Jeffrey P. Harrison

Efficiency of Federal Hospitals in the United States

This study evaluates the technical efficiency of federal hospitals in the United States using a variable returns to scale, input-oriented, data envelopment analysis (DEA) methodology. Hospital executives, health care policy-makers, taxpayers, and other stakeholders, benefit from studies that improve the efficiency of federal hospitals. Data for 280 federal hospitals in 1998 and 245 in 2001 were analyzed using DEA to measure hospital efficiency. Results indicate overall efficiency in federal hospitals improved from 68% in 1998 to 79% in 2001. However, based upon 2001 spending of

The Improving Efficiency Frontier of Religious Not-for-Profit Hospitals

42.5 billion for federal hospitals potential savings of

Trends in Hospital Efficiency Among Metropolitan Markets

2.0 billion annually are possible through more efficient management of resources. From a policy perspective, this study highlights the importance of establishing more specific policies to address inefficiency in the federal health care industry.

Benchmarking electronic medical records initiatives in the US: a conceptual model.

Abstract. By using data-envelopment analysis (DEA), this study evaluates the efficiency of religious not-for-profit hospitals. Hospital executives, healthcare policy makers, taxpayers, and other stakeholders benefit from studies that improve hospital efficiency. Results indicate that overall efficiency in religious hospitals improved from 72% in 1998 to 74% in 2001. What is more important is that the number of religious hospitals operating on the efficiency frontier increased from 40 in 1998 to 47 in 2001. This clearly documents that religious hospitals are becoming more efficient in the management of resources. From a policy perspective, this study highlights the economic importance of encouraging increased efficiency throughout the healthcare industry.

The paradox of the not-for-profit hospital.

This study evaluates trends in efficiency among American hospital markets. A total of 6010 hospitals were identified for use in the analysis from the American Hospital Associations Annual Surveys for 1989 and 1993. Using data envelopment analysis (DEA), a longitudinal study of hospital efficiency was conducted on all 314 metropolitan markets in the United States. Results suggest that large hospital markets generally demonstrated higher inefficiency. The major inefficiencies exist in the availability of hospital services, the number of operating beds, the utilization of hospital staffing and operating expenses. Consequently, the large hospital market had a significant excess of health manpower that resulted in inefficiency that amounted to approximately

The role of laboratory information systems in healthcare quality improvement

23 billion. From a policy perspective, this study has shed some light on the need to establish more specific policies to address inefficiency in the health care industry.

An Efficiency Analysis of Veterans Health Administration Hospitals

This article provides a conceptual model for benchmarking the use of clinical information systems within healthcare organizations. Additionally, it addresses the benefits of clinical information systems which include the reduction of errors, improvement in clinical decision-making and real time access to patient information. The literature suggests that clinical information systems provide financial benefits due to cost-savings from improved efficiency and reduction of errors. As a result, healthcare organizations should adopt such clinical information systems to improve quality of care and stay competitive in the marketplace. Our research clearly documents the increased adoption of electronic medical records in U.S. hospitals from 2005 to 2007. This is important because the electronic medical record provides an opportunity for integration of patient information and improvements in efficiency and quality of care across a wide range of patient populations. This was supported by recent federal initiatives such as the establishment of the Office of the National Coordinator of Health Information Technology (ONCHIT) to create an interoperable health information infrastructure. Potential barriers to the implementation of health information technology include cost, a lack of financial incentives for providers, and a need for interoperable systems. As a result, future government involvement and leadership may serve to accelerate widespread adoption of interoperable clinical information systems.

A profile of hospital acquisitions.

This quantitative research study assesses the organizational characteristics, market factors, and performance of not-for-profit hospitals in the United States. These results have managerial implications related to hospital efficiency, organizational performance, and the role of not-for-profit hospitals within local communities. The study has policy implications on access to clinical services within local communities, the availability of charity care, and the long-term viability of the not-for-profit health care industry due to potential bankruptcy and closure. This study clearly demonstrates that not-for-profit hospital managers are faced with declining profitability and are challenged to reduce hospital-operating expenses while meeting their charitable mission. Additionally, the greater size and increased clinical complexity of not-for-profit hospitals are increasing organizational overhead. In many cases, the increased clinical complexity is a commitment to the organizational mission of providing a full range of services to the community. From a policy perspective, the study suggests that not-for-profit hospitals have aging facilities and reduced cash flow due to lower profit margins. As a result, many not-for-profit hospitals face potential bankruptcy and closure. This study clearly documents a threat to the provision of charity care in local communities and the long-term viability of the not-for-profit health care industry in the United States.

The crisis in United States hospital emergency services

PURPOSE The purpose of this study was to evaluate the status of US hospital Laboratory Information Systems. Laboratory Information Systems are critical to high quality healthcare service provision. Data show that the need for these systems is growing to meet accompanying technological and workload demands. Additionally, laboratory tests provide the majority of information for clinical decision-making. Laboratory processes automation, including patient result verification, has greatly improved laboratory test throughput while decreasing turn-around-times, enabling critical results to reach physicians rapidly for improved clinical outcomes. DESIGN/METHODOLOGY/APPROACH Data were drawn from the 2007 Healthcare Information and Management Systems Society (HIMSS) Analytics Database, which includes over 5,000 US healthcare organizations and provides extensive data on the hardware, software, and information technology infrastructure within healthcare organizations. FINDINGS US hospitals are actively involved in laboratory systems planning to improve health service quality. Specifically, data show 76 new laboratory information systems are currently being installed in 2007 with another 399 under contract for future installation. As a result, increasing investment in laboratory information systems is providing state-of-the-art clinical laboratory support, which enhances clinical care processes and improves quality. These state-of-the-art Laboratory Information Systems, when linked with other clinical information systems such as Computerized Physician Order Entry and Electronic Medical Record, will support further healthcare quality improvement. ORIGINALITY/VALUE This article includes the most current information available on the US hospital laboratory information system applications.

Measuring efficiency among US federal hospitals.

This study evaluates the efficiency of Veterans Health Administration (VHA) hospitals using a variable-returns to scale, input-oriented, data envelopment analysis method. Hospital executives, health care policymakers, taxpayers, and ultimately the veteran patient population benefit from studies that look to improve the efficiency of the VHA. Data for 131 VHA hospitals in 1998 and 121 in 2001 were analyzed by using data envelopment analysis to measure hospital efficiency. The results indicated that efficiency in VHA hospitals improved from 85% in 1998 to 86% in 2001. Although this level of efficiency is commendable, the study documents potential savings through more efficient use of resources. From a management perspective, this study shows opportunities for improved management and the realignment of resources to better meet demand. From a policy perspective, the study highlights the political problems associated with improving efficiency and providing access to critical health care services.