IDEAS home Printed from https://ideas.repec.org/a/kap/hcarem/v17y2014i4p321-330.html
   My bibliography  Save this article

Economies of scale in federally-funded state-organized public health programs: results from the National Breast and Cervical Cancer Early Detection Programs

Author

Listed:
  • Justin Trogdon
  • Donatus Ekwueme
  • Sujha Subramanian
  • Wesley Crouse

Abstract

This study investigates the existence of economies of scale in the provision of breast and cervical cancer screening and diagnostic services by state National Breast and Cervical Cancer Early Detection Program (NBCCEDP) grantees. A translog cost function is estimated as a system with input factor share equations. The estimated cost function is then used to determine output levels for which average costs are decreasing (i.e., economies of scale exist). Data were collected from all state NBCCEDP programs and District of Columbia for program years 2006–2007, 2008–2009 and 2009–2010 (N = 147). Costs included all programmatic and in-kind contributions from federal and non-federal sources, allocated to breast and cervical cancer screening activities. Output was measured by women served, women screened and cancers detected, separately by breast and cervical services for each measure. Inputs included labor, rent and utilities, clinical services, and quasi-fixed factors (e.g., percent of women eligible for screening by the NBCCEDP). 144 out of 147 program-years demonstrated significant economies of scale for women served and women screened; 136 out of 145 program-years displayed significant economies of scale for cancers detected. The cost data were self-reported by the NBCCEDP State programs. Quasi-fixed inputs were allowed to affect costs but not economies of scale or the share equations. The main analysis accounted for clustering of observations within State programs, but it did not make full use of the panel data. The average cost of providing breast and cervical cancer screening services decreases as the number of women screened and served increases. Copyright Springer Science+Business Media New York 2014

Suggested Citation

  • Justin Trogdon & Donatus Ekwueme & Sujha Subramanian & Wesley Crouse, 2014. "Economies of scale in federally-funded state-organized public health programs: results from the National Breast and Cervical Cancer Early Detection Programs," Health Care Management Science, Springer, vol. 17(4), pages 321-330, December.
    • Handle: RePEc:kap:hcarem:v:17:y:2014:i:4:p:321-330
    DOI: 10.1007/s10729-013-9261-z
    as

    Download full text from publisher

    File URL: http://hdl.handle.net/10.1007/s10729-013-9261-z
    Download Restriction: Access to full text is restricted to subscribers.
    File URL: https://libkey.io/10.1007/s10729-013-9261-z?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    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. Edward C. Mansley & Diane O. Duñet & Daniel S. May & Sajal K. Chattopadhyay & Matthew T. Mckenna, 2002. "Variation in Average Costs among Federally Sponsored State-Organized Cancer Detection Programs: Economies of Scale?," Medical Decision Making, , vol. 22(1_suppl), pages 67-79, September.
    2. Daniel Bilodeau & Pierre-Yves Crémieux & Pierre Ouellette, 2000. "Hospital Cost Function In A Non-Market Health Care System," The Review of Economics and Statistics, MIT Press, vol. 82(3), pages 489-498, August.
    3. Joseph Gyourko, 2009. "Understanding Commercial Real Estate: Just How Different from Housing Is It?," NBER Working Papers 14708, National Bureau of Economic Research, Inc.
    4. Christensen, Laurits R & Greene, William H, 1976. "Economies of Scale in U.S. Electric Power Generation," Journal of Political Economy, University of Chicago Press, vol. 84(4), pages 655-676, August.
    5. Deller, Steven C & Chicoine, David L & Walzer, Norman, 1988. "Economies of Size and Scope in Rural Low-Volume Roads," The Review of Economics and Statistics, MIT Press, vol. 70(3), pages 459-465, August.
    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. Kucukyazici, Beste & Zhang, Yue & Ardestani-Jaafari, Amir & Song, Lijie, 2020. "Incorporating patient preferences in the design and operation of cancer screening facility networks," European Journal of Operational Research, Elsevier, vol. 287(2), pages 616-632.
    2. Subramanian, Sujha & Tangka, Florence K.L. & Hoover, Sonja & Royalty, Janet & DeGroff, Amy & Joseph, Djenaba, 2017. "Costs of colorectal cancer screening provision in CDC’s Colorectal Cancer Control Program: Comparisons of colonoscopy and FOBT/FIT based screening," Evaluation and Program Planning, Elsevier, vol. 62(C), pages 73-80.

    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. Swetlana Renner & Thomas Glauben & Heinrich Hockmann, 2014. "Measurement and decomposition of flexibility of multi-output firms," European Review of Agricultural Economics, Oxford University Press and the European Agricultural and Applied Economics Publications Foundation, vol. 41(5), pages 745-773.
    2. Hertrich Markus, 2019. "A Novel Housing Price Misalignment Indicator for Germany," German Economic Review, De Gruyter, vol. 20(4), pages 759-794, December.
    3. Obare, G. A. & Omamo, S. W. & Williams, J. C., 2003. "Smallholder production structure and rural roads in Africa: the case of Nakuru District, Kenya," Agricultural Economics, Blackwell, vol. 28(3), pages 245-254, May.
    4. Crowe, Christopher & Dell’Ariccia, Giovanni & Igan, Deniz & Rabanal, Pau, 2013. "How to deal with real estate booms: Lessons from country experiences," Journal of Financial Stability, Elsevier, vol. 9(3), pages 300-319.
    5. Tung Liu, 2020. "Measuring Technical, Allocative inefficiency, and Cost Inefficiency by Applying Duality Theory," Working Papers 202001, Ball State University, Department of Economics, revised Jun 2020.
    6. Krasachat, W., 2000. "Production Structure and Technical Change in Thai Agriculture, 1972-1994," 2000 Conference (44th), January 23-25, 2000, Sydney, Australia 123688, Australian Agricultural and Resource Economics Society.
    7. Considine, Timothy J. & Larson, Donald F., 2006. "The environment as a factor of production," Journal of Environmental Economics and Management, Elsevier, vol. 52(3), pages 645-662, November.
    8. AZOMAHOU, Théophile & BOUCEKKINE, Raouf & NGUYEN-VAN, Phu, 2009. "Promoting clean technologies under imperfect competition," LIDAM Discussion Papers CORE 2009011, Université catholique de Louvain, Center for Operations Research and Econometrics (CORE).
    9. Oh, Dong-hyun, 2015. "Productivity growth, technical change and economies of scale of Korean fossil-fuel generation companies, 2001–2012: A dual approach," Energy Economics, Elsevier, vol. 49(C), pages 113-121.
    10. Bergeaud, Antonin & Eyméoud, Jean-Benoît & Garcia, Thomas & Henricot, Dorian, 2023. "Working from home and corporate real estate," Regional Science and Urban Economics, Elsevier, vol. 99(C).
    11. Marvin E. Dodson & Thomas A. Garrett, 2004. "Inefficient Education Spending in Public School Districts: A Case for Consolidation?," Contemporary Economic Policy, Western Economic Association International, vol. 22(2), pages 270-280, April.
    12. Theodore Panagiotidis & Georgios Papapanagiotou, 2024. "A note on the determinants of NFTs returns," Working Paper series 24-07, Rimini Centre for Economic Analysis.
    13. James B. Bushnell & Catherine Wolfram, 2009. "The Guy at the Controls: Labor Quality and Power Plant Efficiency," NBER Chapters, in: International Differences in the Business Practices and Productivity of Firms, pages 79-102, National Bureau of Economic Research, Inc.
    14. Schmit, Todd M. & Boisvert, Richard N., 1997. "A Hedonic Approach To Estimating Operation And Maintenance Costs For New York Municipal Water Systems," Agricultural and Resource Economics Review, Northeastern Agricultural and Resource Economics Association, vol. 26(2), pages 1-12, October.
    15. Offutt, Susan & Shoemaker, Robbin, 1989. "Distribution of Domestic Policy Benefits and the Willingness to Support Trade Liberalization," 1989 Occasional Paper Series No. 5 197669, International Association of Agricultural Economists.
    16. Lila J. Truett & Dale B. Truett, 2003. "The Italian Automotive Industry and Economies of Scale," Contemporary Economic Policy, Western Economic Association International, vol. 21(3), pages 329-337, July.
    17. Zhenyu Gao & Michael Sockin & Wei Xiong, 2020. "Learning about the Neighborhood," NBER Working Papers 26907, National Bureau of Economic Research, Inc.
    18. Odolinski, Kristofer & Smith, Andrew & Wheat, Phill & Nilsson, Jan-Eric & Dheilly, Clement, 2023. "Damage or no damage from traffic: Re-examining marginal cost pricing for rail signalling maintenance," Transport Policy, Elsevier, vol. 131(C), pages 13-21.
    19. repec:wvu:wpaper:10-09 is not listed on IDEAS
    20. Del Bono, Emilia & Kinsler, Josh & Pavan, Ronni, 2020. "A Note on the Importance of Normalizations in Dynamic Latent Factor Models of Skill Formation," IZA Discussion Papers 13714, Institute of Labor Economics (IZA).
    21. Vítor Marques & Isabel Soares & Adelino Fortunato, 2012. "Application of a Structural Model to the Spanish Electricity Wholesale Market," European Research Studies Journal, European Research Studies Journal, vol. 0(4), pages 65-108.

    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:kap:hcarem:v:17:y:2014:i:4:p:321-330. 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: Sonal Shukla or Springer Nature Abstracting and Indexing (email available below). General contact details of provider: http://www.springer.com .

    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.