Kimbell L J, Lorant J H
Health Serv Res. 1977 Winter;12(4):367-79.
Cobb-Douglas production functions are used to estimate returns to scale in a sample of solo and group medical practices stratified by size and type of practice. Solo practices and small single-specialty groups are stratified by specialty, and large multispecialty groups are stratified as general practice-general surgery or comprehensive-care groups. Output measures used are gross revenue, total patient visits, and office visits; input measures reflecting practice scale are number of physicians, number of rooms, and number of nonphysician office personnel. Results indicate increasing returns to scale for solo and small group practices but decreasing returns to scale for very large groups. Possible reasons for inefficiency in large practices and the implications of the findings for public policy on health maintenance organizations are discussed.
柯布 - 道格拉斯生产函数用于估计按规模和执业类型分层的个体和团体医疗执业样本中的规模收益。个体执业和小型单一专科团体按专科分层，大型多专科团体则分为全科 - 普通外科或综合护理团体。所使用的产出指标是总收入、患者总就诊次数和门诊就诊次数；反映执业规模的投入指标是医生数量、房间数量和非医生办公人员数量。结果表明，个体和小型团体执业存在规模收益递增，但超大型团体存在规模收益递减。讨论了大型执业效率低下的可能原因以及这些发现对健康维护组织公共政策的影响。
