Total health care expenses have risen significantly in the United States. There are many factors and variables that can impact hospital operating efficiencies. Among them, engaging a distributor or group purchasing organization (GPO) is one method to influence efficiency throughout the entire supply chain. This research investigates the impact of distributors and GPOs on hospital efficiency and profitability. The data from the 2015 American Hospital Association (AHA) Annual Hospital Survey of which 6251 hospitals participated are used. These hospitals were separated by those who purchased supplies through a distributor and those who did not. Likewise, the same was performed for those hospitals that used GPO and those that did not. This study employs DEA-Solver software to develop four types of bilateral DEA models. The results of the DEA model use a ranking variable (rank sum) to rank the variables within the two groups (distributor and no distributor) to determine if there is a significant difference between distributor and nondistributor. The same is performed for GPO and non-GPO. We examined the impact of the several control variables on hospital efficiency for distributors and GPOs. Results indicate that the control variables (region, education, profit/nonprofit, government/nongovernment, and system/nonsystem) made a significant difference for hospitals that used a distributor and a GPO. Lessons and implications are discussed for future research issues, such as quality of patient care and a frontier production function.

中文翻译：

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经销商和团购组织对医院效率和盈利能力的影响：双边数据包络分析模型

美国的医疗保健总费用显着增加。有许多因素和变量会影响医院的运营效率。其中，聘请分销商或团购组织 (GPO) 是影响整个供应链效率的一种方法。本研究调查了分销商和 GPO 对医院效率和盈利能力的影响。使用来自 2015 年美国医院协会 (AHA) 年度医院调查的数据，其中 6251 家医院参与。这些医院被那些通过分销商购买物资的人和没有的人隔开。同样，对于使用 GPO 和不使用 GPO 的医院也进行了同样的操作。本研究采用 DEA-Solver 软件开发了四种双边 DEA 模型。DEA 模型的结果使用一个排名变量（rank sum）对两组（分销商和无分销商）内的变量进行排名，以确定分销商和非分销商之间是否存在显着差异。对于 GPO 和非 GPO 执行相同的操作。我们检查了几个控制变量对经销商和 GPO 医院效率的影响。结果表明，控制变量（地区、教育、利润/非营利、政府/非政府和系统/非系统）对使用分销商和 GPO 的医院产生了显着影响。讨论了未来研究问题的经验教训和影响，例如患者护理质量和前沿生产函数。