Burman M E
School of Nursing, University of Wyoming, Laramie 82070.
Res Nurs Health. 1992 Aug;15(4):285-94. doi: 10.1002/nur.4770150407.
Visiting Nurse Associations (VNAs) and hospital-based home health care agencies (HBHHAs) were used to explore the impact of organizational environments on agency services. Disproportionate stratified random sampling, based on type and region of agency, was used to select the agencies. Seventy-three percent (120 HBHHAs and 156 VNAs) responded to the mail survey. Differences were found in the environments of the two types of agencies in funding and referral sources, amount of competition, accreditation by external bodies, and involvement in professional organizations. In terms of services, HBHHAs provided more types of high-tech services and were more likely to use external arrangements to provide services than VNAs. The organizational environment did have an impact on agency services. Medicare funding and referral sources, as environmental factors, had an impact on agency services.
访视护士协会（VNAs）和医院附属家庭医疗保健机构（HBHHAs）被用于探究组织环境对机构服务的影响。基于机构类型和地区，采用不成比例分层随机抽样来选择机构。73%（120家医院附属家庭医疗保健机构和156家访视护士协会）回复了邮件调查。在两种类型机构的环境方面，发现它们在资金和转诊来源、竞争程度、外部机构认证以及参与专业组织情况等方面存在差异。在服务方面，医院附属家庭医疗保健机构提供更多类型的高科技服务，并且比访视护士协会更有可能利用外部安排来提供服务。组织环境确实对机构服务产生了影响。医疗保险资金和转诊来源作为环境因素，对机构服务产生了影响。
