Golladay, Fredrick L., Marilyn E. Manser, and Kenneth R. Smith. 1974. "Scale Economies in the Delivery of Medical Care: A Mixed Integer Programming Analysis of Efficient Manpower Utilization." Journal of Human Resources 9(1):50-62.

This paper presents an activity analysis model of primary medical care which, through the use of integer constraints, captures both the technology of ambulatory care and the institutional restriction that labor inputs must be employed in discrete units. The result is that staffing patterns and optimal choice of techniques depend on the scale of practice. Empirical experiments demonstrate this relationship and, furthermore, reveal that introduction of physician extenders into the medical care system increases the scale at which economies of staffing are obtained and raises the diseconomies of suboptimal practice.

The authors are, respectively, Assistant Professor of Economics, University of Wisconsin, Madison; Assistant Professor of Economics, State University of New York at Buffalo; and Associate Professor of Economics, University of Wisconsin, Madison. The work upon which this paper was based was performed pursuant to Contract No. HSM-110-70-355 and Contract No. HEW-OS-72-183 with the U.S. Department of Health, Education, and Welfare. The authors wish to acknowledge the valuable comments of Professor Richard H. Day and Dr. Stanley Wallack.

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US ISSN 0022-166X

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