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Benchmarking and networking through collaborative groups.

Journal for healthcare quality : official publication of the National Association for Healthcare Quality 1996年第1期18.0卷 26-31页

作者： Hodges, R. Kelley, L. Wilkes, A. SunHealth Alliance Inc. Charlotte NC United States

The search for better ways to deliver healthcare services at lower cost led a group of hospitals in the Carolinas, 2 years ago, to pioneer a new concept, the collaborative group. A collaborative group typically is composed of five or six similar (but not competing) hospitals that work together closely to help each other make the changes necessary to survive in an increasingly competitive marketplace. Hospital staff members at all levels are able to work together to discover improvement opportunities through benchmarking teams and networking efforts. This article describes their experiences, achievements, and lessons learned.

关键词：效率组织/标准集中研讨小组团体处理医院管理人员/组织和管理机构管理小组/组织和管理机构间关系模型组织管理多机构系统/经济学多机构系统/组织和管理多机构系统/标准北卡罗来纳组织改革组织目标同侪集群南卡罗来纳人类

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Multihospital System Affiliation as a Survival Strategy for Rural Hospitals Under the Prospective Payment System

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The Journal of Rural Health 1992年第2期8卷 93-105页

作者： Halpern, Michael T. Alexander, Jeffrey A. Fennell, Mary L. Department of Public Health Policy and Administration University of Michigan in Ann Arbor Michigan United States Health Services Management and Policy University of Michigan Ann Arbor Michigan United States Pennsylvania State University University Park Pennsylvania United States

The introduction of Medicare's Prospective Payment System (PPS) has disproportionately increased financial pressures on rural hospitals and posed challenges to the survival of these institutions. Increasingly, rural hospitals are seeking strategies that can enhance their chances for survival in a turbulent and hostile environment. This study examined the survival effects of one such strategy, multihospital system affiliation. Specifically, we assessed: (1) whether and how different types of system affiliation in the post‐PPS era affect the likelihood of rural hospital survival;(2) whether particular structural, environmental and hospital performance characteristics moderate the effects of system affiliation on rural hospital survival;and (3) whether systematic selection by rural hospitals into multihospital systems potentially accounts for observed relationships between system affiliation and survival. Proportional hazards analyses indicate that system affiliation with investor‐owned systems significantly reduces survival probabilities of rural hospitals. Affiliation with not‐for‐profit systems or system affiliation under contract management arrangements does not affect survival probabilities of rural hospitals. These general findings are moderated by the effects of hospital ownership and size at the time of affiliation. Finally, study findings indicated that systematic selection by poor performing rural hospitals into investor‐owned systems has occurred in the post‐PPS era. No evidence of selection into not‐for‐profit systems was discovered. Copyright © 1992, Wiley Blackwell. All rights reserved

关键词：合同业务/经济学财务管理医院/发展趋势卫生设施关闭/统计学和数值数据卫生服务研究/方法医院乡村/经济学医院乡村/组织和管理多机构系统/经济学多机构系统/统计学和数值数据多元分析所有权/经济学预期支付系统/经济学回归分析危险美国

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Does system membership enhance financial performance in hospitals?

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MEDICAL CARE RESEARCH AND REVIEW 2000年第1期57卷 29-50页

作者： Tennyson, DH Fottler, MD Birmingham So Coll Dept Business & Grad Programs Birmingham AL 35213 USA Univ Cent Florida Orlando FL 32816 USA

While hospitals continue to join multi-institutional systems, empirical data on the bene fits of system membership are ambiguous. This study examines the same 166 Florida hospitals in 1986 and 1992. System membership, in general, did not enhance financial returns (measured by operating margin, total margin, and return on assets) for the pooled data or for either year. In fact, a significant negative relationship is noted in 1986. However, when only hospitals affiliated with national systems (in this study, American Medical International, Hospital Corporation of America, or Humans) are analyzed, a positive statistically significant association is found for two of the above three profitability indicators for both the pooled data and for 1986. However, there was no statistically significant impact noted for 1992. Reasons for the apparent discrepancy in the impact of national versus local/regional systems on hospital financial performance and the apparent declining ability of national systems to generate above-average returns are explored.

关键词：财务管理医院/标准佛罗里达卫生服务研究医院综合/经济学收入/统计学和数值数据最小二乘法分析 Meta分析模型经济计量学多机构系统/经济学组织隶属关系/经济学人类

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EXPLORING HOSPITAL PRODUCTION RELATIONSHIPS WITH FLEXIBLE FUNCTIONAL FORMS

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JOURNAL OF HEALTH ECONOMICS 1990年第1期9卷 1-21页

作者： VITA, MG FED TRADE COMMISS BUR ECONWASHINGTONDC 20580 USA

This paper estimates a multiproduct variable cost function using data on a sample of California hospitals. The results provide useful insights into the advantages and disadvantages of flexible functional forms for cost analysis. The translog function appears to provide reasonable estimates of marginal costs when evaluated at or near the approximation point of the function. The estimated function performs less satisfactorily, however, when evaluated outside this range. The paper's results do not provide strong evidence of either ray scale economies or of weak cost complementarities. There is some evidence, however, that the degree of scale economies may be underestimated.

关键词：加利福尼亚成本及成本分析/方法经济学医院/统计学和数值数据效率医院病床数住院时间/统计学和数值数据模型统计学多机构系统/经济学所有权病人出院/统计学和数值数据生产线管理/经济学抽样研究

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A Prognosis for the Rural Hospital: Part II: Are Rural Hospitals Economically Viable?

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The Journal of Rural Health 1985年第2期1卷 11-33页

作者： Moscovice, Ira Rosenblatt, Roger A. IRA MOSCOVICE Ph.D. is Associate Professor and Associate Director of the Center for Health Services Research at the University of Minnesota. He is the co-author of Rural Health Care (Wiley 1982). His work has focused on the use of health services research to improve policy decision making in state government. ROGER A. ROSENBLA'IT M.D. M.P.H. is Associate Professor and Director of the Research Section of the Department of Family Medicine at the University of Washington. He is currently principal investigator of a project funded by the W.K. Kellogg Foundation to improve the professional and fiscal functioning of rural hospitals in the Pacific Northwest. Dr. Rosenblatt was the 1985 recepient of the Distinguished Research Award of the American Rural Health Association.

This is the second of a two part series that summarizes what is known about the operation and performance of the rural hospital and discusses potential options and strategies for strengthening the viability of these institutions. In Part II, we focus on the economic viability of the rural hospital and examine external factors that influence the environment within which the rural hospital operates. We conclude that the future will remain precarious for rural hospitals and that they can hope to improve their economic viability only if they are able to determine where they fit as part of the larger health care system. Copyright © 1985, Wiley Blackwell. All rights reserved

关键词：病床调整经济学医院设施的规章和管理财务管理医院/发展趋势预测卫生人力/供应和分配医院改组/经济学医院乡村/经济学多机构系统/经济学美国

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Pharmaceutical costs higher at system hospitals, but rising faster at nonsystem facilities

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AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY 1999年第17期56卷 1702-1702页

作者： [Anonymous]

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