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Health care efficiency is a comparison of delivery system outputs, such as physician vists, RVU's, or health outcomes, with inputs like cost, time, or material. Efficiency can be reported then as a ratio of outputs to inputs or a comparison to optimal productivity using stochastic frontier analysis or data envelopment analysis.

One difficulty in creating a generalized efficiency measure is comparability of outputs. For example, if hospital A discharges 100 people at an average cost of $8000, while hospital B discharges 100 at $7000, the presumption may be that B is more efficient, but hospital B may be discharging patients with poorer health that will require readmission and net higher costs to treat.

Increasing quality
In health care poor quality can mean patients need more services at greater expense. For example, if a patient is repeatedly misdiagnosed, they may return to the ER or doctor's office presenting the same symptoms that remain unresolved, increasing the overall use of health care resources.

Variations in provider practices
"Among the 306 hospital referral regions in the United States, price-adjusted Medicare reimbursements varied twofold in 2014, from about $7,000 per enrollee in the lowest spending region to more than $13,000 in the highest spending region."

"Variation in clinical practice is substantial and is associated with poorer health outcomes, increased costs, and disparities in care. Despite these efforts, practice variation has been difficult to overcome. Challenges to reducing variation include heterogeneity and gaps in clinicians’ knowledge; economic incentives for undesired clinical behaviors; concerns about malpractice risk; physicians’ value of autonomy and personal preference; inadequate communication and decision support tools; and imbalances between clinical demand and resource capacity. Another fundamental barrier to practice standardization is that good clinical practice must sometimes vary to reflect a patient’s specific social, environmental, and biological situation. Sometimes a standard practice would not be best for a given patient. Hence, efforts to legislate or establish policies governing care have been limited because they impede the common sense that there are nearly always exceptions to a given rule."

Care coordination
Effectively sharing information among the providers participating in a patient's care can increase quality and reduce costs. Care fragmentation can result in duplication of tests, preventable hospitalizations, and increased costs.

Electronic health records are developed with the hope of improving care coordination.

Cost sharing
Cost sharing refers to various schemes to ensure health care resources aren't overused. In many health systems, the patient doesn't bear the full cost of services. If the person making the purchase decision effectively sees no cost, the demand for that service would tend to rise. In health care this could manifest as emergency room visits for minor ailments that could be managed through other less expensive remedies like primary care or nursing hotlines.

Common cost sharing mechanisms include copays and deductibles.

Increasing access
If a patient doesn't have access to the appropriate care because they cannot afford it, they may delay treatment until the cost of that treatment and the morbidity of the disease has increased, or choose more expensive emergency care.

Some research suggests people lacking insurance use emergency rooms more. While another study that looked at the population level found that US states that expanded Medicaid actually saw an increase in ER use per capital compared to states that didn't expand access, though it didn't control for other possible variables.

Administrative costs
A 2017 Commonwealth Fund report found that hospital administrative costs comprise 1.43% of GDP in the US, but only 0.41% in Canada.

Administration costs also exist in insurance systems. In the US estimates for Medicare administrative costs range from 2 to 5%, while private insurance estimates have ranged from 12 to 18%. The affordable care act requires insurers to maintain medical loss ratios of at least 80%.