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  • About
  • The Global ETD Search service is a free service for researchers to find electronic theses and dissertations. This service is provided by the Networked Digital Library of Theses and Dissertations.
    Our metadata is collected from universities around the world. If you manage a university/consortium/country archive and want to be added, details can be found on the NDLTD website.
1

Hospital Cost Functions and Quality

Evans, Michael John 12 June 1999 (has links)
This study examines the significance of quality when included in the specification of a hospital cost function. Also, this research estimates a value for scale economies in order to determine if the average hospital experiences increasing returns to scale in the production of hospital care, verifying such findings in previous econometric studies. Furthermore, two functional forms are compared: the Cobb-Douglas and the translog. The results of this study demonstrate that quality has a significant impact on costs. This relationship is positive meaning increasing quality will also increase the cost of producing hospital care. The results for scale economies demonstrate that the average hospital experiences increasing returns to scale in the production of hospital care, which is consistent with previous research. Lastly, based on an F-test, this study is able to accept the translog as the appropriate functional form. / Master of Arts
2

Scorpion Envenomations in Southern Arizona: A Costing Study of Scorpion Stings

Hodges, Zachary, Lambert, Zachary, Nguyen, Michael January 2007 (has links)
Class of 2007 Abstract / Objectives: The purpose of this study is to determine the direct costs of scorpion envenomation events in the acute care setting for patients treated in a southern Arizona hospital. Methods: A chart review analysis of documented treatment of scorpion envenomations at a university hospital was conducted to compile demographic, drug use, and resource utilization information. Patients were selected based on an ICD-9 code diagnosis of scorpion envenomation within the years 1993 to 2001. Results: 103 patient charts were reviewed. The average length of stay was 1.21 days (range 0.5-6.5 days), the average age was 4.7 years (range 0.2-53 years old). Males comprised 54% of the patients, 51.9% Caucasian, 41.6% Hispanic, and 60.2% were from an urban setting. The average drug cost was $51.82 (SD=53.22). The total average cost in the entire population was $6,764.54, (SD= $3,866.55). The average cost of rural versus urban was $7,535.74 and $6,254.55, respectively (p=0.100). The average cost for male versus female was $6,949.64 and $6,520.90 (p= 0.581), and the average cost for the 0-3 years group was $6,721.10, the >3 years to 14 years group’s average cost was $6,643.33, and the >14 years of age group’s average cost was $8,578.42. None of the comparisons between age groups were statistically significant, with p values ranging from 0.274 to 0.922. Conclusions: Although scorpion envenomations were costly, there were no statistically significant differences noted between any of the comparison groups. Transportation, including air transport in the rural setting, did not account for a significant change in cost. Many of the patients that were envenomated in the rural setting were seen at a regional hospital and then transported as necessary.
3

Three Essays on Hospital Efficiency

Rodriguez, Alfonso 24 October 2011 (has links)
This dissertation analyzes hospital efficiency using various econometric techniques. The first essay provides additional and recent evidence to the presence of contract management behavior in the U.S. hospital industry. Unlike previous studies, which focus on either an input-demand equation or the cost function of the firm, this paper estimates the two jointly using a system of nonlinear equations. Moreover, it addresses the longitudinal problem of institutions adopting contract management in different years, by creating a matched control group of non-adopters with the same longitudinal distribution as the group under study. The estimation procedure then finds that labor, and not capital, is the preferred input in U.S. hospitals regardless of managerial contract status. With institutions that adopt contract management benefiting from lower labor inefficiencies than the simulated non-contract adopters. These results suggest that while there is a propensity for expense preference behavior towards the labor input, contract managed firms are able to introduce efficiencies over conventional, owner controlled, firms. Using data for the years 1998 through 2007, the second essay investigates the production technology and cost efficiency faced by Florida hospitals. A stochastic frontier multiproduct cost function is estimated in order to test for economies of scale, economies of scope, and relative cost efficiencies. The results suggest that small-sized hospitals experience economies of scale, while large and medium sized institutions do not. The empirical findings show that Florida hospitals enjoy significant scope economies, regardless of size. Lastly, the evidence suggests that there is a link between hospital size and relative cost efficiency. The results of the study imply that state policy makers should be focused on increasing hospital scale for smaller institutions while facilitating the expansion of multiproduct production for larger hospitals. The third and final essay employs a two staged approach in analyzing the efficiency of hospitals in the state of Florida. In the first stage, the Banker, Charnes, and Cooper model of Data Envelopment Analysis is employed in order to derive overall technical efficiency scores for each non-specialty hospital in the state. Additionally, input slacks are calculated and reported in order to identify the factors of production that each hospital may be over utilizing. In the second stage, we employ a Tobit regression model in order to analyze the effects a number of structural, managerial, and environmental factors may have on a hospital's efficiency. The results indicated that most non-specialty hospitals in the state are operating away from the efficient production frontier. The results also indicate that the structural make up, managerial choices, and level of competition Florida hospitals face have an impact on their overall technical efficiency.
4

Patient, Payer, and Hospital Characteristics of In-Patient Agranulocytosis in the United States; 1997 and 2005.

Cole, Gregory P. January 2008 (has links)
Class of 2008 Abstract / Objectives: This investigation was to assess the patient, hospital, or payer characteristics of inpatient cases of agranulocytosis from 1997 and 2005 with descriptive statistics. Methods: The retrospective database investigation used the U. S. Department of Health & Human Services, Agency for Healthcare Research and Quality, Healthcare Cost & Utilization Project public use database Nationwide Inpatient Sample (H-CUP NIS) for a principal diagnosis of agranulocytosis. Significance of difference between variables, including standard error (SE), was assessed with a z-test and an alpha level of 0.05. Results: alpha level of 0.05. RESULTS: The mean charges increased from 1997 at $19,670(SE $366) per patient vs. 2005 at $26,866 (SE $813) per patient (p<0.001) while inpatient mortality was not different in 1997 at 718(SE 72) vs. 2005 at 759(SE 69) (p=0.63) and the percentage of patients discharged to home declined from 84.32% [0.85%] in 1997 to 80.12% [1.29%] in 2005 (p=0.007). In 2005, inpatient mortality was lower in teaching hospitals at 1.13%( standard error 0.15%) vs. non teaching hospitals at 2.38%(SE 0.25%) (p<0.001) and for metropolitan areas hospitals at 1.42%(SE 0.14%) vs. non-metropolitan area hospitals at 3.60%(SE 0.68%) (p=0.002). Conclusions: Data from H-CUP NIS indicates higher costs per patient for the primary diagnosis of agranulocytosis in 2005 vs. 1997 while overall inpatient survival is not different and the percentage of patients discharged to home decreased. In 2005 rates of inpatient survival were higher in teaching hospitals than in non-teaching hospitals and hospitals in metropolitan areas than in non-metropolitan areas. These differences were not found in 1997.
5

The Maryland Hospital Regulation System and Its Effect on Hospital Pricing and Costs

Kelleher, Brendan B. January 2008 (has links)
Thesis advisor: Francis M. McLaughlin / This thesis examines the impact of the hospital regulatory system in the state of Maryland. The system has been highly successful in lowering the gross charge-to-cost ratios that hospitals charge to their patients. In many states, these charge markups appear to be exorbitantly high, which is a great concern since the cost of health care is becoming more and more expensive for Americans. This thesis will include a description of the regulatory agency in Maryland, an explanation of how it works, and how it affects the Maryland hospital sector. Econometric analysis will then be employed in order to determine whether or not the regulatory system successfully helps hospitals reduce costs, a high priority objective of the system. In this model, Maryland hospital costs will be compared with nearby hospitals in Virginia. The paper will conclude with an evaluation of the merits of the system, and a recommendation on whether or not it would be useful in other states. / Thesis (BS) — Boston College, 2008. / Submitted to: Boston College. College of Arts and Sciences. / Discipline: Economics. / Discipline: College Honors Program. / Discipline: Economics Honors Program.
6

Criteria for evaluation of hospital performance submitted ... in partial fulfillment ... Master of Hospital Administration /

Reberg, Alan J. January 1975 (has links)
Thesis (M.H.A.)--University of Michigan, 1975.
7

The process of change an evaluation of the social consequences of a technological innovation : submitted to the Program in Hospital Administration ... as part of the requirements for the degree of Master of Hospital Administration /

DeLisle, Gary R. January 1972 (has links)
Thesis (M.H.A.)--University of Michigan, 1972.
8

The process of change an evaluation of the social consequences of a technological innovation : submitted to the Program in Hospital Administration ... as part of the requirements for the degree of Master of Hospital Administration /

DeLisle, Gary R. January 1972 (has links)
Thesis (M.H.A.)--University of Michigan, 1972.
9

Criteria for evaluation of hospital performance submitted ... in partial fulfillment ... Master of Hospital Administration /

Reberg, Alan J. January 1975 (has links)
Thesis (M.H.A.)--University of Michigan, 1975.
10

Essays on Healthcare Access, Use, and Cost Containment

Dugan, Jerome 06 September 2012 (has links)
This dissertation is composed of two essays that examine the role of public and private health insurance on healthcare access, use, and cost containment. In Chapter 1, Dugan, Virani, and Ho examine the impact of Medicare eligibility on healthcare utilization and access. Although Medicare eligibility has been shown to generally increase health care utilization, few studies have examined these relationships among the chronically ill. We use a regression-discontinuity framework to compare physician utilization and financial access to care among people before and after the Medicare eligibility threshold at age 65. Specifically, we focus on coronary heart disease and stroke (CHDS) patients. We find that Medicare eligibility improves health care access and physician utilization for many adults with CHDS, but it may not promote appropriate levels of physician use among blacks with CHDS. My second chapter examines the extent to which the managed care backlash affected managed care's ability to contain hospital costs among short-term, non-federal hospitals between 1998 and 2008. My analysis focuses on health maintenance organizations (HMOs), the most aggressive managed care model. Unlike previous studies that use cross-sectional or fixed effects estimators to address the endogeneity of HMO penetration with respect to hospital costs, this study uses a fixed effects instrumental variable approach. The results suggest two conclusions. First, I find the impact of increased HMO penetration on costs declined over the study period, suggesting regulation adversely impacted managed care's ability to contain hospital costs. Second, when costs are decomposed into unit costs by hospital service, I find the impact of increased HMO penetration on inpatient costs reversed over the study period, but HMOs were still effective at containing outpatient costs.

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