Technical efficiency of Critical Access Hospitals: An application of the two-stage approach with double bootstrap

Document Type

Article

Publication Date

1-1-2013

Abstract

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

First Page

27

Last Page

36

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