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HSR&D 2004 National Meeting Abstracts

2046. The Management of Productivity in VHA Vocational Rehabilitation Programs
Anthony B Campinell, PhD, Psychosocial Rehabilitation Mental health Strategic Healthcare Group, VHA, Washington, DC

Objectives: The cost of inefficiency in the operation of VHA clinical programs can be substantial, whether measured by the inefficient use of scarce resources or the lack of treatment access for potential participants. The technical efficiency of 75 Compensated Work Therapy (CWT) programs was evaluated, and explanatory variables were tested for their influence on efficiency.

Methods: Measurement of efficiency was accomplished through the use of Data Envelopment Analysis (DEA), a non-parametric, production frontier analysis technique that calculates the efficiency of each program by enveloping inefficient programs in a best-practice frontier, and ranking them in relation to the most efficient. Inputs and outputs representing staffing and participant outcomes respectively were entered in the equations to determine relative efficiency among the programs.

Results: Wide variation among programs in efficient use of resources was identified. Though nearly 30% of the programs evaluated were fully efficient, inefficiency among the remaining programs represented approximately $14,000,000 in under-utilized resources. If the inefficient programs operated in a fully efficient manner, an additional 15,000 participants could be served each year. Factors showing a significant impact on efficiency were the use of case management, case review, and client focused job development.

Conclusions: Substantial inefficiency exists in CWT, and efficiency improves when evidenced based clinical practices, with substantial supporting research and acceptance in the rehabilitation community are utilized.

Impact: The vocational status of up to 15,000 veterans, twice current participation levels, could be impacted through greater efficiency in CWT programs.