Final Report
Designed for stakeholders, payers, and quality improvement and accrediting organizations,
this report presents a comprehensive and impartial review of the evidence on efficiency
measurement.
The goal of the Agency for Healthcare Research and Quality was to identify, analyze, and
classify current definitions; lay out a linguistic roadmap to help illuminate discussions;
and identify some next steps.
Select for print version (PDF File, 1.5 MB).
PDF Help.
Table of Contents
Disclaimer
Acknowledgements
Copyright
Preface
Executive Summary
Chapter 1. Introduction
Chapter 2. Methods
Analytic Framework—A Typology of Efficiency
Applying the Typology
Approaches That We Do Not Classify as Efficiency Measures
Economic Efficiency for Society as a Whole
Evidence Sources and Searches
Technical Expert Panel
Title Screening, Article Review, and Selection of Individual Studies
Peer Review Process
Chapter 3. Results
Literature Flow
Overview of Article Abstraction
Additional Observations on Measurement Methods
Overview of Vendors and Stakeholder Interviews
Efficiency Measures Identified Through the Grey Literature Review
A Sample of Stakeholders’ Perspectives
Chapter 4. Evaluation of Health Care Efficiency Measures
Important
Scientifically Sound
Feasible
Actionable
Application of Efficiency Measures
Chapter 5. Discussion
Limitations
Conclusions
Future Research
References and Included Studies
List of Acronyms/Abbreviations
Appendixes
Appendix A: Technical Typology
Appendix B: Search Methodology
Appendix C: Abstraction Tools
Appendix D: Technical Expert Panel and Peer Reviewers
Appendix E: Blinded Reviewer Comments
Appendix F: List of Excluded Studies
Appendix G: Evidence Tables
Disclaimer
This report is based on research conducted by the Southern California Evidence-based Practice
Center—RAND Corporation under contract to the Agency for Healthcare Research and Quality
(AHRQ), Rockville, MD (Contract No. 282-00-0005-21). The findings and conclusions in this
document are those of the author(s), who are responsible for its content, and do not necessarily
represent the views of AHRQ. No statement in this report should be construed as an official
position of AHRQ or of the U.S. Department of Health and Human Services. In addition, although
the document has been reviewed for proper grammar and syntax, any editorial errors are the
responsibility of the author(s).
The information in this report is intended to help clinicians, employers, policymakers, and others
make informed decisions about the provision of health care services. This report is intended as a
reference and not as a substitute for clinical judgment.
This report may be used, in whole or in part, as the basis for the development of clinical practice
guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage
policies. AHRQ or U.S. Department of Health and Human Services endorsement of such
derivative products may not be stated or implied.
None of the investigators has any affiliations or financial involvement that conflicts
with the material presented in this report.
Return to Contents
Acknowledgements
Under Contract No. 282-00-0005-21, this document was funded by AHRQ and prepared by the
Southern California Evidence-based Practice Center—RAND Corporation, Santa Monica,
CA. Contributors include:
Principal Investigator:
Elizabeth A. McGlynn, Ph.D.
Evidence-based Practice Center Director:
Paul G. Shekelle, M.D., Ph.D.
Task Order Coordinator:
Susan Chen, B.A.
Economists:
Dana Goldman, Ph.D.
John Romley, Ph.D.
Content Experts:
Peter Hussey, Ph.D.
Han de Vries, M.Sc., M.Phil.
Margaret Wang, Ph.D.
Programmer:
Martha Timmer, M.S.
Database Manager:
Jason Carter, B.A.
Staff Assistant:
Carlo Tringale, B.A
Librarian:
Roberta Shanman, M.S.
Return to Contents
Copyright Information
This document is in the public domain and may be used and reprinted without permission except
those copyrighted materials noted for which further reproduction is prohibited without the
specific permission of copyright holders.
Return to Contents
AHRQ Publication No. 08-0030
Current as of April 2008
Internet Citation:
Health Care Efficiency Measures: Identification, Categorization, and Evaluation. AHRQ Publication No. 08-0030, April 2008, Agency for Healthcare Research and Quality, Rockville, MD. http://www.ahrq.gov/qual/efficiency/