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Updated: Jun 6, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

Hospital efficiency and debt.

Patrick Michael Bernet¹, Michael D Rosko, Vivian G Valdmanis

¹School of Business, Florida Atlantic University, Boca Raton, FL, USA.

Journal of Health Care Finance

|November 30, 2010

Summary

This summary is machine-generated.

Hospital debt financing impacts efficiency. Recent bond issues correlate with lower inefficiency, though credit ratings show a weaker link, and inefficiency may rise post-issuance, suggesting potential debt spirals.

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Last Updated: Jun 6, 2026

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Assessment of Dependence in Activities of Daily Living Among Older Patients in an Acute Care Unit

Published on: September 30, 2020

Area of Science:

Health Economics
Hospital Financial Management
Operations Research

Background:

U.S. hospitals depend on debt financing for capital investments.
Hospital efficiency is linked to the quality and quantity of plant and equipment.
A hospital's access to debt and its credit rating may influence its operational efficiency.

Purpose of the Study:

To explore the relationship between debt financing (issuance and credit rating) and hospital cost inefficiency.
To quantify the impact of bond issuance and credit ratings on hospital efficiency using empirical data.

Main Methods:

Utilized stochastic frontier analysis (SFA) to measure cost inefficiency.
Analyzed a broad sample of U.S. hospitals and their bond issuance histories.

Main Results:

Hospitals with recent bond issues demonstrated lower cost inefficiency.
A potential, though not perfectly linear, relationship was observed between debt rating and inefficiency.
An increase in inefficiency was noted in the years following bond issuance.

Conclusions:

Recent debt issuance may be associated with improved hospital efficiency.
Credit ratings may offer some insight into hospital efficiency, but the relationship is complex.
Hospitals may experience increased inefficiency post-bond issuance, hinting at a potential 'debt death spiral'.