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Article

Seongwon Choi, Robert Weech-Maldonado and Thomas Powers

The objective of this research is to synthesize evidence on the relationship between context, strategies and performance in the context of federally qualified health…

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.

Details

Journal of Health Organization and Management, vol. 22 no. 3
Type: Research Article
ISSN: 1477-7266

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Book part

Robert Weech-Maldonado, Mona Al-Amin, Robyn Y. Nishimi and Fatema Salam

According to the Census, racial/ethnic minority populations are growing at such a fast rate that by 2050 more than 50% of the population will belong to a minority group…

Abstract

According to the Census, racial/ethnic minority populations are growing at such a fast rate that by 2050 more than 50% of the population will belong to a minority group (US Census, 2001). The increasing diversity of the U.S. population is one of the many changes that health care delivery organizations need to proactively address in order to better serve their community and improve their performance. In this paper, we argue that cultural competency not only is important from a societal perspective, i.e., reducing health disparities, but can also be a strategy for health care organizations to improve quality, lower cost, and attract customers. We provide detailed recommendations for health care leaders and managers to adopt in order to successfully serve a diverse patient population.

Details

Organization Development in Healthcare: Conversations on Research and Strategies
Type: Book
ISBN: 978-0-85724-709-4

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Book part

Zo Ramamonjiarivelo, Larry Hearld, Josué Patien Epané, Luceta Mcroy and Robert Weech-Maldonado

Public hospitals have long been major players in the US health care delivery system. However, many public hospitals have privatized during the past few decades. The…

Abstract

Public hospitals have long been major players in the US health care delivery system. However, many public hospitals have privatized during the past few decades. The purpose of this chapter was to investigate the impact of public hospitals' privatization on community orientation (CO). This longitudinal study used a national sample of nonfederal acute-care public hospitals (1997–2010). Negative binomial regression models with hospital-level and year fixed effects were used to estimate the relationships. Our findings suggested that privatization was associated with a 14% increase in the number of CO activities, on average, compared with the number of CO activities prior to privatization. Public hospitals privatizing to for-profit status exhibited a 29% increase in the number of CO activities, relative to an insignificant 9% increase for public hospitals privatizing to not-for-profit status.

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Book part

Rohit Pradhan and Robert Weech-Maldonado

Private equity has acquired multiple large nursing home chains within the past few years; by 2007, it owned 6 of the 10 largest chains. Despite widespread public and…

Abstract

Private equity has acquired multiple large nursing home chains within the past few years; by 2007, it owned 6 of the 10 largest chains. Despite widespread public and policy interest, evidence on the purported impact of private equity on nursing home performance is limited. In our review, we begin by briefly reviewing the organizational and environmental changes in the nursing home industry that facilitated private equity investments. We offer a conceptual framework to hypothesize the relationship between private equity ownership and nursing home performance. Finally, we offer a research agenda focused on the important parameters of nursing home performance: financial performance, and quality of care.

Details

Biennial Review of Health Care Management
Type: Book
ISBN: 978-0-85724-714-8

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Book part

Mona Al-Amin, Robert Weech-Maldonado and Rohit Pradhan

The hospital–physician relationship (HPR) has been the focus of many scholars given the potential impact of this relationship on hospitals’ ability to achieve socially and…

Abstract

Purpose

The hospital–physician relationship (HPR) has been the focus of many scholars given the potential impact of this relationship on hospitals’ ability to achieve socially and organizationally desirable health care outcomes. Hospitals are dominated by professionals and share many commonalities with professional service firms (PSFs). In this chapter, we explore an alternative HPR based on the governance models prevalent in PSFs.

Design/methodology approach

We summarize the issues presented by current HPRs and discuss the governance models dominant in PSFs.

Findings

We identify the non-equity partnership model as a governance archetype for hospitals; this model accounts for both the professional dominance in health care decisions and the increasing demand for higher accountability and efficiency.

Research limitations

There should be careful consideration of existing regulations such as the Stark law and the antikickback statue before the proposed governance model and the compensation structure for physician partners is adopted.

Research implications

While our governance archetype is based on a review of the literature on HPRs and PSFs, further research is needed to test our model.

Practical implications

Given the dominance of not-for-profit (NFP) ownership in the hospital industry, we believe the non-equity partnership model can help align physician incentives with those of the hospital, and strengthen HPRs to meet the demands of the changing health care environment.

Originality/value

This is the first chapter to explore an alternative hospital–physician integration strategy by examining the governance models in PSFs, which similar to hospitals have a high reliance on a predominantly professional staff.

Details

Annual Review of Health Care Management: Revisiting The Evolution of Health Systems Organization
Type: Book
ISBN: 978-1-78350-715-3

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Abstract

Details

Annual Review of Health Care Management: Revisiting The Evolution of Health Systems Organization
Type: Book
ISBN: 978-1-78350-715-3

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Book part

Abstract

Details

Transforming Health Care
Type: Book
ISBN: 978-1-83982-956-7

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Abstract

Details

Biennial Review of Health Care Management
Type: Book
ISBN: 978-0-85724-714-8

To view the access options for this content please click here

Abstract

Details

Organization Development in Healthcare: Conversations on Research and Strategies
Type: Book
ISBN: 978-0-85724-709-4

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Book part

John D. Blair and Myron D. Fottler

John D. Blair examines, in systematic detail, the challenges and opportunities that arise from the significantly different perspectives of context-specific versus…

Abstract

John D. Blair examines, in systematic detail, the challenges and opportunities that arise from the significantly different perspectives of context-specific versus context-free researchers and the literatures to which they contribute. He argues that reviews of one type or the other or both types of literatures may provide different understandings of the state of the art in a particular area of health care management. He also provides some detailed suggestions for writing quality reviews along with suggested topics for future reviews.

Details

Biennial Review of Health Care Management
Type: Book
ISBN: 978-0-85724-714-8

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