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The objective of this study is to shed some light on quality improvement practices of for‐profit and not‐for‐profit hospitals

The scope and effectiveness of several quality improvement efforts are studied for a sample of 110 hospitals. Factor analysis was utilized to analyze the data collected.

The results of this study tended to suggest that for‐profit and not‐for‐profit hospitals were more similar than different with the regard to the effective utilization of quality improvement initiatives, thus underscoring the utility of quality improvement efforts despite differences in operating characteristics, strategies and operating constraints.

The sample used in this study is limited. Thus, the results should be interpreted accordingly.

This study offers decision‐makers in healthcare operational settings empirical evidence of the operational and strategic effectiveness of different quality improvement efforts, thus justifying investments related to the initiation and implementation of such quality improvement efforts.

This study represents an important step toward understanding the effective implementation of quality improvement initiatives in different operational settings.

The issue of gender diversity on hospital boards plays a significant role in the financial health and clinical performance of hospitals. The purpose of this paper is to examine the determinants of gender diversity of hospital boards in Ghana. Specifically, this study examined the proportion of females on hospital boards and considered how hospital-level characteristics such as hospital size, age, location and ownership structure explain the board gender diversity of hospital boards in Ghana.

A quantitative approach based on 100 hospitals was used.

The results of the study indicate that women are represented on all hospitals with governing boards but with different proportions depending on ownership form. In all, women represent less than half of board membership. Smaller and older hospitals were found to have more female representation on their board. Also, not-for-profit mission and for-profit private hospitals tend to engage more females than their counterpart public hospitals.

The study examined female representation on hospital boards depending on only hospital-level characteristics such as hospital size, age, location and ownership. Other factors could be determining the appointment of females on hospital boards other than hospital characteristics.

Efforts on improving the role of women on hospital boards need to be encouraged.

Evidence from this study clearly suggests underrepresentation of women in the top echelons of hospitals owned by government or the state, bigger and newer hospitals.

U.S. hospitals face calls for accountability from regulators, professionals, academics and consumers. Transparency and wider dissemination in reporting of financial performance is an integral component of accountability. This paper investigates the extent to which U.S. hospitals have used the Internet to disseminate financial information and demonstrate accountability to the communities they purport to serve. The authors examine the availability of financial information on the websites of the American Hospital Association’s 100 Most Wired healthcare systems. Results of this investigation indicate that the vast majority of the most technically competent U.S. hospitals have yet to embrace the Internet as a tool for financial disclosure. The findings highlight a lack of transparency and an accountability gap for U.S. healthcare systems.

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.

This study examines whether nonprofit hospitals (NPHs) use price increases to overstate reported charity care spending. Anecdotal evidence points to hospitals raising prices to maximize Medicare's supplemental reimbursement and to maximize collection from self-pay and uninsured patients. This study provides empirical evidence that NPHs raise prices in part to satisfy the state's charity care requirements and to substitute real care with price-valued charity care. The ratio of charges to costs (RCC), price standardized by cost - a measure for comparing revenues generated to estimate costs allocations, is used to test the association between price increases and charity care reporting by NPHs. We hypothesize and find evidence that NPHs facing financial and political pressures in addition to charity care regulations are more likely to report a higher value of charity care.

The purpose of this study is to examine the effects of health-care governance and ownership structure on the performance of hospitals in Ghana.

The study uses multiple regression models based on a sample of 132 hospitals in Ghana.

The results of the study indicate that hospitals with a governing board perform better than those without a governing board. The results of this study also suggest that board characteristics and ownership structure are important in explaining the performance of hospitals in Ghana. The results further indicate that mission-based and private hospitals with effective board governance structures exhibit better performance than public hospitals.

This study makes a number of new and meaningful contributions to the extant literature and the findings support managerialism, stakeholder and resource dependency theories. The findings also have important implications for the effective governance of hospitals.

The purpose of this paper is to identify the underlying metaphors that hospitals use to establish their organizational mission. Metaphors impact the direction and managerial decision making of organizations, and provide a method to more easily communicate to a variety of stakeholders.

A text analytics process is run to evaluate the mission statements from the largest hospitals by revenue in each of the 50 states of the USA and District of Columbia to identify the types of metaphor-based organizational health management methods.

A cluster analysis is generated to evaluate primary mission-based metaphors, and metatriangulation is used to evaluate output, develop theory and provide practical implications for healthcare management.

Key contributions include a review of healthcare metaphors, an analysis for understanding commonly utilized metaphors, a theory building process for developing a new integrated value-based care management metaphor, and a value-based process is developed for providing healthcare managers an easy to follow and repeatable process for improving organizational communication.

It is well recognized that hospitals do not operate in a competitive market typically observed in the economics literature, but rather alternative measures of performance must be developed. In other words, health policy analysts, managers, and decision-makers cannot rely on determining efficiency via the typical profit maximizing/cost minimizing firm but develop techniques that address the issues germane to hospital productivity. What has been presented in this book demonstrates the research in both productivity and policy that must attend to this anomaly. In this introductory section, we briefly summarize the theoretical underpinnings of this book.

The purpose of this paper is to assess the community dynamics and organizational characteristics of US hospitals that participate in accountable care organizations (ACO).

Data were obtained from the 2015 American Hospital Association annual survey and the 2015 medicare final rule standardizing file. The study evaluated 785 hospitals which operate ACO in contrast to 1,446 hospitals without an ACO.

In total, 89 percent of hospitals using ACO’s are located in urban communities and 87 percent are not-for-profit. Hospitals with a higher case mix index are more likely to have an ACO.

ACOs allow healthcare organizations to expand their geographic markets, achieve greater efficiencies, and enhance the development of new clinical services. They also shift the focus of care from acute care hospitalization to the full continuum of care.

This research found ACOs with hospital and physician networks are an effective mechanism to control healthcare costs and reduce medical errors.

The purpose of this paper is to explore the perceived responsibilities of five not‐for‐profit hospitals in Bangalore, India, towards society.

The method used is qualitative design with some quantitative elements. Data were collected through a survey of 79 physicians and 104 managers and other stakeholders of the hospitals.

The analysis reveals the existence of highly significant differences in the perception about workplace responsibilities between the doctors and other stakeholders. It also highlights the importance of top management involvement with various stakeholders in effectively carrying out the overall social responsibilities of the hospitals. It was found that the hospitals must take into account the social, cultural and financial characteristics of the patients while fulfilling societal obligations. Training needs, environmental impact audit and encouragement for employees to join local voluntary organizations are the immediate needs for improving the CSR activities of the hospitals.

The study had a small sample and referred only to the perceptions of physicians/management personnel. Further studies should be done with larger samples, comparing different cohorts of stakeholders and, more importantly, patients/their carers.

The study draws attention to issues that emerge from the social responsibilities of healthcare organizations. Its findings provide new insights into the meaning of social responsibility in the healthcare sector in an Indian context from a stakeholder perspective.

The paper is based on an original study that addresses the current gap in the understanding of issues related to social responsibility by the various stakeholders of hospitals. It is particularly valuable for both the internal and external stakeholders of the healthcare organizations.