
Operations, Information and Decisions Papers
Document Type
Journal Article
Date of this Version
11-2011
Publication Source
Management Science
Volume
57
Issue
11
Start Page
1897
Last Page
1912
DOI
10.1287/mnsc.1110.1401
Abstract
We use hospital-level discharge data from cardiac patients in California to estimate the effects of focus on operational performance. We examine focus at three distinct levels of the organization—at the firm level, at the operating unit level, and at the process flow level. We find that focus at each of these levels is associated with improved outcomes, namely, faster services at higher levels of quality, as indicated by lower lengths of stay (LOS) and reduced mortality rates. We then analyze the extent to which the superior operational outcome is driven by focused hospitals truly excelling in their operations or by focused hospitals simply “cherry-picking” easy-to-treat patients. To do this, we use an instrumental variables estimation strategy that effectively randomizes the assignment of patients to hospitals. After controlling for selective patient admissions, the previously observed benefits of firm level focus disappear; focused hospitals no longer demonstrate a statistically significant reduction in LOS or mortality rate. However, at more granular measures of focus within the hospital (e.g., operating unit level), we find that more focus leads to a shorter LOS, even after controlling for selective admission effects.
Keywords
productivity, quality, health-care operations, service operations
Recommended Citation
KC, D. S., & Terwiesch, C. (2011). The Effects of Focus on Performance: Evidence from California Hospitals. Management Science, 57 (11), 1897-1912. http://dx.doi.org/10.1287/mnsc.1110.1401
Included in
Health and Medical Administration Commons, Operations and Supply Chain Management Commons
Date Posted: 27 November 2017