The Production and Cost of Ambulatory Medical Care In Community Health Centers

Fred Goldman and Michael Grossman

No 907, NBER Working Papers from National Bureau of Economic Research, Inc

Abstract: An assessment of the efficiency of Federally funded community health centers (CHCs) in delivering ambulatory medical care to poverty populations reveals that the centers' input decisions reflect departures from cost-minimizing behavior. In particular, they employ too few physician aids (nurses and physician assistants) relative to primary care physicians and too many medical support and ancillary personnel relative to primary care physicians. The CHC system-wide cost reduction due to the elimination of allocative inefficiency is estimated at $32 million in 1978 dollars or 6 percent of total cost. This modest cost reduction and evidence that allocative inefficiency is not more widespread among CHCs than among private sector physicians seriously question the conventional wisdom that services in the public sector are produced less efficiently than in the private sector. Support is also reported for the hypothesis that, since grants are not tied to particular services rendered, centers who derive most of their revenue from this source relative to Medicaid and private insurance have a greater incentive to provide a given mix of services in the least-cost method.

Date: 1982-06
Note: EH
References: View references in EconPapers View complete reference list from CitEc
Citations: View citations in EconPapers (2)

Published as Goldman, Fred and Michael Grossman. "The Production and Cost of Ambulatory Medical Care In Community Health Centers." Advances in Health Economics and Health Services Research, edited by Richard M. Schettler and Louis F. Rossoter, Vol. 4, Greenwich, Conn.: JAI Press, (1983), pp. 1-56.

Downloads: (external link)
http://www.nber.org/papers/w0907.pdf (application/pdf)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:nbr:nberwo:0907

Ordering information: This working paper can be ordered from
http://www.nber.org/papers/w0907

Access Statistics for this paper

More papers in NBER Working Papers from National Bureau of Economic Research, Inc National Bureau of Economic Research, 1050 Massachusetts Avenue Cambridge, MA 02138, U.S.A.. Contact information at EDIRC.
Bibliographic data for series maintained by ().