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Journal of Medical Systems
Erschienen in: Journal of Medical Systems 4/2011

01.08.2011 | Original Paper

Rural Health Clinic Efficiency and Effectiveness: Insight from a Nationwide Survey

verfasst von: Judith Ortiz, Natthani Meemon, Chiung-Ya Tang, Thomas T. H. Wan, Seung Chun Paek

Erschienen in: Journal of Medical Systems | Ausgabe 4/2011

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Abstract

This study reports the results of a nationwide survey of Rural Health Clinics (RHCs). The purpose was to identify factors that contribute to efficiency and effectiveness in RHCs. Factors related to cost efficiency were analyzed using multiple regression; factors related to the likelihood of providing preventive diabetic care, an effectiveness indicator, were analyzed using logistic regression. The study found: (1) technical efficiency to be positively related to cost efficiency; (2) non-profit control to be inversely related to cost efficiency in independent RHCs; and (3) provider-based RHCs and technology use to be related to the likelihood of providing preventive diabetic care. Implications for RHCs are: (1) improvement in technical efficiency could enhance cost efficiency; (2) visits to PAs and NPs, an indicator of process efficiency, may not guarantee the provision of preventive diabetic care; and (3) strategies for improving RHC efficiency and effectiveness may be different for provider-based and independent clinics.
Literatur
1.
Gale, J. A., and Coburn, A. F., The characteristics and roles of Rural Health Clinics in the United States: a chartbook. University of Southern Maine: Portland, 2003, 57 pp.
2.
McBride, T., and Mueller, K., Effects of Medicare payment on rural health care systems. J. Rural. Health. 18 (S)147–163, 2002.CrossRef
3.
Office of Inspector General, DHHS, Status of the Rural Health Clinic Program, Aug., 2005.
4.
5.
Wan, T. T. H., Evidence-based health care management: multivariate modeling approaches. Kluwer: Boston, 2002.CrossRef
6.
Institute of Medicine (IOM), Crossing the quality chasm: a new health system for the 21st century. National Academy Press: Washington, 2001.
7.
Kanter, R., and Brinkerhoff, D., Organizational performance. Annu. Rev. Sociology. 7:321–349, 1981.CrossRef
8.
Scott, W. R., and Shortell, S. M., Organizational performance: managing efficiency and effectiveness. In: Shortell, S. M., and Kaluzny, A. D. (Eds.), Health Care Management. New York: Wiley, 1988, pp. 418–455.
9.
Institute of Medicine (IOM), Primary care: America’s health in a new era. National Academy Press: Washington, 1996, 395 pp.
10.
Gamm, L., and Hutchison, L., Rural health priorities in America: where you stand depends on where you sit. J. Rural. Health. 19 (3)209–213, 2003.CrossRef
11.
Lee, K., and Wan, T. T. H., Effects of hospitals’ structural clinical integration on efficiency and patient outcome. Health. Serv. Manag. Res. 15:234–244, 2002.CrossRef
12.
Wan, T. T. H., Lin, Y. J., and Ma, A., Integration mechanisms and hospital efficiency in integrated healthcare delivery systems. J Med Syst. 26 (2)127–144, 2002.CrossRef
13.
Ortiz, J., Fottler, M. D., and Hofler, R., Performance of health centers in networks. Health. Care. Manage. Rev. 30 (2)126–138, 2005.
14.
Marathe, S., Wan, T. T. H., Zhang, J. N., and Sherin, K., Factors influencing community health centers’ efficiency: a growth curve modeling approach. J. Med. Syst. 31 (5)365–374, 2007.CrossRef
15.
Rosenblatt, R. A., Baldwin, L., Chan, L., Fordyce, M. A., Hirsch, I. B., Palmer, J. P., Wright, G. E., and Hart, L. G., Improving the quality of outpatient care for older patients with diabetes: lessons from a comparison of rural and urban communities. J. Fam. Pract. 50 (8)676–680, 2001.
16.
Centers for Medicare and Medicaid Services (CMS), CMS online survey, certification, and reporting. OSCAR, 2007.
17.
Centers for Medicare and Medicaid Services (CMS), Chronic care condition data warehouse. 2007.
18.
Bureau of Health Professions, Area Resource File (ARF) Access system, 2007.
19.
Goldsmith, H. F., Wagenfeld, M. O., Manderscheid, R. W., and Stiles, D., Specialty mental health services in metropolitan and nonmetropolitan areas: 1983 and 1990. Adm Policy Ment. Health. 24 (6)475–488, 1997.CrossRef
20.
Coyne, J. S., Hospital performance in multihospital systems: a comparative study of system and independent hospitals. Health. Serv. Res. 17:303–327, 1982.
21.
Sinay, T., Productive efficiency of rural health clinics: the Midwest experience. J. Rural. Health. 17 (3)239–250, 2001.CrossRef
22.
Institute of Medicine (IOM), Quality through collaboration: the future of rural health. The National Academies Press: Washington, 2005, 267 pp.
23.
Murthy, J. M., Meena, A. K., and Kumar, S. R., Severity-of-illness scoring systems and models: neurological and neurosurgical intensive care units. Neurol. India. 49 (1)S91–S96, 2001.
24.
Spath, P. L., Error reduction in health care: a systems approach to improving patient safety. Wiley: New York, 2000.
25.
Graf, J., Graf, C., and Janssens, U., Analysis of resource use and cost-generating factors in a German medical intensive care unit employing the Therapeutic Intervention Scoring System. Intensive Care Med. 28 (3)324–331, 2002.CrossRef
26.
Menachemi, N., Perkins, R. M., Durme, D. J. V., and Brooks, R. G., Examining the adoption of electronic health records and personal digital assistants by family physicians in Florida. Inform. Prim. Care. 14 (1)1–9, 2006.
27.
Ward, M. M., Jaana, M., Bahensky, J., Vartak, S., and Wakefield, D., Clinical information system availability and use in urban and rural hospitals. J. Med. Syst. 30 (6)429–438, 2006.CrossRef
28.
Bahensky, J. A., Jaana, M., and Ward, M. E., Health care information technology in rural America: electronic medical record adoption status in meeting the national agenda. J. Rural. Health. 2008. Retrieved from http://​www.​ruralhealthweb.​org.
29.
Melzner, S. M., Grossman, D. C., Hart, L. G., and Rosenblatt, R. A., Hospital services for rural children in Washington state. Pediatrics. 99 (2)196–203, 1997.CrossRef
30.
Aday, L. A., and Cornelius, L. J., Designing and conducting health surveys: a comprehensive guide, 3rd edition. Jossey-Bass: San Francisco, 2005, 518 pp.
31.
32.
33.
Nunamaker, T., Measuring routine nursing service efficiency: a comparison of cost per patient day and data envelopment analysis models. Health. Serv. Res. 18:183–205, 1983.
34.
Valdmanis, V. G., Ownership and technical efficiency of hospitals. Med. Care. 28:552–560, 1990.CrossRef
35.
Ehreth, J. L., The development and evaluation of hospital performance measures for policy analysis. Med. Care. 32:568–587, 1994.CrossRef
36.
37.
National Rural Health Association (NRHA), Issue Paper, Feb. 1997.
Metadaten
Titel
Rural Health Clinic Efficiency and Effectiveness: Insight from a Nationwide Survey
verfasst von
Judith Ortiz
Natthani Meemon
Chiung-Ya Tang
Thomas T. H. Wan
Seung Chun Paek
Publikationsdatum
01.08.2011
Verlag
Springer US
Erschienen in
Journal of Medical Systems / Ausgabe 4/2011
Print ISSN: 0148-5598
Elektronische ISSN: 1573-689X
DOI
https://doi.org/10.1007/s10916-009-9404-4

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