| Titre : | Does chain affiliation make a difference in efficiency of dialysis providers in the USA. (2006) |
| Auteurs : | OZGEN (Hacer) : TUR. Hacettepe University Ankara. |
| Type de document : | Article |
| Dans : | Social science and medicine (vol. 62, n° 9, 2006) |
| Pagination : | 2112-2124 |
| Langues: | Anglais |
| Mots-clés : | Etude comparée ; Efficacité ; Etats Unis ; Amérique ; Homme ; Insuffisance rénale ; Hémodialyse ; Assurance maladie ; Politique santé ; Economie santé ; Appareil urinaire [pathologie] ; Rein [pathologie] ; Appareil épuration extrarénale ; Amérique du Nord |
| Résumé : | [BDSP. Notice produite par INIST-CNRS udR0x7MM. Diffusion soumise à autorisation]. There has been an accelerated movement in the USA dialysis market towards affiliation with chain organizations. But little is known about the impact of this strategy of consolidation on provider performance of efficiency. This paper examines whether affiliation with multi-center dialysis chains creates a difference in technical efficiency. Data were obtained from 1994 to 2000 Independent Renal Facility Cost Report Data files of the Centers for Medicare and Medicaid Studies. Using multiple time series design with a comparison group, technical efficiency was examined through an intertemporal data envelopment analysis. The results showed that mean efficiency scores of chain-affiliated facilities in both pre-and post-affiliation periods are slightly higher than those of their independent counterparts, but the difference was not statistically significant. Members of the first and second largest chains did not appear to gain benefit from affiliation. In conclusion, greater technical efficiency of affiliated facilities is not the result of system engagement but rather the result of organizational maturation, or organizational learning. Engagement with the two largest systems does not provide members with its theoretical premises to achieve technically efficient production of dialysis treatments in multiple product markets. |
Service Documentation EHESP
Me connecter
PORTAIL DOCUMENTAIRE
École des hautes études en santé publique
Catalogue
Multi-bases
Accueil
Sélection de la langue
Adresse
Service Documentation EHESPBibliothèque Rennes Avenue du Professeur Léon Bernard – CS 74312 – 35043 Rennes Cedex Bibliothèque MSSH Paris 20 avenue George Sand - 93210 La Plaine Saint-Denis
France
Bibliothèque Rennes : 02 99 02 29 50 Bibliothèque MSSH Paris : 02 99 02 24 50
contact