Hospitals' Choices and the Institutional Environment PDF Download

Author: Cory E. Cronin
Publisher:
ISBN:
Category : Medical care
Languages : en
Pages : 0

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Book Description
Hospitals are social institutions that play multiple societal roles and respond to pressures exerted upon them by policy changes, societal expectations, and fiscal realities. Previous literature documents the charitable history of hospitals, but in recent years, much attention has been paid to a shift to a more corporate environment within the health care sector. Recent policy changes, however, have brought a renewed focus to ways in which hospitals interact with their communities. Using an institutional theory framework, this research identifies ways in which environmental pressures affect choices hospitals make regarding community benefit and business-like practices and what the effects of these choices might be. Due to the complex nature of hospital organizations, a wide range of factors influences their operation and their relationships with their communities, including organizational, market and regulative factors. This study brings together data from multiple sources to offer a more complete picture of the pressures on hospitals, including the American Hospital Association Annual Survey for 2004, 2006, 2008, and 2010, the Dartmouth Atlas of Health Care, and The Hilltop Institute. Using multilevel logistic and linear regression analyses as well as descriptive statistics, this study provides evidence that hospital community benefit participation is gaining increasing traction within the health care environment and that policy is a factor. Particularly, state and federal policies requiring hospitals to publicly report community benefit participation are tied to higher levels of participation. It is also notable that higher participation in business-like practices is positively associated with community benefit participation, indicating that these values are not competing in nature. This research shows that community benefit participation can be beneficial to both organizations and their communities. High levels of community benefit participation are tied to stronger organizational performance measures. Within the market, greater levels of community health education initiatives are associated with better health outcomes. Findings from this work provide organizations with a better understanding of ways in which engaging in community practices may be mutually beneficial to organizations and their communities. Furthermore, future policy makers should note the success of policies that emphasize public accountability in regard to hospital community benefit participation.