical
Financial
Physician visit, Hosp discharge, Hosp days
Health services
X  X SFANo /Yes/No
Chirikos TN, 199846ResearchHospital186 HospitalsSecondary dataLongitudinal1982-1993Other labor costs(f), Equipment capital costs(f), Other capital costs(f), Beds (counts)(p), Total costs(f)
Physical
Financial
Hosp discharge, Hosp days
Health services
XX X SFANo /Yes/No
O'Neill L, 199847ResearchHospital27 HospitalsSecondary dataCross-sectional1992Number of other personnel(p), Beds (counts)(p), Other counts(p), Operating cost(f)
Physical
Financial
Physician visit, Hosp discharge, Training
Health services
   X DEANo /No /No
Chirikos TN, 199848ResearchHospital186 HospitalsSecondary dataLongitudinal1982-1993Equipment capital costs(f), Other capital costs(f), Total costs(f), Wage rate/wages(p)
Physical
Financial
Hosp discharge, Hosp days
Health services
X  X SFANo /No /No
Ozcan YA et al., 199849ResearchHospital214 HospitalsSecondary dataCross-sectional1989Hosp days(p), Total charges(f), Other costs(f)
Physical
Financial
Hosp discharge
Health services
X    DEANo /No /No
Picker Institute, 199950DescriptiveHospitalNRData source N/ALongitudinalYrs N/RTotal costs
Financial
Hosp discharge
Health services
   X RatiosNo /No /No
       Number of other personnel
Physical
Hosp days
Health services
     RatiosNo /No /No

[This table is continued in next section]

*Explanatory variables: PR=Provider characteristics, AC=Area characteristics, PT=Patient characteristics, CM=Case mix adjustment, PM=Payment method

Page last reviewed April 2008
Internet Citation: Appendix G: Characteristics of Health Care Efficiency Measures Published in Peer-Reviewed Literature [1982-2006]: Health Care Efficiency Measures: Identification, Categorization, and Evaluation. April 2008. Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/research/findings/final-reports/efficiency/hcemappg.html