IDEAS home Printed from https://ideas.repec.org/a/eee/socmed/v62y2006i9p2112-2124.html
   My bibliography  Save this article

Does chain affiliation make a difference in efficiency of dialysis providers in the USA

Author

Listed:
  • Ozgen, Hacer

Abstract

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.

Suggested Citation

  • Ozgen, Hacer, 2006. "Does chain affiliation make a difference in efficiency of dialysis providers in the USA," Social Science & Medicine, Elsevier, vol. 62(9), pages 2112-2124, May.
    • Handle: RePEc:eee:socmed:v:62:y:2006:i:9:p:2112-2124
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0277-9536(05)00553-8
    Download Restriction: Full text for ScienceDirect subscribers only
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Randy I. Anderson & H. Shelton Weeks & Bradley K. Hobbs & James R. Webb, 2003. "Nursing Home Quality, Chain Affiliation, Profit Status and Performance," Journal of Real Estate Research, American Real Estate Society, vol. 25(1), pages 43-60.
    2. G D Ferrier & V G Valdmanis, 2004. "Do mergers improve hospital productivity?," Journal of the Operational Research Society, Palgrave Macmillan;The OR Society, vol. 55(10), pages 1071-1080, October.
    3. Dranove, David & Lindrooth, Richard, 2003. "Hospital consolidation and costs: another look at the evidence," Journal of Health Economics, Elsevier, vol. 22(6), pages 983-997, November.
    4. Becker, Edmund R & Sloan, Frank A, 1985. "Hospital Ownership and Performance," Economic Inquiry, Western Economic Association International, vol. 23(1), pages 21-36, January.
    Full references (including those not matched with items on IDEAS)

    Citations

    Citations are extracted by the CitEc Project, subscribe to its RSS feed for this item.
    as


    Cited by:

    1. Pedro V. Amaral & Alan T. Murray, 2016. "Equity in regional access to renal dialysis in Brazil," Regional Science Policy & Practice, Wiley Blackwell, vol. 8(1-2), pages 27-44, March.
    2. David Dreyfus & Anand Nair & Srinivas Talluri, 2020. "The Impact of Chain Organization Size on Efficiency and Quality of Affiliated Facilities—Implications for Multi‐Unit Organizational Forms," Production and Operations Management, Production and Operations Management Society, vol. 29(7), pages 1605-1623, July.
    3. Özgen, Hacer & Sahin, Ismet, 2010. "Measurement of efficiency of the dialysis sector in Turkey using data envelopment analysis," Health Policy, Elsevier, vol. 95(2-3), pages 185-193, May.

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Helda Azevedo & Céu Mateus, 2014. "Cost effects of hospital mergers in Portugal," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(9), pages 999-1010, December.
    2. Per J. Agrell & Pontus Mattsson & Jonas Månsson, 2020. "Impacts on efficiency of merging the Swedish district courts," Annals of Operations Research, Springer, vol. 288(2), pages 653-679, May.
    3. Mika Kortelainen & Kalevi Luoma & Antti Moisio, 2014. "Break-ups of municipal health centre federations: Expenditure and efficiency effects," ERSA conference papers ersa14p1144, European Regional Science Association.
    4. Jonathan Zhang & Yiwei Chen & Liran Einav & Jonathan Levin & Jay Bhattacharya, 2021. "Consolidation of primary care physicians and its impact on healthcare utilization," Health Economics, John Wiley & Sons, Ltd., vol. 30(6), pages 1361-1373, June.
    5. Ying Li & Yung-Ho Chiu & Tai-Yu Lin & Tzu-Han Chang, 2020. "Pre-Evaluating the Technical Efficiency Gains from Potential Mergers and Acquisitions in the IC Design Industry," International Journal of Information Technology & Decision Making (IJITDM), World Scientific Publishing Co. Pte. Ltd., vol. 19(02), pages 525-559, April.
    6. Ariane Charpin & Joanna Piechucka, 2020. "Merger Efficiency Gains: Evidence from a Large Transport Merger in France," Discussion Papers of DIW Berlin 1843, DIW Berlin, German Institute for Economic Research.
    7. Bergman, Mats A. & Johansson, Per & Lundberg, Sofia & Spagnolo, Giancarlo, 2016. "Privatization and quality: Evidence from elderly care in Sweden," Journal of Health Economics, Elsevier, vol. 49(C), pages 109-119.
    8. Kurt R. Brekke & Luigi Siciliani & Odd Rune Straume, 2013. "Hospital Mergers: A Spatial Competition Approach," NIPE Working Papers 04/2013, NIPE - Universidade do Minho.
    9. Nurhafiza Md Hamzah & Kok Fong See, 2019. "Technical efficiency and its influencing factors in Malaysian hospital pharmacy services," Health Care Management Science, Springer, vol. 22(3), pages 462-474, September.
    10. Onder Belgin, 2024. "Efficiency Analysis of EU and Non-EU R&D Investor Firms on Matched Samples," Journal of the Knowledge Economy, Springer;Portland International Center for Management of Engineering and Technology (PICMET), vol. 15(3), pages 13601-13621, September.
    11. James M. Poterba, 1996. "Government Intervention in the Markets for Education and Health Care: How and Why?," NBER Chapters, in: Individual and Social Responsibility: Child Care, Education, Medical Care, and Long-Term Care in America, pages 277-308, National Bureau of Economic Research, Inc.
    12. Juan Du & Justin Wang & Yao Chen & Shin-Yi Chou & Joe Zhu, 2014. "Incorporating health outcomes in Pennsylvania hospital efficiency: an additive super-efficiency DEA approach," Annals of Operations Research, Springer, vol. 221(1), pages 161-172, October.
    13. Gaynor, Martin & Laudicella, Mauro & Propper, Carol, 2012. "Can governments do it better? Merger mania and hospital outcomes in the English NHS," Journal of Health Economics, Elsevier, vol. 31(3), pages 528-543.
    14. Patricia M. Danzon & Andrew Epstein & Sean Nicholson, 2007. "Mergers and acquisitions in the pharmaceutical and biotech industries," Managerial and Decision Economics, John Wiley & Sons, Ltd., vol. 28(4-5), pages 307-328.
    15. Mark Dusheiko & Maria Goddard & Hugh Gravelle & Rowena Jacobs, 2008. "Explaining trends in concentration of healthcare commissioning in the English NHS," Health Economics, John Wiley & Sons, Ltd., vol. 17(8), pages 907-926, August.
    16. Paul Gertler & Jennifer Kuan, 2009. "Does It Matter Who Your Buyer Is? The Role of Nonprofit Mission in the Market for Corporate Control of Hospitals," Journal of Law and Economics, University of Chicago Press, vol. 52(2), pages 295-306, May.
    17. Garcia-Lacalle, Javier & Martin, Emilio, 2010. "Rural vs urban hospital performance in a 'competitive' public health service," Social Science & Medicine, Elsevier, vol. 71(6), pages 1131-1140, September.
    18. Angeliki Flokou & Vassilis Aletras & Dimitris Niakas, 2017. "Decomposition of potential efficiency gains from hospital mergers in Greece," Health Care Management Science, Springer, vol. 20(4), pages 467-484, December.
    19. Joaquín Matías Liwski, 2023. "Should I stay or should I go? Effects of being acquired on employee outcomes: evidence from Brazil," Young Researchers Working Papers 13, Universidad de San Andres, Departamento de Economia, revised Feb 2023.
    20. Giulia Garavaglia & Emanuele Lettieri & Tommaso Agasisti & Silvano Lopez, 2011. "Efficiency and quality of care in nursing homes: an Italian case study," Health Care Management Science, Springer, vol. 14(1), pages 22-35, March.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:socmed:v:62:y:2006:i:9:p:2112-2124. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu (email available below). General contact details of provider: http://www.elsevier.com/wps/find/journaldescription.cws_home/315/description#description .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.