Global ETD Search

1	Determinants of Hospital Choice of Rural Hospital Patients: The Impact of Networks, Service Scopes, and Market Competition Roh, Chul, Lee, Keon Hyung, Fottler, Myron D. 01 August 2008 (has links) Among 10,384 rural Colorado female patients who received MDC 14 (obstetric services) from 2000 to 2003, 6,615 (63.7%) were admitted to their local rural hospitals; 1,654 (15.9%) were admitted to other rural hospitals; and 2,115 (20.4%) traveled to urban hospitals for inpatient services. This study is to examine how network participation, service scopes, and market competition influences rural women's choice of hospital for their obstetric care. A conditional logistic regression analysis was used. The network participation (p < 0.01), the number of services offered (p < 0.05), and the hospital market competition had a positive and significant relationship with patients' choice to receive obstetric care. That is, rural patients prefer to receive care from a hospital that participates in a network, that provides more number of services, and that has a greater market share (i.e., a lower level of market competition) in their locality. Rural hospitals could actively increase their competitiveness and market share by increasing the number of health care services provided and seeking to network with other hospitals. Conditional logistic regression Hospital choice Hospital competition Rural hospitals
2	Análise da competitividade entre hospitais a partir do fluxo de pacientes no DRS-XIII / Analysis of competition among hospitals from the flow of patients in DRS-XIII Chiari, Natália Santana 19 September 2014 (has links) O processamento automático de dados hospitalares tem uma grande importância nas tomadas de decisão em ambientes de saúde. Gestores e profissionais dessa área podem utilizar ferramentas e sistemas de informação que facilitem a visualização e análise destes dados. Neste sentido, o objetivo deste trabalho foi propor uma metodologia de análise que auxiliasse estes profissionais da saúde na gerência de dados hospitalares. Particularmente, esta nova abordagem foi o estudo e a inserção de uma estatística de segunda ordem, que é o caso da competição entre hospitais, no Portal Web do Observatório Regional de Atenção Hospitalar, que tem como objetivo divulgar informações estatísticas de assistência hospitalar. Para isso, foi desenvolvida uma ferramenta para expressar a competitividade entre dois hospitais a partir da medida de Aproximação Relacional proposta por Min-Woong Sohn. Os resultados mostraram que a ferramenta desenvolvida não só permitiu que fosse realizada uma classificação dos hospitais do DRS-XIII com relação à força competitiva exercida por cada um deles no mercado hospitalar, como ainda possibilitou uma maior exploração da medida proposta por Sohn. Isso se deve ao fato da ferramenta disponibilizar aos usuários um conjunto de filtros que permitem a realização de diversas consultas em tempo real. Essa característica contribuiu para a identificação de importantes fenômenos que não seriam reconhecidos no método tradicional. / The automatic processing in hospital data has great significance in making decisions at healthcare environments. Managers and professionals in this area can use tools and information systems to facilitate the view and analyze of these data. In this context, the intent of this study was to propose a methodology of analysis to support healthcare professionals in the management of hospital data. Particularly, this new approach was the study and the inclusion of a second order statistic, which is the case of competition among hospitals, in the Web Portal of the Regional Observatory of Hospital Care (Observatório Regional de Atenção Hospitalar - ORAH), which aims to disseminate statistical information of hospital care. For this, we developed a tool to express the competition among two hospitals using the measurement Relational Approach proposed by Min-Woong Sohn. The results showed that the developed tool not only allowed a classification of DRS-XIII hospitals about competitive force exerted by each of them in the hospital market, but also allowed greater exploitation of the measure proposed by Sohn. This is because the tool provide users a list of filters that allow you to perform several queries in real time. This characteristic has contributed to the identification of important phenomena that would not be recognized in the traditional method. Competitividade hospitalar Gestão em saúde Health information systems Health management Hospital competition Sistemas de informação em saúde
3	Análise da competitividade entre hospitais a partir do fluxo de pacientes no DRS-XIII / Analysis of competition among hospitals from the flow of patients in DRS-XIII Natália Santana Chiari 19 September 2014 (has links) O processamento automático de dados hospitalares tem uma grande importância nas tomadas de decisão em ambientes de saúde. Gestores e profissionais dessa área podem utilizar ferramentas e sistemas de informação que facilitem a visualização e análise destes dados. Neste sentido, o objetivo deste trabalho foi propor uma metodologia de análise que auxiliasse estes profissionais da saúde na gerência de dados hospitalares. Particularmente, esta nova abordagem foi o estudo e a inserção de uma estatística de segunda ordem, que é o caso da competição entre hospitais, no Portal Web do Observatório Regional de Atenção Hospitalar, que tem como objetivo divulgar informações estatísticas de assistência hospitalar. Para isso, foi desenvolvida uma ferramenta para expressar a competitividade entre dois hospitais a partir da medida de Aproximação Relacional proposta por Min-Woong Sohn. Os resultados mostraram que a ferramenta desenvolvida não só permitiu que fosse realizada uma classificação dos hospitais do DRS-XIII com relação à força competitiva exercida por cada um deles no mercado hospitalar, como ainda possibilitou uma maior exploração da medida proposta por Sohn. Isso se deve ao fato da ferramenta disponibilizar aos usuários um conjunto de filtros que permitem a realização de diversas consultas em tempo real. Essa característica contribuiu para a identificação de importantes fenômenos que não seriam reconhecidos no método tradicional. / The automatic processing in hospital data has great significance in making decisions at healthcare environments. Managers and professionals in this area can use tools and information systems to facilitate the view and analyze of these data. In this context, the intent of this study was to propose a methodology of analysis to support healthcare professionals in the management of hospital data. Particularly, this new approach was the study and the inclusion of a second order statistic, which is the case of competition among hospitals, in the Web Portal of the Regional Observatory of Hospital Care (Observatório Regional de Atenção Hospitalar - ORAH), which aims to disseminate statistical information of hospital care. For this, we developed a tool to express the competition among two hospitals using the measurement Relational Approach proposed by Min-Woong Sohn. The results showed that the developed tool not only allowed a classification of DRS-XIII hospitals about competitive force exerted by each of them in the hospital market, but also allowed greater exploitation of the measure proposed by Sohn. This is because the tool provide users a list of filters that allow you to perform several queries in real time. This characteristic has contributed to the identification of important phenomena that would not be recognized in the traditional method. Competitividade hospitalar Gestão em saúde Sistemas de informação em saúde Health information systems Health management Hospital competition
4	The Impact of Payer-Specific Hospital Case mix on Hospital Costs and Revenues for Third-Party Patients Lee, Keon Hyung, Chul-Young Roh, M. P.H. 01 February 2007 (has links) Competition among hospitals and managed care have forced hospital industry to be more efficient. With higher degrees of hospital competition and managed care penetration, hospitals have argued that the rate of increase in hospital cost is greater than the rate of increase in hospital revenue. By developing a payer-specific case mix index (CMI) for third-party patients, this paper examined the effect of hospital case mix on hospital cost and revenue for third-party patients in California using the hospital financial and utilization data covering 1986-1998. This study found that the coefficients for CMIs in the third-party hospital revenue model were greater than those in the hospital cost model until 1995. Since 1995, however, the coefficients for CMIs in the third-party hospital revenue model have been less than those in hospital cost models. Over time, the differences in coefficients for CMIs in hospital revenue and cost models for third-party patients have become smaller and smaller although those differences are statistically insignificant. hospital competition hospital costs hospital revenues payer-specific case mix index
5	A Determination of the Association of Competition and Regulation With Hospital Strategic Orientation Heatwole, Kathleen B. 01 January 2006 (has links) This research study examines the influence of two major forces, competition and regulation, on the strategic orientation of hospitals. This is a particularly relevant subject, as the effectiveness of competition versus the effectiveness of regulation in the health care market has been called one of the Bellwether issues in health care policy, and the most controversial and far reaching philosophical battle facing the health care industry. Even after three decades of research and debate, there is still no consensus on how the hospital industry responds to either a competitive environment or a regulated environment. There continues to be significant variation across the country on which model provides the environmental context for hospitals, and there is no resolution of the issue on the horizon. It is clear that the dichotomy of a competitive environment or a regulated environment and the wide variation from market to market will continue to be significant factors influencing the development of hospital strategies. Developing strategies that provide an appropriate fit with the particular environmental context is a critical aspect of the success of an organization.This study provides a unique perspective on the subject, with an examination of the relationship between the level of competition in the market and the level of regulation in the market, and whether these dimensions influence hospital strategic orientation. Porter's strategic orientation typology is used as the model for hospital strategy, and the theoretical framework combines the legitimacy seeking elements of institutional theory and the resource and cost control elements of resource dependency theory.The findings of this study indicate an association between a competitive environment and a differentiation orientation. As competition decreases, there is a greater likelihood of association with cost inefficiency. The results also indicate that in the absence of CON or as CON decreases, there is a greater likelihood of cost inefficiency. Although this study provides a timely analysis of a very controversial topic, it is clear that additional research efforts are needed on this critical issue that impacts every hospital in the country. economic model hospital strategy hospital competition hospital regulation health care industry hospital administration health care market health care policy Health and Medical Administration Medicine and Health Sciences
6	Disruptive Transformations in Health Care: Technological Innovation and the Acute Care General Hospital Lucas, D. Pulane 24 April 2013 (has links) Advances in medical technology have altered the need for certain types of surgery to be performed in traditional inpatient hospital settings. Less invasive surgical procedures allow a growing number of medical treatments to take place on an outpatient basis. Hospitals face growing competition from ambulatory surgery centers (ASCs). The competitive threats posed by ASCs are important, given that inpatient surgery has been the cornerstone of hospital services for over a century. Additional research is needed to understand how surgical volume shifts between and within acute care general hospitals (ACGHs) and ASCs. This study investigates how medical technology within the hospital industry is changing medical services delivery. The main purposes of this study are to (1) test Clayton M. Christensen’s theory of disruptive innovation in health care, and (2) examine the effects of disruptive innovation on appendectomy, cholecystectomy, and bariatric surgery (ACBS) utilization. Disruptive innovation theory contends that advanced technology combined with innovative business models—located outside of traditional product markets or delivery systems—will produce simplified, quality products and services at lower costs with broader accessibility. Consequently, new markets will emerge, and conventional industry leaders will experience a loss of market share to “non-traditional” new entrants into the marketplace. The underlying assumption of this work is that ASCs (innovative business models) have adopted laparoscopy (innovative technology) and their unification has initiated disruptive innovation within the hospital industry. The disruptive effects have spawned shifts in surgical volumes from open to laparoscopic procedures, from inpatient to ambulatory settings, and from hospitals to ASCs. The research hypothesizes that: (1) there will be larger increases in the percentage of laparoscopic ACBS performed than open ACBS procedures; (2) ambulatory ACBS will experience larger percent increases than inpatient ACBS procedures; and (3) ASCs will experience larger percent increases than ACGHs. The study tracks the utilization of open, laparoscopic, inpatient and ambulatory ACBS. The research questions that guide the inquiry are: 1. How has ACBS utilization changed over this time? 2. Do ACGHs and ASCs differ in the utilization of ACBS? 3. How do states differ in the utilization of ACBS? 4. Do study findings support disruptive innovation theory in the hospital industry? The quantitative study employs a panel design using hospital discharge data from 2004 and 2009. The unit of analysis is the facility. The sampling frame is comprised of ACGHs and ASCs in Florida and Wisconsin. The study employs exploratory and confirmatory data analysis. This work finds that disruptive innovation theory is an effective model for assessing the hospital industry. The model provides a useful framework for analyzing the interplay between ACGHs and ASCs. While study findings did not support the stated hypotheses, the impact of government interventions into the competitive marketplace supports the claims of disruptive innovation theory. Regulations that intervened in the hospital industry facilitated interactions between ASCs and ACGHs, reducing the number of ASCs performing ACBS and altering the trajectory of ACBS volume by shifting surgeries from ASCs to ACGHs. Disruptive Disruptive Innovation Theory Disruptive Transformations Disruptive Innovation Innovation Technology Technological Innovation Medical Innovation Medical Technology Medical Advancement Laparoscopy Laparoscopic Surgery open surgery appendectomy cholecystectomy bariatric surgery weight loss surgery appendectomies cholecystectomies inpatient outpatient ambulatory ambulatory surgery ambulatory surgery center acute care general hospital hospital acute care hospital general hospital health care healthcare hospital industry health care industry Clayton Christensen Clayton M Christensen Michael Porter Harvard Business School Virginia Commonwealth University CMS Health policy public policy public administration organizational theory organization theory Population Ecology Theory Competitive Strategy policy analysis John Kimberly Organization Size Structural Inertia liability of smallness health spending health care cost specialty medical facility open system niche width dynamic outpatient department technology shift surgical setting surgical setting shift medical facility shift substitution threat health system system level analysis Ecological Approach hospital trends ambulatory surgery trends reimbursement rate Medicare CMS coverage decision P J DiMaggio DiMaggio and Powell w w Powell Hannan and Freeman M T Hannan Organizational change minimally invasive surgery less invasive surgery Prospective Payment System Outpatient Prospective Payment System entreprenuerial physician health care organization health care management Roice Luke Carl Ameringer new technology surgical utilization elective surgery Medicare Payment Advisory Commission MedPAC coverage decision trends in surgery abdominal surgery surgical variation physician-owned physician ownership physician autonomy outpatient clinic utilization trends unnecessary surgery Pfeffer Salancik technology diffusion redefining health care interdisciplinary research health care delivery panel design diffusion of hospital technology state variation regional variation local health care market government intervention medical facility health care capacity focused factory advances in health care physician organization relationship hospital competition medical specialization hospital expansion medical arms race integrated care integrated health system J E Wennberg health care transformation reimbursement scheme surgical volume Florida Wisconsin policy making health policy analysis competitive dynamics center of excellence intervening factor service line competition service-line competition surgical reimbursement innovative business model innovative technology environmental influence established firm new market entrant patient safety sophisticated technology Harvard Divinity School Social and Behavioral Sciences

1

Page generated in 0.4976 seconds