Li T, Rosenman R
Department of Economics, Wylie Hall, Indiana University, Bloomington, IN, USA.
Health Econ. 2001 Sep;10(6):523-38. doi: 10.1002/hec.605.
This paper estimates a long-run hospital cost function with multiple outputs and inputs using a panel data set from Washington State hospitals during 1988-1993. We find that with our data the generalized Leontief function is more appropriate than a translog for estimating hospital cost functions. With respect to hospital costs, we find that hospitals readily adjust the use of intermediate products. Radiology, therapies and surgery, and other inpatient days, all serve as substitutes for core inpatient days. Outpatient services are found to be complementary to core inpatient services, indicating that the growth of stand-alone outpatient clinics might increase the costs of providing healthcare services. Our analysis finds that hospitals show significant economies of scale, but there is a limited amount of evidence of scope economies. Also, there is some evidence that profit-seeking hospitals achieve some of their goals by controlling costs, and that diagnostically related groups (DRG)-based Medicare services are effective in getting hospitals to control costs.
本文使用1988 - 1993年期间华盛顿州医院的面板数据集，估计了一个具有多个产出和投入的长期医院成本函数。我们发现，对于我们的数据而言，广义列昂惕夫函数比超越对数函数更适合用于估计医院成本函数。关于医院成本，我们发现医院能够轻松调整中间产品的使用。放射科、治疗和手术以及其他住院天数，都可作为核心住院天数的替代品。门诊服务被发现与核心住院服务互补，这表明独立门诊诊所的增长可能会增加提供医疗服务的成本。我们的分析发现，医院显示出显著的规模经济，但范围经济的证据有限。此外，有证据表明，营利性医院通过控制成本实现了部分目标，并且基于诊断相关组（DRG）的医疗保险服务在促使医院控制成本方面是有效的。
