Alexander J A, Morrisey M A
Department of Health Services Administration, School of Community and Allied Health, University of Alabama, Birmingham 35294.
Med Care. 1988 Feb;26(2):159-76. doi: 10.1097/00005650-198802000-00007.
The growing literature on multihospital systems (MHS) has concentrated on assessing system performance without a concurrent examination of the assumptions related to the conditions under which hospitals and systems affiliate with each other. Using a net present-value framework the current study develops and tests a model that explains the entry patterns of hospitals into multihospital systems. Specifically, we assess the role of the hospital's market, management activity, and mission compatibility with the system as predisposing conditions of MHS affiliation. The model is tested on a sample of 306 affiliated and 918 nonaffiliated hospitals under conditions of market equilibrium and disequilibrium, and for hospital entry into both non-profit and investor-owned multihospital systems. Results suggest that the relative impact of market factors, hospital management characteristics, and mission compatibility on MHS entry will vary systematically as a function of assumptions about the hospital's market and the type of system with which the hospital affiliates.
关于多医院系统（MHS）的文献越来越多，这些文献主要集中在评估系统绩效上，而没有同时考察与医院和系统相互附属的条件相关的假设。本研究使用净现值框架，开发并测试了一个解释医院进入多医院系统的进入模式的模型。具体而言，我们评估医院的市场、管理活动以及与系统的使命兼容性作为多医院系统附属的前置条件所起的作用。该模型在306家附属医院和918家非附属医院的样本上进行了测试，测试条件包括市场均衡和非均衡情况，以及医院进入非营利性和投资者所有的多医院系统的情况。结果表明，市场因素、医院管理特征和使命兼容性对多医院系统进入的相对影响将根据关于医院市场的假设以及医院附属的系统类型而系统地变化。
