Appendix G (continued, 2): 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: Physician N=32

Author,
year
Type of
paper
Unit of
observation
Sample
size
Data
source
Time frameYearsInputsOutputsPRACPTCMPMMethodData on
reliability,
sensitivity
analysis,
validity
reported?
Thomas JW, 200694ResearchPhysician104,744 PatientsPrimary dataLongitudinal1999-2002Total costs
Financial
Episode of care
Health services
X  X Other regression-based approachNo /Yes/No
Pope GC, 199095DescriptivePhysicianNRSecondary dataTime series1976-1986Number of physicians
Physical
Week, month, or year of care provided
Health services
     RatiosNo /No /No
       Number of physicians
Physical
Physician visit
Health services
     RatiosNo /No /No
       Physician time
Physical
Physician visit
Health services
     RatiosNo /No /No
       Number of physicians
Physical
Charges
Health services
     RatiosNo /No /No
       Physician time
Physical
Charges
Health services
     RatiosNo /No /No
       Number of physicians, Number of other personnel
Physical
Charges
Health services
     RatiosNo /No /No
Chilingerian JA et al., 199796ResearchPhysician326 PhysiciansPrimary dataCross-sectional1990Other counts, Hosp days, Physician visits
Physical
Week, month, or year of care provided
Health services
X X  DEANo /No /No
Ozcan YA, 199897ResearchPhysician160 PhysiciansSecondary dataCross-sectional1993Drugs (counts), Physician visits, Number of lab/diagnostic tests, Discharges
Physical
Episode of care
Health services
X  X DEA  No /Yes/No
Ozcan YA et al., 200098ResearchPhysician178 PhysiciansSecondary dataCross-sectional1993Drugs (counts), Physician visits, Emergency visit, Number of lab/diagnostic tests Physical
Other counts,
Hosp discharge, Episode of care
Health services
X    DEANo /No /No
Abouleish AE et al., 200099DescriptivePhysician26 PhysiciansPrimary dataCross-sectional1997-1998Number of physicians
Physical
Week, month, or year of care provided
Health services
     RatiosNo /No /No
       Number of physicians
Physical
Relative value unit
Health services
     RatiosNo /No /No
Chilingerian JA et al., 1996100ResearchPhysician326 PhysiciansPrimary dataCross-sectional1990Other capital costs(f), Other counts(p), Physician visits(p), Hosp days(p)
Physical
Financial
Week, month, or year of care provided
Health services
X X  DEA, Other regression-based approachNo /Yes/No
Pai CW et al., 2000101ResearchPhysician176 PhysiciansSecondary dataCross-sectional1993Drugs (counts)(p), Total costs(f), Physician visits(p), Number of lab/diagnostic tests(p), Emergency visit(p)
Physical
Financial
Episode of care
Health services
     DEANo /No /No
Chilingerian JA, 1989102ResearchPhysician36 Physicians, 1,992 PatientsPrimary dataCross-sectional1987Ancillary cost(f), Hosp days(p)
Physical
Financial
Hosp discharge
Health services
X XX DEANo /Yes/No
Chilingerian JA et al., 1990103ResearchPhysician15 PhysiciansPrimary dataCross-sectionalYrs
N/R
Ancillary cost(f), Hosp days(p)
Physical
Financial
Hosp discharge
Health services
   X DEANo /No /No
Burns LR et al., 1994104ResearchPhysician43,625 PatientsSecondary dataCross-sectional1989-1990Hosp days
Physical
Hosp discharge
Health services
XXXX Other regression-based approachNo /Yes/No
       Total charges
Financial
Hosp discharge
Health services
XXXX Other regression-based approachNo /Yes/No
Chilingerian JA, 1995105ResearchPhysician36 PhysiciansSecondary dataCross-sectionalYrs
N/R
Hosp days(p), Ancillary cost(f)
Physical
Financial
Hosp discharge
Health services
X  X DEANo /Yes/No
Diamond HS et al., 1998106DescriptivePhysician9,935 PatientsPrimary dataLongitudinal1994-1995Hosp days
Physical
Hosp discharge
Health services
     RatiosNo /No /No
       Total costs
Financial
Hosp discharge
Health services
     RatiosNo /No /No
Garg ML et al., 1991107DescriptivePhysician130 PhysiciansPrimary dataLongitudinal1985-1986Number of physicians
Physical
Physician visit
Health services
     RatiosNo /No /No
Camasso MJ et al., 1994108ResearchPhysician1,424 Patients, 64 PhysiciansPrimary dataCross-sectional1985Physician time
Physical
Physician visit
Health services
X    RatiosNo /Yes/No
Defelice LC et al., 1997109ResearchPhysician924 PhysiciansSecondary dataCross-sectional1984-1985Physician time, Nurse time, Administrative staff time, Other counts
Physical
Physician visit
Health services
XX   SFANo /No /No
Weeks WB et al., 2003110DescriptivePhysician1,930 PhysiciansSecondary dataLongitudinal1987-1998Physician time
Physical
Physician visit
Health services
X    RatiosNo /No /No
       Number of physicians
Physical
Physician visit
Health services
X    RatiosNo /No /No
Editor, 2002111DescriptivePhysicianNRSecondary dataCross-sectional2002Total charges
Financial
Relative value unit
Health services
     RatiosNo /No /No
Albritton TA et al., 1997112DescriptivePhysician4,987 Patients, 11 PhysiciansPrimary dataCross-sectional1996Number of physicians
Physical
Relative value unit
Health services
     RatiosNo /No /No
       Physician visits
Physical
Relative value unit
Health services
     RatiosNo /No /No
Hilton C et al., 1997113DescriptivePhysician17 PhysiciansPrimary dataCross-sectional1996Number of physicians
Physical
Relative value unit
Health services
     RatiosNo /No /No
Cramer JS et al., 2000114DescriptivePhysician21 PhysiciansPrimary dataLongitudinal1997-1999Number of physicians
Physical
Relative value unit
Health services
     RatiosNo /No /No
Melzer SM et al., 2001115DescriptivePhysician1,738 Patients, 28 PhysiciansPrimary dataCross-sectional1997-1998Number of physicians
Physical
Relative value unit
Health services
     RatiosNo /No /No
Andreae MC et al., 2002116DescriptivePhysician35 PhysiciansPrimary data, Secondary dataLongitudinal1999-2000Physician time
Physical
Relative value unit
Health services
     RatiosNo /No /No
American Medical Group Association, 2002117DescriptivePhysicianNRSecondary dataCross-sectional2002Number of physicians
Physical
Relative value unit
Health services
X    RatiosNo /No /No
Coleman DL et al., 2003118Research, Descriptive, Develop methodologyPhysicianNRNot specifiedCross-sectionalYrs
N/A
Number of physicians
Physical
Relative value unit(s), Training(other), Research(other)
Health services Other
     RatiosNo /No /No
Fairchild DG et al., 2001119DescriptivePhysician132 PhysiciansPrimary dataCross-sectional1996-1997Physician time
Physical
Relative value unit
Health services
X  X RatiosNo /No /No
       Total costs
Financial
Covered lives
Health services
X  X RatiosNo /No /No
Thomas JW et al., 2004120DescriptivePhysician100,755 Patients, 804 PhysiciansSecondary dataCross-sectional1997-1998Total costs
Financial
Covered lives
Health services
X XX RatiosNo /Yes/Yes
Gaynor M et al., 1990121ResearchPhysician, Medical groups957 Medical groups, 6,353 PhysiciansSecondary dataCross-sectional1978Physician time, Nurse time, Administrative staff time
Physical
Physician visit
Health services
XX   SFANo /Yes/No
Conrad DA et al., 2002122ResearchPhysician, Medical groups383 Medical groups, 6,129 PhysiciansSecondary dataCross-sectional1997Number of nurses(p), Number of administrative staff(p), Physician time(p), Other capital costs(f)
Physical
Financial
Charges
Health services
XX   Other regression-based approachNo /Yes/No
       Number of nurses(p), Number of administrative staff(p), Physician time(p), Other capital costs(f)
Physical
Financial
Relative value unit
Health services
XX    No /Yes/No
Rosenman R et al., 2004123ResearchPhysician, Medical groups502 Medical groupsSecondary dataCross-sectional1998Number of physicians(p), Number of other personnel(p), Other capital costs(f), Other counts(p), Wage rate/wages(p)
Physical
Financial
Outpatient procedure, Inpatient procedure
Health services
XX   DEA, Other regression-based approachNo /Yes/No
Kralewski JE et al., 2000124ResearchPhysician, Medical groups86 Medical groups, 57,123 PatientsPrimary dataCross-sectional1995Total costs
Financial
Covered lives
Health services
X XXXRatios, Other regression-based approachNo /No /No
Blunt E, 1998125DescriptivePhysician, Nurse6 Physicians, 2 NursesPrimary dataCross-sectional1996-1997Number of other personnel
Physical
Physician visit
Health services
   X RatiosNo /No /No

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

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United States Only - Unit of Observation: Health Plans N=9

Author,
year
Type of
paper
Unit of
observation
Sample
size
Data
source
Time frameYearsInputsOutputsPRACPTCMPMMethodData on
reliability,
sensitivity
analysis,
validity
reported?
Cutler,David M et al., 1998126ResearchHealth plan908 Patients, 4,243 PatientsPrimary data, Secondary dataCross-sectional1993/ 1995Total costs
Financial
Episode of care
Health services
X    Other regression-based approachNo /No /No
Cutler DM et al., 2000127ResearchHealth plan6,965 PatientsSecondary dataCross-sectional1993-1995Total costs
Financial
Episode of care
Health services
     RatiosNo /No /No
Ahern M et al., 1996128ResearchHealth plan20 Health plansSecondary dataLongitudinal1991-1993Total costs
Financial
Physician visit, Covered lives, Hosp days, Non-physician visit
Health services
XX   Other regression-based approachNo /No /No
Rollins J et al., 2001129ResearchHealth plan36 Health plansSecondary dataLongitudinal1993-1997Physician labor costs, Other labor costs, Administrative expenditures, Inpatient expenses
Financial
Physician visit, Hosp days, Non-physician visit
Health services
X    DEANo /No /No
Brockett PL et al., 2004130ResearchHealth plan108 Health plansSecondary dataCross-sectional1995Total premiums
Financial
Physician visit, Hosp days
Health services
 X   DEANo /Yes/No
       Total costs
Financial
Physician visit, Covered lives, Hosp days
Health services
 X   DEANo /Yes/No
Siddharthan K et al., 2000131ResearchHealth plan125 Health plansSecondary dataCross-sectional1994Operating cost
Financial
Covered lives
Health services
XX   SFANo /Yes/No
Siddharthan K et al., 2000132ResearchHealth plan164 Health plansSecondary dataCross-sectional1995Hosp days, Physician visits, Emergency room visits, Outpatient procedure performed
Physical
Covered lives
Health services
     DEANo /No /No
Rosenman R et al., 1997133ResearchHealth plan28 Health plansSecondary dataCross-sectional1994Total assets(p), Administrative expenditures(f), Medical cost(f)
Physical
Financial
Covered lives
Health services
X    DEANo /No /No
Bryce CL et al., 2000134Research, Develop methodologyHealth plan585 Health plansSecondary dataLongitudinal1985-1994Hosp days(p), Physician visits(p), Administrative expenditures(f), Other costs(f)
Physical
Financial
Covered lives
Health services
XX X DEA, SFA, Other regression-based approachNo /Yes/No

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

Current as of April 2008
Internet Citation: Appendix G (continued, 2): 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/hcemappg3.html