Luke R D, Ozcan Y A, Begun J W
Department of Health Administration, Medical College of Virginia, Virginia Commonwealth University, Richmond 23298-0203.
Health Serv Res. 1990 Jun;25(2):305-25.
The strategic behaviors of small multihospital systems have received little attention in the literature despite the fact that small systems are the predominant scale among multihospital systems. This study examines one important aspect of small-system strategic behaviors: the birth-order or evolutionary patterns of hospital acquisition. The evolutionary patterns of acquisition are compared across three strategic model types studied elsewhere: local market, investment, and historical. Using data obtained from a variety of sources, local market model systems are found, in the sequence of acquisition, to be significantly different from the other two model types in terms of relative distances of acquisitions from the initiating or parent hospital, the sizes of acquisition hospitals, the complexity of those hospitals, and the likelihood that the acquisitions are located in rural areas. Differences between parents and acquisitions are also significant, as hypothesized, for the market model system types, although they are not generally significant for the other two model types. The findings suggest that the market model represents an important strategic form that may have important implications for the restructuring of hospital markets.
尽管小型多医院系统在多医院系统中占主导规模，但小型多医院系统的战略行为在文献中很少受到关注。本研究考察了小型系统战略行为的一个重要方面：医院收购的出生顺序或演变模式。在其他地方研究的三种战略模型类型（本地市场、投资和历史）中比较了收购的演变模式。使用从各种来源获得的数据，发现在收购顺序方面，本地市场模型系统在收购距离发起医院或母医院的相对距离、收购医院的规模、这些医院的复杂性以及收购位于农村地区的可能性方面，与其他两种模型类型有显著差异。正如所假设的那样，对于市场模型系统类型，母医院和收购医院之间的差异也很显著，尽管对于其他两种模型类型来说，这种差异通常不显著。研究结果表明，市场模型代表了一种重要的战略形式，可能对医院市场的重组具有重要意义。
