College of Business, Florida Atlantic University, Boca Raton, Florida.
School of Health Professions, University of Alabama at Birmingham, Birmingham, Alabama.
J Healthc Manag. 2021;66(1):48-61. doi: 10.1097/JHM-D-20-00004.
Financial distress is a persistent problem in U.S. hospitals, leading them to close at an alarming rate over the past two decades. Given the potential adverse effects of hospital closures on healthcare access and public health, interest is growing in understanding more about the financial health of U.S. hospitals. In this study, we set out to explore the extent to which relevant organizational and environmental factors potentially buffer financially distressed hospitals from closure, and even at the brink of closure, enable some to merge with other hospitals. We tested our hypotheses by first examining how factors such as slack resources, environmental munificence, and environmental complexity affect the likelihood of survival versus closing or merging with other organizations. We then tested how the same factors affect the likelihood of merging relative to closing for financially distressed hospitals that undergo one of these two events. We found that different types of slack resources and environmental forces impact different outcomes. In this article, we discuss the implications of our findings for hospital stakeholders.
财务困境是美国医院长期存在的问题，在过去的二十年中，它们以惊人的速度关闭。鉴于医院关闭对医疗保健的获取和公共卫生可能产生的不利影响，人们越来越感兴趣地了解更多关于美国医院财务状况的信息。在这项研究中，我们着手探讨相关的组织和环境因素在多大程度上可以缓冲财务困境中的医院免于关闭，甚至在濒临关闭的情况下，使一些医院能够与其他医院合并。我们通过首先检查诸如冗余资源、环境丰饶度和环境复杂性等因素如何影响生存或与其他组织合并的可能性来检验我们的假设。然后，我们测试了对于经历这两种情况之一的财务困境医院，相同的因素如何影响合并相对于关闭的可能性。我们发现，不同类型的冗余资源和环境力量会产生不同的结果。在本文中，我们讨论了我们的研究结果对医院利益相关者的意义。
