Glandon G L, Counte M A
Rush-Presbyterian-St Luke's Medical Center, Chicago, IL, USA.
Health Serv Manage Res. 1995 Nov;8(4):243-51. doi: 10.1177/095148489500800404.
The adoption of new medical technologies has received significant attention in the hospital industry, in part, because of its observed relation to hospital cost increases. However, few comprehensive studies exist regarding the adoption of non-medical technologies in the hospital setting. This paper develops and tests a model of the adoption of a managerial innovation, new to the hospital industry, that of cost accounting systems based upon standard costs. The conceptual model hypothesizes that four organizational context factors (size, complexity, ownership and slack resources) and two environmental factors (payor mix and interorganizational dependency) influence hospital adoption of cost accounting systems. Based on responses to a mail survey of hospitals in the Chicago area and AHA annual survey information for 1986, a sample of 92 hospitals was analyzed. Greater hospital size, complexity, slack resources, and interorganizational dependency all were associated with adoption. Payor mix had no significant influence and the hospital ownership variables had a mixed influence. The logistic regression model was significant overall and explained over 15% of the variance in the adoption decision.
新医疗技术的采用在医院行业受到了极大关注，部分原因在于其与医院成本增加之间的明显关联。然而，关于医院环境中采用非医疗技术的全面研究却很少。本文构建并测试了一种针对医院行业全新的管理创新——基于标准成本的成本核算系统采用情况的模型。该概念模型假设四个组织背景因素（规模、复杂性、所有权和闲置资源）以及两个环境因素（付款人组合和组织间依赖性）会影响医院对成本核算系统的采用。基于对芝加哥地区医院的邮件调查回复以及1986年美国医院协会年度调查信息，对92家医院的样本进行了分析。医院规模越大、复杂性越高、闲置资源越多以及组织间依赖性越强，都与采用成本核算系统相关。付款人组合没有显著影响，医院所有权变量的影响则较为复杂。逻辑回归模型总体上具有显著性，解释了采用决策中超过15%的方差。
