Davis Jullet A, Marino Louis D, Vecchiarini Mariangela
Adv Health Care Manag. 2013;14:147-65. doi: 10.1108/s1474-8231(2013)00000140011.
This paper explores the relationship between entrepreneurial orientation (EO) (i.e., their innovativeness, proactiveness and risk-taking) and financial performance in nursing homes. We hypothesize that nursing homes that are more proactive will report better short-term financial performance, while when firms with higher propensities for innovativeness and risk-taking will experience poorer financial performance in the short period due to the high costs associated with the initial adoption of innovation and with pursuing high-risks ventures.
DESIGN/METHODOLOGY/APPROACH: In 2004, a survey was developed and mailed to a population of 670 nursing homes in the state of Florida who were listed in the Florida Nursing Home Guide of the Agency for Health Care Administration. The final sample for this study included 104 respondents. The data from these surveys were merged with additional variables gathered from the 2004 Online Survey Certification and Reporting (OSCAR) system and the 2004/2005 Medicare Cost Reports (MCR). EO was operationalized using a nine-item scale adapted from Covin and Slevin (1989), and financial performance was assessed using total profit margin.
The overall findings suggest partial support for the hypotheses. Support was found for the negative relationship between innovativeness and short-term financial performance, but only partial support was found for the relationship between performance and risk-taking. Our results demonstrated that the various aspects of entrepreneurial behaviors have a differential effect on firm performance.
From a managerial perspective, nursing home administrators may continue to seek ways to be entrepreneurial while understanding that some activities may only lead to short-term profitability. These findings should not dissuade administrators from innovative behaviors. They do suggest, however, that innovative administrators should prepare for some initial decrease in profitability following new service implementation.
Findings suggest that to varying degrees, nursing home administrators may view themselves as being entrepreneurial despite the intense pressures from governments, poor public perceptions, decreasing reimbursement, more impaired residents, and increasing competition from substitute providers. Further administrators may need to manage the expectations of key stakeholders when they undertake innovative programs that will support social outcomes but which may not enhance short term financial performance.
VALUE/ORIGINALITY: This paper demonstrates the complex relationship between entrepreneurial activities and firm performance in nursing homes and has implications for the broader health care setting.
本文探讨养老院的创业导向（即创新性、主动性和冒险性）与财务绩效之间的关系。我们假设，更具主动性的养老院将报告更好的短期财务绩效，而具有较高创新和冒险倾向的公司在短期内将经历较差的财务绩效，这是由于与创新的初步采用和追求高风险项目相关的高成本。
设计/方法/途径：2004年，我们设计了一项调查，并将其邮寄给佛罗里达州医疗保健管理局《佛罗里达养老院指南》中列出的670家养老院。本研究的最终样本包括104名受访者。这些调查的数据与从2004年在线调查认证和报告（OSCAR）系统以及2004/2005年医疗保险成本报告（MCR）中收集的其他变量合并。创业导向使用从科文和斯莱文（1989年）改编的一个包含九个项目的量表进行衡量，财务绩效使用总利润率进行评估。
总体研究结果表明对这些假设提供了部分支持。研究发现了创新与短期财务绩效之间的负相关关系，但仅发现了绩效与冒险之间关系的部分支持。我们的结果表明，创业行为的各个方面对公司绩效有不同的影响。
从管理角度来看，养老院管理人员可能会继续寻求创业的方法，同时要明白有些活动可能只会带来短期盈利能力。这些发现不应劝阻管理人员进行创新行为。然而，它们确实表明，创新型管理人员在新服务实施后应准备好应对盈利能力的一些初步下降。
研究结果表明，尽管面临来自政府的巨大压力、公众的负面看法、报销减少、居民状况更差以及替代服务提供商竞争加剧，但养老院管理人员在不同程度上可能将自己视为具有创业精神。此外，当管理人员开展支持社会成果但可能不会提高短期财务绩效的创新项目时，可能需要管理关键利益相关者的期望。
价值/原创性：本文展示了养老院创业活动与公司绩效之间的复杂关系，并对更广泛的医疗保健环境具有启示意义。
