Hay J W, Mandes G
Health Care Financ Rev. 1984 Spring;5(3):111-6.
An exploratory home health care (HHC) cost-function model is estimated using State rate-setting data for the 74 traditional (nonprofit) Connecticut agencies. The analysis demonstrates U-shaped average costs curves for agencies' provision of skilled nursing visits, with substantial diseconomies of scale in the observable range. It is determined from the estimated cost function that the sample representative agency is providing fewer visits than optimal, and its marginal cost is significantly below average cost. The finding that an agency's costs are predominantly related to output levels, with little systematic variation due to other agency or patient characteristics, suggests that the economic inefficiency in a cost-based HHC reimbursement policy may be substantial.
利用康涅狄格州74家传统（非营利性）机构的费率设定数据，估计了一个探索性的家庭医疗保健（HHC）成本函数模型。分析表明，各机构提供专业护理探访的平均成本曲线呈U形，在可观察范围内存在显著的规模不经济。根据估计的成本函数确定，样本代表性机构提供的探访次数低于最优水平，其边际成本显著低于平均成本。研究发现，机构成本主要与产出水平相关，因其他机构或患者特征导致的系统性变化较小，这表明基于成本的家庭医疗保健报销政策可能存在严重的经济效率低下问题。
