Bazzoli G J, Chan B, Shortell S M, D'Aunno T
Institute for Health Services Research and Policy Studies, Northwestern University, Evanston, IL 60208-4170, USA.
Inquiry. 2000 Fall;37(3):234-52.
The U.S. health industry is experiencing substantial restructuring through ownership consolidation and development of new forms of interorganizational relationships. Using an established taxonomy of health networks and systems, this paper develops and tests four hypotheses related to hospital financial performance. Consistent with our predictions, we find that hospitals in health systems that had unified ownership generally had better financial performance than hospitals in contractually based health networks. Among health network hospitals, those belonging to highly centralized networks had better financial performance than those belonging to more decentralized networks. However, health system hospitals in moderately centralized systems performed better than those in highly centralized systems. Finally, hospitals in networks or systems with little differentiation or centralization experienced the poorest financial performance. These results are consistent with resource dependence, transaction cost economics, and institutional theories of organizational behavior, and provide a conceptual and empirical baseline for future research.
美国医疗行业正通过所有权合并以及新型组织间关系的发展经历重大重组。本文运用已确立的医疗网络和系统分类法，提出并检验了四个与医院财务绩效相关的假设。与我们的预测一致，我们发现，统一所有权的医疗系统中的医院总体财务绩效通常优于基于合同的医疗网络中的医院。在医疗网络医院中，隶属于高度集中化网络的医院财务绩效优于隶属于更分散化网络的医院。然而，适度集中化系统中的医疗系统医院比高度集中化系统中的医院表现更好。最后，在几乎没有差异化或集中化的网络或系统中的医院财务绩效最差。这些结果与资源依赖、交易成本经济学以及组织行为的制度理论相一致，并为未来研究提供了概念和实证基础。
