Skip to main content
Log in

Relative economic efficiency in Texas nursing facilities: A profit function analysis

  • Published:
Journal of Economics and Finance Aims and scope Submit manuscript

Abstract

The purpose of this analysis is to examine the relative economic efficiency of profit-seeking versus nonprofit nursing facilities. A Cobb-Douglas profit function is used on cross-sectional data to determine the technical efficiency, price efficiency, and overall economic efficiency of Texas nursing facilities. Ownership form influences the profit level of the firm. Profit-seeking firms are more economically efficient than their nonprofit counterparts. Inclusion of price efficiency analyses reinforces profit-seeking firms’ superior technical efficiency. Additionally, nursing facilities are price takers in the output market as well as in resource markets, indicating effective industry regulation.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Subscribe and save

Springer+ Basic
$34.99 /Month
  • Get 10 units per month
  • Download Article/Chapter or eBook
  • 1 Unit = 1 Article or 1 Chapter
  • Cancel anytime
Subscribe now

Buy Now

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Alchian, A.A., and H. Demsetz. 1972. “Production, Information Costs, and Economic Organization.”The American Economic Review 62: 777–795.

    Google Scholar 

  • Atkinson, Scott E., and Robert Halvorsen. 1980. “A Test of Relative and Absolute Price Efficiency in Regulated Utilities.”Review of Economics and Statistics 62: 81–88.

    Article  Google Scholar 

  • Arling, Greg, Richard H. Nordquist, and John A. Capitman. 1987. “Nursing Home Cost and Ownership Type: Evidence of Interaction Effects.”Health Services Research 22: 255–269.

    Google Scholar 

  • Bishop, Christine, and Avi Dor. 1994. “Medicare Costs in Urban and Rural Nursing Homes: Are Differential Payments Required?”Inquiry 31: 153–162.

    Google Scholar 

  • Claggett, E. Tylor, Jr., Daniel R. Hollas, and Stanley R. Stansell. 1995. “The Effects of Ownership Form on Profit Maximization and Cost Minimization Behavior within Municipal and Cooperative Electrical Distribution Utilities.”The Quarterly Review of Economics and Finance 35: 533–550.

    Article  Google Scholar 

  • Cowing, Thomas G. 1978. “The Effectiveness of Rate-of-Return Regulation: An Empirical Test Using Profit Functions.” InProduction Economies: A Dual Approach to Theory and Application, edited by M. Fuss and D. McFadden. New York: North Holland.

    Google Scholar 

  • Dahlman, C.J. 1979. “The Problem of Externalities.”The Journal of Law and Economics 21: 141–162.

    Article  Google Scholar 

  • Davis, Mark A. 1993. “Nursing Home Ownership Revisited: Market, Cost and Quality Relationships.”Medical Care 31: 1062–1068.

    Article  Google Scholar 

  • De Alessi, Louis. 1974. “An Economic Analysis of Government Ownership and Regulation: Theory and Evidence from the Electric Power Industry.”Public Choice 19: 1–42.

    Article  Google Scholar 

  • —. 1983. “Property Rights, Transactions Costs, and X-Efficiency: An Essay on Economic Theory.”The American Economic Review 73: 64–81.

    Google Scholar 

  • Demsetz, Harold. 1966. “Some Aspects of Property Rights.”The Journal of Law and Economics 9: 61–70.

    Article  Google Scholar 

  • —. 1967. “Toward a Theory of Property Rights.”The American Economic Review 57: 347–359.

    Google Scholar 

  • —. 1968. “Why Regulate Utilities?”The Journal of Law and Economics 11: 55–65.

    Article  Google Scholar 

  • Diewert, W.E. 1971. “An Application of the Shephard Duality Theorem: A Generalized Leontieff Production Function.”Journal of Political Economy 79: 481–507.

    Article  Google Scholar 

  • —. 1973. “Functional Forms for Profit and Transformation Functions.”Journal of Economic Theory 6: 284–316.

    Article  Google Scholar 

  • Furubotn, Eirik G., and Svetozar Pejovich. 1972. “Property Rights and Economic Theory: A Survey of Recent Literature.”Journal of Economic Literature 10: 1137–1162.

    Google Scholar 

  • Gaynor, Martin, and Gerard F. Anderson. 1995. “Uncertain Demand, the Structure of Hospital Costs, and the Cost of Empty Hospital Beds.”The Journal of Health Economics 14: 291–317.

    Article  Google Scholar 

  • Hoerger, Thomas J. 1991. “Profit' Variability in For-profit and Not-for-profit Hospitals.”The Journal of Health Economics 10: 259–289.

    Article  Google Scholar 

  • Holahan, John. 1985. “State Rate-Setting and Its Effects on the Cost of Nursing Home Care.”Journal of Health Politics, Policy and Law 9: 647–668.

    Google Scholar 

  • Hollas, Daniel R., and Stanley R. Stansell. 1988a. “An Examination of the Effect of Ownership Form on Price Efficiency: Proprietary, Cooperative and Municipal Electric Utilities.”Southern Economic Journal 55: 331–350.

    Article  Google Scholar 

  • —. 1988b. “Regulation, Interfirm Rivalry, and the Economic Efficiency of Natural Gas Distribution Facilities.”Quarterly Review of Economics and Business 28: 21–37.

    Google Scholar 

  • —. 1991. “Regulation, Ownership Form and the Economic Efficiency of Rural Electric Distribution Cooperatives.”Review of Regional Studies 21: 201–220.

    Google Scholar 

  • —. 1994. “The Economic Efficiency of Public vs. Private Gas Distribution Utilities.”Annals Of Public and Cooperative Economics 65: 280–300.

    Article  Google Scholar 

  • Hollas, Daniel R., Stanley R. Stansell, and E. Tylor Claggett, Jr. 1994. “Ownership Form and Rate Structure: An Examination of Cooperative and Municipal Electric Distribution Utilities.”Southern Economic Journal 61: 519–529.

    Article  Google Scholar 

  • Jensen, Michael C., and William H. Meckling. 1976. “Theory of the Firm: Managerial Behavior, Agency Costs and Ownership Structure.”Journal of Financial Economics 3: 305–360.

    Article  Google Scholar 

  • — 1979. “Rights and Production Functions: Application to Labor-Managed Firms and Codetermination.”Journal of Business 52: 469–506.

    Article  Google Scholar 

  • Lau, Lawrence J. 1973. “Profit Functions of Technologies with Multiple Inputs and Outputs.”Review of Economics and Statistics 54: 281–289.

    Article  Google Scholar 

  • —. 1978a. “Application of Profit Functions.” InProduction Economics: A Dual Approach to Theory and Application, edited by M. Fuss and D. McFadden. New York: North Holland.

    Google Scholar 

  • — 1978b. “Testing and Imposing Monotonicity, Convexity and Quasi-Convexity Constraints.” InProduction Economics: A Dual Approach to Theory and Applications, edited by M. Fuss and D. McFadden, New York: North Holland, 409–453.

    Google Scholar 

  • Lau, Lawrence J., and Pan A. Yotopoulos. 1971. “A Test for Relative Efficiency and Application to Indian Agriculture.”American Economic Review 61: 94–109.

    Google Scholar 

  • — 1972. “Profit, Supply and Factor Demand Functions.”American Journal of Agricultural Economics 54: 11–18.

    Article  Google Scholar 

  • Lee, M.L. 1971. “A Conspicuous Production Theory of Hospital Behavior.”Southern Economic Journal 38: 48–58.

    Article  Google Scholar 

  • Marion Merrell Dow, Inc. 1997.Institutional Digest.

  • McCue, Michael J., Jan P. Clement, and Thomas J. Hoerger. 1993. “The Association of Ownership and System Affiliation with Financial Performance of Inpatient Psychiatric Hospitals.”Inquiry 30: 306–317.

    Google Scholar 

  • McFadden, D.L. 1978. “Cost, Revenue, and Profit Functions.” InProduction Economics: A Dual Approach to Theory and Application, edited by M. Fuss and D. McFadden. New York: North Holland.

    Google Scholar 

  • McKay, Niccie L. 1991. “The Effect of Chain Ownership on Nursing Home Costs.”Health Services Research 26: 109–124.

    Google Scholar 

  • Mullineaux, Donald J. 1978. “Economies of Scale and Organizational Efficiency in Banking: A Profit-Function Approach.”Journal of Finance 33: 259–280.

    Article  Google Scholar 

  • Newhouse, J.P. 1973. “Towards a Theory of Nonprofit Institutions: An Economic Model of a Hospital.”American Economic Review, 60: 87–92.

    Google Scholar 

  • Nyman, John A. 1988a. “Excess Demand, the Percentage of Medicaid Residents, and the Quality of Nursing Home Care.”The Journal of Human Resources 23: 76–91.

    Article  Google Scholar 

  • — 1988b. “The Effect of Competition on Nursing Home Expenditures Under Prospective Reimbursement.”Health Services Research 23: 555–574.

    Google Scholar 

  • Pauly, M.V., and M. Redisch. 1973. “The Not-for-Profit Hospital as a Physicians' Cooperative.”American Economic Review 63: 87–99.

    Google Scholar 

  • Rousseeuw, Peter J., and Annick M. Leroy. 1987.Robust Regression and Outlier Detection. New York: Wiley.

    Google Scholar 

  • Sareewiwatthana, Salya, Stanley R. Stansell, and Dan R. Hollas. 1991. “Price Efficiency, Technical Efficiency, Regulation and the Economic Efficiency of Credit Unions.”The International Journal of Finance 4: 107–134.

    Google Scholar 

  • Scanlon, William J. 1980. “A Theory of the Nursing Home Market.”Inquiry 17: 25–41.

    Google Scholar 

  • Schlenker, Robert 1991. “Nursing Home Costs, Medicaid Rates and Profits under Alternative Medicaid Payments Systems.”Health Services Research 26: 623–649.

    Google Scholar 

  • Schlenker, Robert, and Peter Shaughnessy. 1984. “Case Mix, Quality, and Cost Relationships in Colorado Nursing Homes.”Health Care Financing Review 6: 61–71.

    Google Scholar 

  • Shephard, R.W. 1953.Cost and Production Functions. Princeton: Princeton University Press.

    Google Scholar 

  • Stansell, Stanley R., and Daniel R. Hollas. 1988. “An Examination of the Economic Efficiency of Class I Railroads: A Profit Function Analysis.”Review of Industrial Organization: 93–117.

  • — 1990. “An Examination of the Relative Economic Efficiency of Mutual vs. Stock Savings Institutions.”The Journal of Real Estate Finance and Economics 3: 73–90.

    Article  Google Scholar 

  • Stigler, George J. 1976. “The Xistence of X-Efficiency.”The American Economic Review 66: 213–216.

    Google Scholar 

  • Stutzman, J.R., and Stanley R. Stansell. 1992. “An Examination of the Relative Economic Efficiency of Commercial vs. Cooperative Telephone Companies.”The Journal of Economics and Finance 16: 47–68.

    Article  Google Scholar 

  • Texas Administrative Code. 1999. Tit. 40, part 1, §§ 19.2322, 19.2324–19.2325.

  • Texas Department of Human Services. 1994.Texas Medicaid Nursing Facility 1994 Cost Report. Austin, TX.

  • Texas Health Care Association. 1997.Basic Facts About Texas Nursing Facilities. Austin, TX.

  • Tuckman, H.P., and C.F. Chang. 1988. “Cost Convergence Between For-Profit Nursing Homes: Does Competition Matter?”Quarterly Review of Economics and Business 28: 50–65.

    Google Scholar 

  • Ullmann, Steven G. 1987. “Ownership, Regulation, Quality Assessment, and Performance in the Long-Term Health Care Industry.”Gerontologist 27: 233–239.

    Google Scholar 

  • Yotopoulos, Pan A., and Lawrence J. Lau. 1973. “A Test for Relative Economic Efficiency: Some Further Results.”The American Economic Review 63: 214–223.

    Google Scholar 

  • Zellner, Arnold. 1962. “An Efficient Method of Estimating Seemingly Unrelated Regression and Tests for Aggregation Bias.”Journal of The American Statistical Association 57: 348–368.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Kris Joseph Knox.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Knox, K.J., Blankmeyer, E.C. & Stutzman, J.R. Relative economic efficiency in Texas nursing facilities: A profit function analysis. J Econ Finan 23, 199–213 (1999). https://doi.org/10.1007/BF02757705

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF02757705

Keywords