Organizational change has become commonplace among U.S. hospitals. Empirical investigations of the consequences of organizational change, however, are relatively scarce, and findings of existing studies are inconsiste...
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Organizational change has become commonplace among U.S. hospitals. Empirical investigations of the consequences of organizational change, however, are relatively scarce, and findings of existing studies are inconsistent. In this article, the authors review the rationale and performance implications of hospital organizational change in three areas: (1) the development of new multi-institutional arrangements, (2) change in traditional ownership and management configurations, and (3) diversification in organizational products/services and consolidation of organizational scale. Empirical research on hospital change published between 1980 and 1999 in the health services research, social science, and business literatures is reviewed to highlight the potential pitfalls that hospitals may encounter in their effort to remain viable. The article also summarizes the strengths and weaknesses of current hospital change research and provides specific suggestions for future research in this area.
With the recent formation of the Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia, a number of challenges have arisen that must be addressed. One involves the porter service, which faces increased dem...
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With the recent formation of the Queen Elizabeth II Health Sciences Centre in Halifax, Nova Scotia, a number of challenges have arisen that must be addressed. One involves the porter service, which faces increased demands since every department has new and often expanded duties for porters. This paper identifies obstacles facing the porter service and develops recommendations, which may also be of interest to other healthcare facilities facing similar challenges.
Many hospitals are turning to cluster relationships to gain the benefits of diversification without the troubles of increased capital costs and management conflicts. The goal of healthcare clusters is to provide a con...
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Remote data exchange is extremely useful to a number of medical applications. It requires an infrastructure including systems, network and software tools. With such an infrastructure, existing local applications can b...
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Remote data exchange is extremely useful to a number of medical applications. It requires an infrastructure including systems, network and software tools. With such an infrastructure, existing local applications can be extended to serve national needs. There are many approaches to providing remote data exchange. Selection of an approach for an application requires balancing of various factors, including the need for rapid interactive access to data and ad hoc queries, the adequacy of access to predefined data sets, the need for an integrated view of the data, the ability to provide adequate security protection, the amount of data required, and the time frame in which data is required. The applications described here demonstrate new ways that the VA is reaping benefits from its infrastructure and its compatible integrated hospital information systems located at its facilities. The needs that have been met are also needs of private hospitals. However, in many cases the infrastructure to allow data exchange is not present. The VA's experiences may serve to establish the benefits that can be obtained by all hospitals.
作者：
BOOTH, FVMHASSETT, JMDepartment of Surgery
School of Medicine and Biomedical Sciences State University of New York at Buffalo 100 High Street Buffalo New York 14203-1154
Woolley (1989) attempted to analyze the competitive impact of horizontal hospital mergers using the 'event study' method. Woolley characterized his results as consistent with traditional 'oligopoly' th...
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Woolley (1989) attempted to analyze the competitive impact of horizontal hospital mergers using the 'event study' method. Woolley characterized his results as consistent with traditional 'oligopoly' theories of market behavior. We scrutinize in detail a large number of his events, however, and find that most either generated concentration increases too small to plausibly produce market power, or could not have conferred monopoly returns on firms improperly characterized as rivals. Accordingly, any observed abnormal returns are likely attributable to some other cause; we suggest some alternative interpretations of his results. Our paper highlights the need for care in the selection of events and the identification of rivals when applying the event study method to the analysis of mergers.
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