Powered by: Blackwell Publishing

HRET - Health Research & Educational Trust

HSR - Health Services Research

Impacting Health Practice and Policy Through State-of-the-Art Research and Thinking

Our Next Issue

March 2018
Coming Soon! Read


VOLUME 44 | NUMBER 3 | JUNE 2009

A Systematic Review of Health Care Efficiency Measures

Free Access

Objective. To review and characterize existing health care efficiency measures in order to facilitate a common understanding about the adequacy of these methods.

Data Sources. Review of the MedLine and EconLit databases for articles published from 1990 to 2008, as well as search of the "gray" literature for additional measures developed by private organizations.

Study Design. We performed a systematic review for existing efficiency measures. We classified the efficiency measures by perspective, outputs, inputs, methods used, and reporting of scientific soundness.

Principal Findings. We identified 265 measures in the peer-reviewed literature and eight measures in the gray literature, with little overlap between the two sets of measures. Almost all of the measures did not explicitly consider the quality of care. Thus, if quality varies substantially across groups, which is likely in some cases, the measures reflect only the costs of care, not efficiency. Evidence on the measures' scientific soundness was mostly lacking: evidence on reliability or validity was reported for six measures (2.3 percent) and sensitivity analyses were reported for 67 measures (25.3 percent).

Conclusions. Efficiency measures have been subjected to few rigorous evaluations of reliability and validity, and methods of accounting for quality of care in efficiency measurement are not well developed at this time. Use of these measures without greater understanding of these issues is likely to engender resistance from providers and could lead to unintended consequences.

Click here  to download this article for free.

back to top | back to article index | purchase full article

Copyright© 2017, Health Research & Educational Trust. All rights reserved. Content Disclaimer
Health Research & Educational Trust, 155 North Wacker, 4th Floor Chicago, IL 60606 (312) 422.2600