Technical efficiency of Critical Access Hospitals: An application of the two-stage approach with double bootstrap
The Critical Access Hospital (CAH) Program has offered Medicare cost-based reimbursement to small hospitals that meet certain eligibility criteria to improve their financial viability and quality of care. However, cost-based reimbursement has been associated with inefficiency in hospital operations. This study uses a two-stage approach and bootstrap procedures to examine the effects of environmental variables on the technical efficiency of CAHs. The two-stage approach with quality controls significantly improved statistical efficiency of parameter estimates in the second stage bootstrapped truncated regression relative to a similar model without quality controls. Overall, our results suggest that enhanced Medicare reimbursement may not have had detrimental effects on the technical efficiency of CAHs. © 2012 Springer Science+Business Media, LLC.
Publication Source (Journal or Book title)
Health Care Management Science
Nedelea, I., & Fannin, J. (2013). Technical efficiency of Critical Access Hospitals: An application of the two-stage approach with double bootstrap. Health Care Management Science, 27-36. https://doi.org/10.1007/s10729-012-9209-8