Utilization: Is More Always Better? Zone of Efficiency, Complexity, and Costs of Care

Sriram Thirumalai
Corresponding Author
Sriram Thirumalai
[email protected]
https://orcid.org/0000-0001-7540-5377
Neeley School of Business, Texas Christian University, Fort Worth, Texas 76109
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Sarv Devaraj
Sarv Devaraj
[email protected]
https://orcid.org/0000-0001-5760-8162
Mendoza College of Business, University of Notre Dame, Notre Dame, Indiana 46556
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Sriram Thirumalai

Corresponding Author

Sriram Thirumalai

[email protected]

https://orcid.org/0000-0001-7540-5377

Neeley School of Business, Texas Christian University, Fort Worth, Texas 76109

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,

Sarv Devaraj

[email protected]

https://orcid.org/0000-0001-5760-8162

Mendoza College of Business, University of Notre Dame, Notre Dame, Indiana 46556

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Published Online:11 May 2026https://doi.org/10.1287/msom.2023.0702

Supplemental Material

msom.2023.0702.sm1.pdf

cover image Manufacturing & Service Operations Management

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Received:December 06, 2023
Accepted:February 24, 2026
Published Online:May 11, 2026

Copyright © 2026, INFORMS

Cite as

Sriram Thirumalai, Sarv Devaraj (2026) Utilization: Is More Always Better? Zone of Efficiency, Complexity, and Costs of Care. Manufacturing & Service Operations Management 0(0).

https://doi.org/10.1287/msom.2023.0702

Keywords

Acknowledgments

The authors thank the editor, the associate editor, and three anonymous reviewers for their constructive and thoughtful feedback. The authors acknowledge the data support from the Nationwide Inpatient Sample (NIS), the Healthcare Cost and Utilization Project (HCUP), and the Agency for Healthcare Research and Quality (AHRQ).