Gaynor M, Anderson G F
H. John Heinz III School of Public Policy and Management, Carnegie Mellon University, Pittsburgh, PA 15213, USA.
J Health Econ. 1995 Aug;14(3):291-317. doi: 10.1016/0167-6296(95)00004-2.
In this paper we reformulate the theory of cost and production to take account of uncertain demand facing a firm. In the reformulated theory the duality between cost and production no longer obtains, and demand distribution parameters enter the cost function as well as the traditional outputs and input prices. We then estimate a short run cost function for a hospital facing uncertain demand using data from a national sample of over 5000 hospitals for the years 1983-1987. The traditional cost model is strongly rejected in favor of the reformulated model. This model is used to calculate the cost of empty hospital beds, controlling for the effect of uncertain demand on the structure of hospital costs. The cost of an empty hospital bed is calculated as $36,443 in 1987 dollars. We estimate that a one percent decrease in the number of hospital beds would decrease hospital costs by slightly over one-third of one percent. Increasing the occupancy rate from the average 1992 level (65 percent) back to the average 1980 level (76 percent) is estimated to save the average hospital over $2 million, or 9.5 percent of costs.
在本文中，我们重新阐述了成本与生产理论，以考虑企业面临的不确定需求。在重新阐述的理论中，成本与生产之间的对偶性不再成立，需求分布参数以及传统的产出和投入价格都进入了成本函数。然后，我们使用1983 - 1987年期间全国5000多家医院的样本数据，估计了一家面临不确定需求的医院的短期成本函数。传统成本模型被强烈拒绝，而支持重新阐述的模型。该模型用于计算空置病床的成本，同时控制不确定需求对医院成本结构的影响。以1987年美元计算，一张空置病床的成本为36,443美元。我们估计，病床数量减少1%将使医院成本降低略超过0.33%。将入住率从1992年的平均水平（65%）提高到1980年的平均水平（76%），估计可为平均规模的医院节省超过200万美元，即成本的9.5%。
