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Impact of Medicare Advantage penetration and hospital competition on technical efficiency of nursing care in US intensive care units

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  • Ari Min
  • Linda D. Scott
  • Chang Park
  • Catherine Vincent
  • Catherine J. Ryan
  • Taewha Lee

Abstract

This study aimed to evaluate technical efficiency of US intensive care units and determine the effects of environmental factors on technical efficiency in providing quality of nursing care. Data were obtained from the 2014 National Database of Nursing Quality Indicators and the Centers for Medicare and Medicaid Services. Data envelopment analysis was used to estimate technical efficiency for each intensive care unit. Multilevel modeling was used to determine the effects of environmental factors on technical efficiency. Overall, Medicare Advantage penetration and hospital competition in a market did not create pressure for intensive care units to become more efficient by reducing their inputs. However, these 2 environmental factors showed positive influences on technical efficiency in intensive care units with certain levels of technical efficiency. The implications of the study results for management strategies and health policy may vary according to the levels of technical efficiency in intensive care units. Further studies are needed to examine why and how intensive care units with particular levels of technical efficiency are differently affected by certain environmental factors.

Suggested Citation

  • Ari Min & Linda D. Scott & Chang Park & Catherine Vincent & Catherine J. Ryan & Taewha Lee, 2018. "Impact of Medicare Advantage penetration and hospital competition on technical efficiency of nursing care in US intensive care units," International Journal of Health Planning and Management, Wiley Blackwell, vol. 33(3), pages 733-745, July.
    • Handle: RePEc:bla:ijhplm:v:33:y:2018:i:3:p:733-745
    DOI: 10.1002/hpm.2528
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    Cited by:

    1. Mª Isabel Ortega-Díaz & Ricardo Ocaña-Riola & Carmen Pérez-Romero & José Jesús Martín-Martín, 2020. "Multilevel Analysis of the Relationship between Ownership Structure and Technical Efficiency Frontier in the Spanish National Health System Hospitals," IJERPH, MDPI, vol. 17(16), pages 1-19, August.
    2. Ricardo Ocaña-Riola & Carmen Pérez-Romero & Mª Isabel Ortega-Díaz & José Jesús Martín-Martín, 2021. "Multilevel Zero-One Inflated Beta Regression Model for the Analysis of the Relationship between Exogenous Health Variables and Technical Efficiency in the Spanish National Health System Hospitals," IJERPH, MDPI, vol. 18(19), pages 1-18, September.

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