The population ecology literature argues that at the macro level, organizations experience various liabilities to their continued survival. This study examined the effect of size, age, and niche density on the closure of acute care hospitals in Florida between 1965 and 1999.
The primary data for the study was created using information about Florida hospitals found in the annual reports of the American Hospital Association (n = 427). Using the technique of survival analysis, it was found that newer hospitals and hospitals originally established in organizationally dense areas (five or more hospitals within a five mile radius) experienced a significantly greater incidence of closure than did those which were older or founded in less dense areas. Small hospitals (<100 beds) were also shown to be significantly more likely to close than large ones (>300 beds), as were hospitals located in organizationally sparse areas (no other hospitals in 5 mile radius) compared to those in organizationally dense areas (>5 hospitals in 5 mile radius).
The study concludes with an examination of the policy and management implications of the results.
Get full access to this article
View all access options for this article.
References
1.
AlexanderJ. A., D'AunnoT. A., and SucciM. J. (1996). Determinants of Profound Organizational Change: Choice of Conversion or Closure among Rural Hospitals. Journal of Health and Social Behavior, 37, 238–251.
2.
AlexanderJ. A., FennelM., Halpern, (1993). Leadership Instability in Hospitals: the Influences of Board-CEO Relations and Organizational Growth and Decline. Administrative Science Quarterly, 38, 74–99.
3.
AmburgeyT. L., LentisaloM., KellyD., (1988). Suppression and Failure in the political Press: Government Control, Party Affiliation, and Organizational Life Chances. In Carroll, G. R., ed. Ecological Models of Organizations (pp. 135–73). Cambridge, MA: Ballinger.
4.
American Hospital Association (1965-1995). AHA Guide to the Healthcare Field.Chicago, IL: American Hospital Association.
5.
Armenakis and Bedeian, 1999BarnettW. P., and CarrollG R. (1987). Competition and Mutualism Among Early Telephone Companies. Administrative Science Quarterly, 32, 400–21.
6.
BindmanA. B., KeaneD., LurieN., (1990). A Public Hospital Closes: Impact on Patients’ Access to Care and Health Status. Journal of the American Medical Association, 464, 2899–2904.
7.
CarrollG., and HannanM T. (1989). Density Delray in the Evolution of Organizational Populations: A model of five empirical tests. Administrative Science Quarterly, 34, 411–430.
8.
CarrollG. R. (1984). Dynamics of Publisher Succession on Newspaper Organizations. Administrative Science Quarterly, 29, 93–113.
9.
CarrollG. R., and DelacroixJ., (1982). Organizational Mortality in the Newspaper Industries of Argentina and Freland: An Ecological Approach. Administrative Science Quarterly, 27, 169–98.
10.
CarrollG. R., and HannanM T. (1990). Density Delray in the Evolution of Organizational Populations: A model and five empirical tests. In Singh, J.V., ed. Organizational Evolution: New Directions. Newbury Park, CA: Sage.
11.
CarrollG. R., and HouY. P. (1986). Organizational Task and Institutional Environments in Ecological Perspective: Findings from thee Local Newspaper Industry. American Journal of Sociology, 91, 838–73.
12.
CarrollG. R., and SwaminathanA., (1989). Documentation for Public-use Data Set on American Breweries. Working paper no. OBIR-37, Center for Research Management, University of California, Berkeley.
13.
CaveH., BoschJ., SuciuS., (1998). Clinical Significance of Minimal Residual Disease in Childhood Acute Lymphoblastic Leukemia. New England Journal of Medicine, 339, 9, 591–598.
14.
CoxD. R., and OaksD., (1984). Analysis off survival data. London: Chapman and Hall.
15.
D'AunnoT., and ZuckermanH., (1987). The Emergence of Hospital Federations: An Integration Perspective from Organizational Theory. Medical Care Review, 44, 223–233.
16.
DelacroixJ., SwaminathanA., and SoltM. E. (1989). Density Dependence versus Population Dynamics: An Ecological Study of Failings in the California Wine Industry. American Sociological Review, 54, 245–62.
17.
FennellM., AlexanderJ., (1993). Perspectives on Organizational Change in the U.S Medical Care Sector. Annual Review of Sociology, 19, 89–112.
18.
Florida Medical Business (1999). Legislature will Focus on Providers, HMOs and Long Term Care. Florida Medical Business: Florida's First Health Business Newsletter, January 12, 1999, p.3.
19.
FranklynJ. A., MaisonneuveP., SheppardM. C., Betteridge, and BoyleJ., P. (1998). Mortality after the Treatment of Hyperthyroidism with Radioactive Iodine. New England Journal of Medicine, 338, 11, 712–718.
20.
FreemanJ., (1990). Ecological Analysis of Semi-conductor Firm Mortality. in Singh, J. V. (ed.). Organizational Evolution: New Directors (53–77). Newbury Park, CA: Sage Publications.
21.
FreemanJ., and HannaM. T. (1983). Niche Width and the Dynamics of Organizational Populations. American Journal of Sociology, 88, 6, 1116–45.
22.
FreemanJ., CarrollG. R.HannanM. T. (1983). The Liability of Newness: Age Dependence in Organizational Death Rates. American Sociological Review, 40, 215–28.
23.
GageL. S., AndrulisD. P., BeerV., (1987). America's Safety Net: A report on the Situation of our Nation's Metropolitan Areas. National Association of Public Hospitals, October 1987.
24.
GiffordB. D., and MullnerR. M. (1988). Modeling Hospital Closure Relative to Organizational Theory: The Applicability of Ecology Theory's Environmental Determinism and Adaptation Perspectives. Social Science and Medicine, 27, 11, 1287–1294.
25.
HannanM. T. (1986). A Model of Competitive and Institutional Processes in Organizational Ecology. Technical Report 86-13. Department of Sociology. Cornell University.
26.
HannanM. T. (1988). Age Dependence in the Mortality of National Labor Unions: Comparison of Parametric Models. Journal of Mathematics and Sociology, 14, 1–30.
27.
HannanM. T. and FreemanJ., (1987). The Ecology of Organizational Founding: American Labor Unions, 1836-1985. American Journal of Sociology, 92, 910–43.
28.
HannanM. T., and FreemanJ., (1977). The Population Ecology of Organizations. American Journal of Sociology, 82, 929–64.
29.
HedstormP., (1992). Is Organizational Ecology at an Impasse?Contemporary Sociology, 21, 6, 751–753.
30.
KaplanE L., and MeierP., (1958). Nonparametric Estimation from Incomplete Observations. American Statistical Association Journal, 53, 457–481.
31.
Lee and Alexander, 1999
32.
LongoD. R., and ChaseG., (1984). Structural Determinants of Hospital Closure. Medical Care, 22, 5, 388–402.
33.
LuftH S., and MaerkiS., (1984). Competitive Potential of Hospitals and Their Neighbors. Contemporary Policy Issues, 3, 4, 89–102.
34.
MullnerR. M., RydmanR. J., WhiteisD G., RichR F. (1989). Rural Community Hospitals and Factors Correlated with their Risk of Closing. Public Health Reports, 104, 4, 315–325.
35.
MussK., LudtkeR., and GibbensB., (1995). Community Perceptions of Rural Hospital Closure. Journal of Community Health, 20, 1, 65–73.
36.
Pew Health Professions Commission (1995). Critical Challenges: Revitalizing the Health Professions for the Twenty-First Century. San Francisco: UCSF Center for the Health Professions.
37.
RosenbachtM., and DayhoffD., (1995). Access to Care in Rural America: Impact of Hospital Closures. Health Care Financing Review, 17, 1, 115–37.
38.
RundallT.G. (1987). The Organization of Medical Practice: a Population Ecology Perspective. Medical Care Review, 44, 375–406.
39.
SamuelS., CunninghamJ., ChoiC., (1991). The Impact of Hospital Closures on Travel Time to Hospitals. Inquiry, 28, 194–199.
40.
SingerJ. D., and WillettJ B. (1991). Modeling the Days of Our Lives: using Survival Analysis when Designing and Analyzing Longitudinal Studies of Duration and the Timing of Events. Psychological Bulletin, 110, 2, 268–290.
41.
SinghJ V. (1986). Performance, Slack and Risk-Taking in Organizational Decision-Making. Academy of Management Journal, 29, 562–585.
42.
SinghJ V. (1990). (ed.) Organizational Evolution New Directions. Newbury Park, CA: Sage.
43.
SinghJ V. and LumsdenC. J. (1990). Theory and Research in Organizational Ecology. In ScottW.R. and BlakeJ. (Eds.), Annual Review of Sociology, 16, 161–195.
44.
SucciM., LeeS., AlexanderJ., (1997). Effects of Market Position and Competition on Rural Hospital Closures. Health Services Research, 31, 6, 679–699.
45.
Wertheim and Lynn, 1993WholeyD., and BrittainJ., (1986)). Organizational Ecology: Findings and Implications. Academy of Management Review, 11, 3, 513–533.
46.
WholeyD. R., ChristiansonJ B., SanechezS M. (1992). Organizations. American Sociological Review, 57, 829–842.
