Mitchell S; Academy for Health Services Research and Health Policy. Meeting.
Abstr Acad Health Serv Res Health Policy Meet. 2001; 18: 131.
U.C. Berkeley, 444 28th Street #30, Oakland, CA 94609, Phone: (510) 645-1327, E-mail: shannonm@uclink4.berkeley.edu
RESEARCH OBJECTIVE: The aim of this study is to assess the relationship interorganizational structure in health networks and systems and hospital level clinical quality indicators.STUDY DESIGN: The conceptual framework is based on the premise that (1) the structure of interorganizational relationships between organizations in multi-institutional delivery networks and systems differ systematically, (2) such variation plays an important role in the level of clinical integration and quality indicators within member organizations, and (3) the level of clinical integration is related to the level of quality indicators. The following hypothesis are based on prior research and literature in organizational behavior and health services research. H1a: Hospitals belonging to health systems will have higher levels of clinical integration than hospitals belonging to health networks. H1b: Hospitals belonging to health systems will have higher levels of quality indicators than hospitals belonging to health networks. H2a: Hospitals belonging to centralized health networks will have higher levels on quality indicators than hospitals belonging to decentralized health networks. H2b: Hospitals belonging to health systems will experience positive but diminishing levels of quality with increasing levels of centralizations. H2c: Hospitals belonging to centralized health networks will have higher levels of clinical integration than hospitals belonging to decentralized health networks. H2d: Hospitals belonging to health systems will experience positive but diminishing levels of integration with increasing levels of centralization. H3a: Hospitals with higher levels of clinical integration will have higher levels of quality indicators. The proposed study will draw from three primary data sources, including (1) the 1995 Taxonomy of Health Networks and Health Systems, (2) the Health Care Utilization Project State Inpatient Databases (SID), and (3) the 1997 Hospital Quality Improvement Survey, as well as other relevant data sets. The empirical analysis will contol for hospital selection into different interorganizational relationships and employ newly developed risk adjustment methods for the HCUP Quality Indicators.POPULATION STUDIED: The sample for the proposed study will consist of those hospitals that (1) are included in the 1995 Taxonomy data; (2) responded to the 1997 Hospital Quality Improvement Survey and (3) are located in the twenty-two states that participated in HCUP in 1997.PRINCIPAL FINDINGS: Currently in progress.IMPLICATIONS FOR POLICY, DELIVERY, OR PRACTICE: Quality of care provided in hospitals in the US has received increased attention due to recent findings of underuse, overuse or misuse (Chassin and Galvin, 1998). The effect of organizational structure and practices on quality of care is not well understood. The findings of this study provide a preliminary analysis of the effects of organizational structure, specifically, interorganizational networkks, on qualty of care provided by hospitals across the US. The sutdy findings may provide the basis for standards and benchmarkes regarding the organization of large multihospital networks and systems. Policy makers, researchers and hospital managers will benefits from the large sample of hospitals, operating under a range of organizational and enviornmental conditions, included in the study sample. Finally, the study serves as one of the first tests of the newly developed risk adjustmented HUCP Quality Indicators.PRIMARY FUNDING SOURCE: AHRQ Dissertation Grant
Publication Types:
Keywords:
- Data Collection
- Health Services Research
- Hospitals
- Quality Indicators, Health Care
- Risk Adjustment
- hsrmtgs
Other ID:
UI: 102273418
From Meeting Abstracts