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Cost-Output Relation, Technological Progress, and Clinical Activity Mix of US Hospital Pharmacies

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  • Albert Okunade

Abstract

The fairly recent discovery and growing use of costly, revolutionary biotechnology drugs (e.g., GM-CSFs) in hospitals represent a major technical innovation in clinical pharmacy intervention. This paper models the translog production cost impacts of ten distinct clinical pharmacy tasks including pharmacokinetics, consultations with MDs, monitoring drug interactions,..., and presents results on decomposed technical change, economies of scope, scale economies, total factor productivity, and the alternatively defined pairwise factor substitution possibilities. The model was fitted to 1981–1990 time-series/cross-sectional data of US hospital pharmacies (source: Eli-Lilly Co.®). Zellner's ISURE (Iterative Seemingly Unrelated Regression Equations) system estimates reveal a non-homothetic underlying technology with biased and pure technical change effects dominating scale-augmentation. Certain clinical tasks increase costs but are cost-saving if jointly produced with selective others. One of the largest and statistically significant economies of scope estimates is between ‘monitoring drug interactions’ and ‘consultations with MDs’. Cost implications of findings are given in light of the recent trends in hospital pharmacy clinical activities, related professional health manpower, and piecemeal health policy reforms. Copyright Kluwer Academic Publishers 2001

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  • Albert Okunade, 2001. "Cost-Output Relation, Technological Progress, and Clinical Activity Mix of US Hospital Pharmacies," Journal of Productivity Analysis, Springer, vol. 16(2), pages 167-193, September.
    • Handle: RePEc:kap:jproda:v:16:y:2001:i:2:p:167-193
    DOI: 10.1023/A:1011635411864
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    Cited by:

    1. Okunade, Albert A. & Suraratdecha, Chutima, 2006. "The pervasiveness of pharmaceutical expenditure inertia in the OECD countries," Social Science & Medicine, Elsevier, vol. 63(1), pages 225-238, July.
    2. Okunade, Albert A. & Murthy, Vasudeva N. R., 2002. "Technology as a 'major driver' of health care costs: a cointegration analysis of the Newhouse conjecture," Journal of Health Economics, Elsevier, vol. 21(1), pages 147-159, January.
    3. Paresh Kumar Narayan, 2007. "Do health expenditures 'catch-up'? Evidence from OECD countries," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 993-1008.
    4. Richard Cebula, 2006. "A Further Analysis of Determinants of Health Insurance Coverage," International Advances in Economic Research, Springer;International Atlantic Economic Society, vol. 12(3), pages 382-389, August.
    5. Daniel L. Friesner & Matthew Q. McPherson & Robert Rosenman, 2010. "Are Hospital Pharmacies More Efficient if They Employ Nurses?," Economics Bulletin, AccessEcon, vol. 30(1), pages 139-156.
    6. 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.
    7. repec:ebl:ecbull:v:30:y:2010:i:1:p:139-156 is not listed on IDEAS
    8. Blank, Jos L. T. & Vogelaar, Iris, 2004. "Specifying technical change: a research on the nature of technical change in Dutch hospital industry," The Quarterly Review of Economics and Finance, Elsevier, vol. 44(3), pages 448-463, July.
    9. Gregory G. Lubiani & Albert A. Okunade, 2013. "Production Cost Structure In Us Outpatient Physical Therapy Health Care," Health Economics, John Wiley & Sons, Ltd., vol. 22(2), pages 212-223, February.
    10. Albert A. Okunade, 2003. "Are Factor Substitutions in HMO Industry Operations Cost Saving?," Southern Economic Journal, John Wiley & Sons, vol. 69(4), pages 800-821, April.
    11. Albert Okunade & Vasudeva Murthy, 2008. "Are physician and non-physician providers of outpatient mental healthcare substitutes or complements? a conceptual clarification," Health Care Management Science, Springer, vol. 11(4), pages 393-398, December.
    12. Suraratdecha, Chutima & Okunade, Albert A., 2006. "Measuring operational efficiency in a health care system: A case study from Thailand," Health Policy, Elsevier, vol. 77(1), pages 2-23, June.
    13. Jos L. T. Blank & Bart L. Van Hulst, 2009. "Productive innovations in hospitals: an empirical research on the relation between technology and productivity in the Dutch hospital industry," Health Economics, John Wiley & Sons, Ltd., vol. 18(6), pages 665-679, June.
    14. Paresh Kumar Narayan, 2007. "Do health expenditures ‘catch‐up’? Evidence from OECD countries," Health Economics, John Wiley & Sons, Ltd., vol. 16(10), pages 993-1008, October.

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