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Determinants of hospital efficiency and patient safety in the United States

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Date Issued:
2017
Abstract/Description:
Hospitals engage in undertakings on a continual basis to enhance IT capabilities, diffusion of innovations, hospital-physician integration, and standardization to improve their performance. This empirical study explored the interdependence of three macro-level structural factors and their independent impact on the hospital performance measures efficiency and patient safety, with standardization as an important mediator. The researcher conducted a cross-sectional analysis of multiple data sets from public user files on the acute care hospital industry. The theoretical underpinnings of the study included the structure-process-outcome theory and institutional isomorphism theory. The statistical analysis comprised confirmatory factor analysis (CFA) and covariance structural equation modeling (SEM). The study comprised data for 2,352 acute care hospitals in the United States, which represented more than half of the hospital population. As expected by the hypotheses, the study demonstrated that IT capability, hospital-physician integration, and innovativeness directly affect the variability in standardization, but they did not directly influence the variation in hospital efficiency and patient safety. This revealed that hospitals should focus on standardization because it is the mediating process between structural variables and performance variables. The results indicated a strong negative influence of standardization on hospital efficiency and a weak positive influence on patient safety. The study confirmed the triadic model that (")structure(") influences the process, which in turn influences organizational outcomes. As standardization through coercive, mimetic, and normative pressure mechanisms becomes more common through system integration and increased collaborative governance, more research on how the implementation of standards may perpetuate isomorphism or uniformity is imperative. The researcher recommends future studies to employ a longitudinal study design to explore the determinants of a variety of performance and outcome indicators, such as patient satisfaction, timeliness of care, the effectiveness of care, and equity/financial performance in addition to patient safety and hospital efficiency.
Title: Determinants of hospital efficiency and patient safety in the United States.
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Name(s): Shettian, Kruparaj, Author
Wan, Thomas, Committee Chair
Noblin, Alice, Committee Member
Gurupur, Varadraj, Committee Member
Cobb, Enesha, Committee Member
Anderson, Kim, Committee Member
University of Central Florida, Degree Grantor
Type of Resource: text
Date Issued: 2017
Publisher: University of Central Florida
Language(s): English
Abstract/Description: Hospitals engage in undertakings on a continual basis to enhance IT capabilities, diffusion of innovations, hospital-physician integration, and standardization to improve their performance. This empirical study explored the interdependence of three macro-level structural factors and their independent impact on the hospital performance measures efficiency and patient safety, with standardization as an important mediator. The researcher conducted a cross-sectional analysis of multiple data sets from public user files on the acute care hospital industry. The theoretical underpinnings of the study included the structure-process-outcome theory and institutional isomorphism theory. The statistical analysis comprised confirmatory factor analysis (CFA) and covariance structural equation modeling (SEM). The study comprised data for 2,352 acute care hospitals in the United States, which represented more than half of the hospital population. As expected by the hypotheses, the study demonstrated that IT capability, hospital-physician integration, and innovativeness directly affect the variability in standardization, but they did not directly influence the variation in hospital efficiency and patient safety. This revealed that hospitals should focus on standardization because it is the mediating process between structural variables and performance variables. The results indicated a strong negative influence of standardization on hospital efficiency and a weak positive influence on patient safety. The study confirmed the triadic model that (")structure(") influences the process, which in turn influences organizational outcomes. As standardization through coercive, mimetic, and normative pressure mechanisms becomes more common through system integration and increased collaborative governance, more research on how the implementation of standards may perpetuate isomorphism or uniformity is imperative. The researcher recommends future studies to employ a longitudinal study design to explore the determinants of a variety of performance and outcome indicators, such as patient satisfaction, timeliness of care, the effectiveness of care, and equity/financial performance in addition to patient safety and hospital efficiency.
Identifier: CFE0006794 (IID), ucf:51810 (fedora)
Note(s): 2017-08-01
Ph.D.
Health and Public Affairs, Dean's Office COHPA
Doctoral
This record was generated from author submitted information.
Subject(s): hospital performance -- isomorphism -- standardization -- IT capability -- integration -- innovation -- efficiency -- patient safety
Persistent Link to This Record: http://purl.flvc.org/ucf/fd/CFE0006794
Restrictions on Access: public 2017-08-15
Host Institution: UCF

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