People who work in the health system can be resistant to learning from other sectors. They may claim that health care is different, and it is hard to argue otherwise when looking at the range and diversity of the stakeholders and the ways in which authority is distributed between them. But some challenges are common to all sectors, and it would be wasteful to ignore transferable solutions. Health maintenance organizations reduce health costs through programs, including an initial screening and periodic physical examinations, to prevent or avoid illness. just as the HMO is a competitive threat to conventional office practice, it is a threat to the hospital, since its interests run directly but relatively to the hospital manager’s imperative to maintain his or her level of use. Health care inflation consistently outpaces economic growth, and threatens to ‘crowd out’ other important societal priorities.
Increasing the efficiency of hospital care has been a longstanding in U.S. costs containment, with prospective payment implemented in the Medicare program, in the mid-1980s and with many private insurers following suit. Several measurement-related issues may also have contributed to the large number of analyses of hospitals efficiency. The first is data availability: hospitals routinely collect utilization and cost data that can be used for efficient measurement. For example, many studies use data from hospital discharge abstracts and the American Hospital Association (AHA) Annual Survey. Secondly, hospitals are relatively closed systems, which may be easier to measure and attribute all relevant inputs and outputs.
