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In the face of growing demand for care and tightening resource constraints, hospitals need to ensure access to care that is affordable and effective. Yet, the multiplicity of objectives is a key challenge in this industry. An understanding of the interrelationships (tradeoffs) between the multiple outcome objectives of care (throughput, experiential and financial performance) and returns to operational inputs (diversification of care) is fundamental to improving access to care that is effective and affordable. This study serves to address this need.

The empirical analysis in the study builds on an output-oriented distance function model and uses a longitudinal panel dataset from 153 hospitals in California.

This study results point to key insights related to output–output tradeoffs along the production frontier. Specifically, the authors find that higher throughput rates may lead to significantly lower levels of experiential quality, and net revenue from operations, accounting for the clinical quality of care. Similarly, the authors’ findings highlight the resource intensity and operational challenges of improving experiential quality of care. In regards to input–output relationships, this study finds diversification of care is associated with increased throughput, improvements in service satisfaction and a corresponding increase in the net revenue from operations.

Highlighting the tradeoffs along the production frontier among the various outcomes of interest (throughput, experiential quality and net revenue from operations), and highlighting the link between diversification of care and care delivery outcomes at the hospital level are key contributions of this study. An understanding of the tradeoffs and returns in healthcare delivery serves to inform policy-making with key managerial implications in the delivery of care.