Has Health Care Efficiency Improved Over Time?

• Activity Number: 418
• Type: Contributed
• Date/Time: Tuesday, July 31, 2012 : 2:00 PM to 3:50 PM
• Sponsor: Health Policy Statistics Section
• Author(s): Ana Mutu*+ and Byron Gajewski and Nancy Dunton
• Companies: University of Kansas Medical Center and University of Kansas Medical Center and NDNQI Project at University of Kansas Medical Center
• Keywords: Data Envelopment Analysis ; DEA ; NDNQI

Abstract

The U.S. per person medical care spending rate is nearly twice as other developed nations, yet has mediocre health outcomes. Thus, improving health care efficiency is a national economic priority. We applied Data Envelopment Analysis to data from nursing units that have submitted complete data (n=399) to the National Database of Nursing Quality Indicators® in order to estimate nursing units' efficiency across time. We specified an output oriented DEA model: both variable and constant returns to scale (VRS/CRS). Our input data was RN, LPN, and UAP (unlicensed) hours per patient day. The output data was Fall and Pressure Ulcer Rates. Regression models estimated time trends. A spline in 2009 was added for the CRS model. Under VRS, efficiencies for all unit types are increasing over time (p=.003). Medical and medical-surgical units had the largest increase in efficiency (p=.034). Step-down and surgical unit types significantly decreased pre-2009 and their rates significantly increased post-2009 (p< .05). Critical care units did the opposite and increased then decreased (p< .05). Medical significantly decreased and med-surgical had no significant change. These are promising results.