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The context, strategy and performance of the American safety net primary care providers: a systematic review

Seongwon Choi (Department of Health Care Administration, Trinity University, San Antonio, Texas, USA)
Robert Weech-Maldonado (Department of Health Services Administration, University of Alabama at Birmingham, Birmingham, Alabama, USA)
Thomas Powers (Department of Marketing, Industrial Distribution and Economics, University of Alabama at Birmingham, Birmingham, Alabama, USA)

Journal of Health Organization and Management

ISSN: 1477-7266

Article publication date: 25 June 2020

Issue publication date: 16 July 2020

209

Abstract

Purpose

The objective of this research is to synthesize evidence on the relationship between context, strategies and performance in the context of federally qualified health centers (FQHCs), a core safety net health services provider in the United States. The research also identifies prior approaches to measure contextual factors, FQHC strategy and performance. Gaps in the research are identified, and directions for future research are provided.

Design/methodology/approach

A systematic review of peer-reviewed journal articles published between the years 1997 and 2017 was conducted using a bibliographic search of PubMed, Business Source Premier and ABI/Inform databases.

Findings

28 studies were selected for the analysis. Results supported associations among contextual factors (organizational and environmental) and FQHC strategy and FQHC performance. The research also indicates that previous research was primarily emphasized on clinical performance with less focus on other types of FQHC performance. In addition, there exists a wide variability in terms of measuring context, FQHC strategy and performance.

Originality/value

Operating in resource-scarce and highly constraining environments, FQHCs have demonstrated the ability to stay innovative and competent as serving often unhealthier and costlier patient populations. To date, there has been no study that reviewed the relationships between context, FQHC strategy and FQHC performance. In addition, there is an absence of consensus on how context, FQHC strategy and FQHC performance are measured. This study is the first that examined context–strategy–performance relationships in the context of FQHCs.

Keywords

Citation

Choi, S., Weech-Maldonado, R. and Powers, T. (2020), "The context, strategy and performance of the American safety net primary care providers: a systematic review", Journal of Health Organization and Management, Vol. 22 No. 3, pp. 529-550. https://doi.org/10.1108/JHOM-11-2019-0319

Publisher

:

Emerald Publishing Limited

Copyright © 2020, Emerald Publishing Limited

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