Khuntia Jiban, Mejia Frances J, Ning Xue, Helton Jeff, Stacey Rulon
Health Administration Research Consortium, University of Colorado Denver, Denver, CO, United States.
Business Department, University of Wisconsin Parkside, Kenosha, WI, United States.
JMIR Form Res. 2022 Jun 15;6(6):e35317. doi: 10.2196/35317.
Given the widespread disruptions to supply chains in 2020 because of the COVID-19 pandemic, questions such as how health systems are shaping strategies to restore the supply chain disruptions are essential to have confidence in health systems' supply chain model strategies. Plausibly, health systems have an opportunity for redesign, growth, and innovation by utilizing collaborative strategies now, compared to the usual strategies of integrating their existing supply chains to reduce inefficiencies.
This study focuses on teasing out the nuance of supply chain integration versus collaborative redesign strategies for health systems in the post-COVID-19 new normal. We focus on 2 research questions. First, we explore the impact of perceived supply chain challenges and disruptions on health systems' supply chain integration (SC-INTEGRATION) and collaborative redesign (SC-REDESIGN) strategies. Second, we examine the outcomes of integration and collaborative redesign strategic choices on growth and service outcomes.
We used data for this study collected through a consultant from a robust group of health system chief executive officers (CEOs) across the United States from February to March 2021. Among the 625 health system CEOs contacted, 135 (21.6%) responded to our survey. We considered supply chain-relevant strategy and outcome variables from the literature and ratified them via expert consensus. We collected secondary data from the Agency for Healthcare Research and Quality (AHRQ) Compendium of the US Health Systems, leading to a matched data set from the 124 health systems. Next, we used ordered logit model estimation to examine CEO preferences for partnership strategies to address current supply disruptions and the outcomes of strategy choices.
Health systems with higher disruptions would choose integration (positive, P<.001) over redesign, indicating that they still trust the existing partners. Integration strategy is perceived to result in better service outcomes (P<.01), while collaborations are perceived to lead to greater growth opportunities (P<.05); however, the role of integration in growth is not entirely ruled out (combined model, P<.001). Plausibly, some health systems would choose integration and collaborative redesign models, which have a significant relationship with both services (combined model, P<.01) and growth, establishing the importance of mixed strategies for health systems.
The cost of health care continues to rise, and supply-related costs constitute a large portion of a hospital's expenditure. Understanding supply chain strategic choices are essential for a health system's success. Although collaboration is an option, focusing on and improving existing integration dynamics is helpful to foster both growth and services for health systems.
鉴于2020年因新冠疫情导致供应链广泛中断，诸如卫生系统如何制定战略来恢复供应链中断等问题，对于信任卫生系统的供应链模式战略至关重要。相比通常整合现有供应链以减少低效率的战略，卫生系统现在有可能通过利用协作战略进行重新设计、发展和创新。
本研究聚焦于梳理新冠疫情后新常态下卫生系统供应链整合与协作重新设计战略的细微差别。我们关注两个研究问题。其一，我们探讨感知到的供应链挑战和中断对卫生系统供应链整合（SC - INTEGRATION）和协作重新设计（SC - REDESIGN）战略的影响。其二，我们考察整合和协作重新设计战略选择对增长和服务成果的影响。
我们使用了2021年2月至3月通过一名顾问从美国一批实力雄厚的卫生系统首席执行官（CEO）那里收集的数据。在联系的625名卫生系统CEO中，135名（21.6%）回复了我们的调查。我们从文献中考虑了与供应链相关的战略和结果变量，并通过专家共识予以认可。我们从医疗保健研究与质量局（AHRQ）的美国卫生系统汇编中收集了二手数据，得到了来自124个卫生系统的匹配数据集。接下来，我们使用有序逻辑模型估计来考察CEO对解决当前供应中断的伙伴关系战略的偏好以及战略选择的结果。
中断程度较高的卫生系统会选择整合（正向，P <.001）而非重新设计，这表明它们仍然信任现有合作伙伴。整合战略被认为会带来更好的服务成果（P <.01），而协作被认为会带来更大的增长机会（P <.05）；然而，整合在增长方面的作用并未被完全排除（综合模型，P <.001）。一些卫生系统可能会选择整合和协作重新设计模式，这与服务（综合模型，P <.01）和增长都有显著关系，确立了混合战略对卫生系统的重要性。
医疗保健成本持续上升，与供应相关的成本占医院支出的很大一部分。理解供应链战略选择对卫生系统的成功至关重要。尽管协作是一种选择，但专注于并改善现有的整合动态有助于促进卫生系统的增长和服务。
