IDEAS home Printed from https://ideas.repec.org/p/ies/wpaper/e201404.html
   My bibliography  Save this paper

A Directional Distance Function Approach to Identifying the Input/Output Status of Medical Residents

Author

Listed:
  • Gary D. Ferrier

    (University of Arkansas)

  • Hervé Leleu

    (CNRS-LEM and IESEG School of Management)

  • Viviane Valdmanis

    (University of the Sciences in Philadelphia and IESEG School of Management)

  • Michael Vardanyan

    (IESEG School of Management (LEM-CNRS))

Abstract

The application of the human capital theory, the production theory, and the comparison of costs between teaching and non-teaching hospitals all point to the difficulties in identifying whether medical residents should be considered as inputs or outputs. We add to the debate by using a data-driven parametric approach based on the directional technology distance function to determine the status of medical residents. Using the American Hospital Association data from 1994 to 2010 we show that residents are inputs in all rural and in public non-teaching hospitals, but outputs in urban-area teaching not-for-profit hospitals. We also demonstrate that the status of residents is related to the case-mix index and that it can sometimes vary with hospital size.

Suggested Citation

  • Gary D. Ferrier & Hervé Leleu & Viviane Valdmanis & Michael Vardanyan, 2014. "A Directional Distance Function Approach to Identifying the Input/Output Status of Medical Residents," Working Papers 2014-EQM-04, IESEG School of Management.
    • Handle: RePEc:ies:wpaper:e201404
    as

    Download full text from publisher

    File URL: http://www.ieseg.fr/wp-content/uploads/2014-EQM-04_Vardanyan.pdf
    Download Restriction: no
    ---><---

    Other versions of this item:

    References listed on IDEAS

    as
    1. Gary S. Becker, 1962. "Investment in Human Capital: A Theoretical Analysis," NBER Chapters, in: Investment in Human Beings, pages 9-49, National Bureau of Economic Research, Inc.
    2. Rolf Färe & Carlos Martins-Filho & Michael Vardanyan, 2010. "On functional form representation of multi-output production technologies," Journal of Productivity Analysis, Springer, vol. 33(2), pages 81-96, April.
    3. Chambers, Robert & Färe, Rolf & Grosskopf, Shawna & Vardanyan, Michael, 2013. "Generalized quadratic revenue functions," Journal of Econometrics, Elsevier, vol. 173(1), pages 11-21.
    4. Paolo Guarda & Abdelaziz Rouabah & Michael Vardanyan, 2013. "Identifying bank outputs and inputs with a directional technology distance function," Journal of Productivity Analysis, Springer, vol. 40(2), pages 185-195, October.
    5. Mark Pauly, 1980. "Doctors and Their Workshops: Economic Models of Physician Behavior," NBER Books, National Bureau of Economic Research, Inc, number paul80-1.
    6. Sloan, Frank A. & Feldman, Roger D. & Steinwald, A. Bruce, 1983. "Effects of teaching on hospital costs," Journal of Health Economics, Elsevier, vol. 2(1), pages 1-28, March.
    7. Edward C. Norton & Douglas O. Staiger, 1994. "How Hospital Ownership Affects Access to Care for the Uninsured," RAND Journal of Economics, The RAND Corporation, vol. 25(1), pages 171-185, Spring.
    8. Lee, Robert H. & Hadley, Jack, 1985. "The demand for residents," Journal of Health Economics, Elsevier, vol. 4(4), pages 357-371, December.
    9. Jos Blank & Vivian Valdmanis, 2010. "Environmental factors and productivity on Dutch hospitals: a semi-parametric approach," Health Care Management Science, Springer, vol. 13(1), pages 27-34, March.
    10. Grosskopf, Shawna & Margaritis, Dimitri & Valdmanis, Vivian, 2001. "The effects of teaching on hospital productivity," Socio-Economic Planning Sciences, Elsevier, vol. 35(3), pages 189-204, September.
    11. Nicholson, Sean & Song, David, 2001. "The incentive effects of the Medicare indirect medical education policy," Journal of Health Economics, Elsevier, vol. 20(6), pages 909-933, November.
    12. Guilhermina Rego & Rui Nunes & José Costa, 2010. "The challenge of corporatisation: the experience of Portuguese public hospitals," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 11(4), pages 367-381, August.
    13. Chambers, Robert G. & Chung, Yangho & Fare, Rolf, 1996. "Benefit and Distance Functions," Journal of Economic Theory, Elsevier, vol. 70(2), pages 407-419, August.
    14. Aigner, Dennis & Lovell, C. A. Knox & Schmidt, Peter, 1977. "Formulation and estimation of stochastic frontier production function models," Journal of Econometrics, Elsevier, vol. 6(1), pages 21-37, July.
    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. Layer, Kevin & Johnson, Andrew L. & Sickles, Robin C. & Ferrier, Gary D., 2020. "Direction selection in stochastic directional distance functions," European Journal of Operational Research, Elsevier, vol. 280(1), pages 351-364.
    2. Maria J. Perez-Villadóniga & Ana Rodriguez-Alvarez & David Roibas, 2022. "The contribution of resident physicians to hospital productivity," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(2), pages 301-312, March.
    3. Vardanyan, Michael & Valdmanis, Vivian G. & Leleu, Hervé & Ferrier, Gary D., 2022. "Estimating technology characteristics of the U.S. hospital industry using directional distance functions with optimal directions," Omega, Elsevier, vol. 113(C).
    4. Boussemart, Jean Philippe & Leleu, Hervé & Shen, Zhiyang, 2015. "Environmental growth convergence among Chinese regions," China Economic Review, Elsevier, vol. 34(C), pages 1-18.

    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. Galina Besstremyannaya & Sergei Golovan, 2023. "Measuring heterogeneity in hospital productivity: a quantile regression approach," Journal of Productivity Analysis, Springer, vol. 59(1), pages 15-43, February.
    2. Färe, Rolf & Pasurka, Carl & Vardanyan, Michael, 2017. "On endogenizing direction vectors in parametric directional distance function-based models," European Journal of Operational Research, Elsevier, vol. 262(1), pages 361-369.
    3. Sloan, Frank A. & Picone, Gabriel A. & TaylorJr., Donald H. & Chou, Shin-Yi, 2001. "Hospital ownership and cost and quality of care: is there a dime's worth of difference?," Journal of Health Economics, Elsevier, vol. 20(1), pages 1-21, January.
    4. Vardanyan, Michael & Valdmanis, Vivian G. & Leleu, Hervé & Ferrier, Gary D., 2022. "Estimating technology characteristics of the U.S. hospital industry using directional distance functions with optimal directions," Omega, Elsevier, vol. 113(C).
    5. Paolo Guarda & Abdelaziz Rouabah & Michael Vardanyan, 2013. "Identifying bank outputs and inputs with a directional technology distance function," Journal of Productivity Analysis, Springer, vol. 40(2), pages 185-195, October.
    6. Tomasz Gerard Czekaj, 2013. "Measuring the Technical Efficiency of Farms Producing Environmental Output: Parametric and Semiparametric Estimation of Multi-output Stochastic Ray Production Frontiers," IFRO Working Paper 2013/21, University of Copenhagen, Department of Food and Resource Economics.
    7. Chambers, Robert & Färe, Rolf & Grosskopf, Shawna & Vardanyan, Michael, 2013. "Generalized quadratic revenue functions," Journal of Econometrics, Elsevier, vol. 173(1), pages 11-21.
    8. Pedro Barros & Sara Machado, 2010. "Money for nothing?," Health Care Management Science, Springer, vol. 13(3), pages 234-255, September.
    9. Czekaj, Tomasz G., 2015. "Measuring the Technical Efficiency of Farms Producing Environmental Output: Semiparametric Estimation of Multi-output Stochastic Ray Production Frontiers," 2015 Conference, August 9-14, 2015, Milan, Italy 211555, International Association of Agricultural Economists.
    10. Zhu, Ning & Wu, Yanrui & Wang, Bing & Yu, Zhiqian, 2019. "Risk preference and efficiency in Chinese banking," China Economic Review, Elsevier, vol. 53(C), pages 324-341.
    11. Badau, Flavius & Färe, Rolf & Gopinath, Munisamy, 2016. "Global resilience to climate change: Examining global economic and environmental performance resulting from a global carbon dioxide market," Resource and Energy Economics, Elsevier, vol. 45(C), pages 46-64.
    12. Kuosmanen, Timo & Johnson, Andrew, 2017. "Modeling joint production of multiple outputs in StoNED: Directional distance function approach," European Journal of Operational Research, Elsevier, vol. 262(2), pages 792-801.
    13. Tovar, Beatriz & Wall, Alan, 2015. "Can ports increase traffic while reducing inputs? Technical efficiency of Spanish Port Authorities using a directional distance function approach," Transportation Research Part A: Policy and Practice, Elsevier, vol. 71(C), pages 128-140.
    14. Vaneet Bhatia & Sankarshan Basu & Subrata Kumar Mitra & Pradyumna Dash, 2018. "A review of bank efficiency and productivity," OPSEARCH, Springer;Operational Research Society of India, vol. 55(3), pages 557-600, November.
    15. Caitlin O’Loughlin & Léopold Simar & Paul W. Wilson, 2023. "Methodologies for assessing government efficiency," Chapters, in: António Afonso & João Tovar Jalles & Ana Venâncio (ed.), Handbook on Public Sector Efficiency, chapter 4, pages 72-101, Edward Elgar Publishing.
    16. Barros, Carlos P. & Guironnet, Jean-Pascal & Peypoch, Nicolas, 2011. "Productivity growth and biased technical change in French higher education," Economic Modelling, Elsevier, vol. 28(1-2), pages 641-646, January.
    17. Macedo, Pedro & Scotto, Manuel, 2014. "Cross-entropy estimation in technical efficiency analysis," Journal of Mathematical Economics, Elsevier, vol. 54(C), pages 124-130.
    18. Abdelaati Daouia & Léopold Simar & Paul W. Wilson, 2017. "Measuring firm performance using nonparametric quantile-type distances," Econometric Reviews, Taylor & Francis Journals, vol. 36(1-3), pages 156-181, March.
    19. Färe, Rolf & Grosskopf, Shawna & Hayes, Kathy J. & Margaritis, Dimitris, 2008. "Estimating demand with distance functions: Parameterization in the primal and dual," Journal of Econometrics, Elsevier, vol. 147(2), pages 266-274, December.
    20. Julia Schaefer & Marcel Clermont, 2018. "Stochastic non-smooth envelopment of data for multi-dimensional output," Journal of Productivity Analysis, Springer, vol. 50(3), pages 139-154, December.

    More about this item

    Keywords

    hospitals; directional distance functions;

    JEL classification:

    • C13 - Mathematical and Quantitative Methods - - Econometric and Statistical Methods and Methodology: General - - - Estimation: General
    • D24 - Microeconomics - - Production and Organizations - - - Production; Cost; Capital; Capital, Total Factor, and Multifactor Productivity; Capacity
    • I12 - Health, Education, and Welfare - - Health - - - Health Behavior

    NEP fields

    This paper has been announced in the following NEP Reports:

    Statistics

    Access and download statistics

    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:ies:wpaper:e201404. 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: Lies BOUTEN (email available below). General contact details of provider: https://edirc.repec.org/data/iesegfr.html .

    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.