Hospitals have been increasingly involved in health promotion and disease prevention (HPDP) in the last two decades. Concurrent with this trend, environmental changes and market pressures have resulted in more hospital consolidations and conversions from not-for-profit (NFP) to for-profit (FP) organizations. The emergence of a large number of sole community hospitals has attracted the attention of policy-makers and community stakeholders because sole community hospitals have more power in the local market and may discontinue unprofitable services to pursue profit maximization. This may be especially true when the sole hospital is a FP organization. On the other hand, sole community hospitals are confronted with a variety of expectations to offer community-oriented services that promote community population health, regardless of ownership.
There is relatively little literature that has attempted to examine the behavior of sole community hospitals. This study depicts the profile of sole hospitals’ involvement in HPDP services and estimates the possible influence of community constituencies on hospitals with respect to their providing community-oriented services. The results indicate that typically, when there is only one hospital in the community, hospital ownership has no significant influence on hospital HPDP services than their NPD counterparts. Implications for policy-makers and health care leaders are also discussed.
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References
1.
American Hospital Association (2001). “American Hospital Association News 2001.”Chicago: Author.
2.
AHA Center for Health Care Leadership (1997). “Community Health Initiatives: Activities of Selected State and Metropolitan Associations.”Chicago: Author, AHA Annual Survey, 1970–1999.
3.
BakerC.M. (2001). “Hospital Conversion Foundations,” Issues in Creation, Operation, and Evaluation. Jona's Healthcare Law, Ethics and Regulation3(1):19–29.
4.
BakerC.M.. (2000). “Hospital Ownership, Performance, and Outcomes: Assessing the State-of-the-Science.” Journal of Nursing Administration30(5):227–240.
5.
ClaxtonG.. (1997), “Public Policy Issues in Nonprofit Conversions: An Overview.” Health Affairs16(2):9–28.
6.
ClementJ.P. and WhiteK.R. (2002). “Charity Care: Do Not-for-Profits Influence For-Profits?” Medical Care Research and Review59(1):59–78.
7.
CoberlyS., MortimerJ.D., and KemnitzD. (1996). “Developing a Competitive Advantage: Price, Outcome Measures, Enrollee Satisfaction. What Employers are Looking For.” National Forum on Hospital Health Affairs3–21, Discussion 22–29.
8.
DavisG.R. (1991). “Agents Without Principles? The Spread of the Poison Pill through the Intercorporate Network.” Administrative Science Quarterly36(4):583–613.
9.
DiMaggioP. and PowellW. (1983). “The Iron Cage Revisited: Institutional Isomorphism and Collective Rationality in Organizational Fields.” American Sociological Review48(2):147–160.
10.
DowlingJ. and PfefferJ. (1975). “Organizational Legitimacy: Social Vakues and Organizational Behavior.” Pacific Sociological Review18(1):122–135.
11.
GalaskiewiczJ. (1991). “Making Corporate Actors Accountable: Institution Building in Minneapolis-St. Paul,” in PowellW.W. and DiMaggioP.J. (eds.). The New Institutionalism in Organizational Analysis. Chicago: University of Chicago Press.
12.
GoodsteinJ. (1994). “Profit and Nonprofit Organizations in Health Care: A Sociological Perspective,” in SeayJ.D. and VladeckB.C. (eds.). In Sickness and In Health. New York: McGraw-Hill.
13.
GriffithJ.R. (1997). “The Strategic Agenda for Community Health Care Organizations.” Health Care Management Review22(3):82–91.
14.
HasanM.M. (1996). “Let's End the Nonprofit Charade.” New England Journal of Medicine334(16):1055–1057.
15.
HoV. and HamiltonB.H. (2000). “Hospital Mergers and Acquisitions: Does Market Consolidation Harm Patients?” Journal of Health Economics19(5):767–791.
16.
HultmanC.I. (1991). “Uncompensated Care Before and After Prospective Payment: The Role of Hospital Location and Ownership.” Health Services Research26(5):613–646.
17.
JapsenB. (1996). “Another Record Year for Deal Making.” Modern Healthcare26(52):37–46.
18.
JapsenB. (1998). “An Off Year for Consolidation.” Modern Healthcare28(2):40–48.
19.
JudgeW.Q.Jr. and ZeithamlC.P. (1992). “Institutional and Strategic Choice Perspectives on Board Involvement in the Strategic Decision Process.” Academy of Management Journal35(4):766–794.
20.
KovnerA.R. (1994). “Community Benefit and Health Care Reform: Some Critical Issues and an Overview.” Journal of Health Administration Education12(3):253–258.
21.
LutzS. (1996). “Merger, Acquisition Activity Hits Record in 1st Quarter, Report Says.” Modern Healthcare26(22):2–3.
22.
MarkT.L. (1999). “Analysis of the Rationale for, and Consequences of, Nonprofit and For-Profit Ownership Conversions.” Health Services Research34(1):83–101.
23.
MarstellerJ.R., BovbjergR.R., and NicholsL.M. (1998). “Nonprofit Conversion Theory, Evidence and State Policy Options.” Health Services Research33(5 Pt 2):1495–1535.
24.
MeyerJ. and RowanB. (1977). “Institutional Organizations: Formal Structure as Myth and Ceremony.” American Journal of Sociology83(2):340–363.
25.
MonroeS.M. (1999). The Hospital Acquisition Report. Irving Levin Associates.
26.
NewboldP.A. (1995). “Building Healthy Communities.” Frontiers of Health Services Management11(4):45–48.
27.
OldenP.C. and ClementD.G. (2000). “The Prevalence of Hospital Health Promotion and Disease Prevention Services: Good News, Bad News, and Policy Implications.” Milbank Quarterly78(1):115–146
28.
OlfsonM. “The Array of Psychiatric Services in General Hospitals.” General Hospital Psychiatry15(5):277–283.
29.
OliverC. (1991). “Strategic Responses to Institutional Processes.” Academy of Management Review16(1):145–179.
30.
PhillipsJ.F. (1999). “For-profit Chains Seek to Acquire Successful Not-for-profit Hospitals in America.” Healthcare Financial Management53(9):52–55.
31.
PotterS.J. (2001). “A Longitudinal Analysis of the Distinction Between For-profit and Not-for-profit Hospitals in America.” Journal of Health and Social Behavior42(1):17–44.
32.
PowellW.W. (1991) “Expanding the Scope of Institutional Analysis,” in PowellW.W. and DiMaggioP.J. (eds.). The New Institutionalism in Organizational Analysis. Chicago: University of Chicago Press.
33.
ProencaE.J. (1998). “Community Orientation in Health Services Organizations: The Concept and Its Implementation.” Health Care Management Review23(2):28–38.
34.
ProencaE.J., RoskoM.D., and ZinnJ.S. (2000). “Community Orientation to Hospitals: An Institutional and Resource Dependence Perspectine.” Health Services Research35(5 Pt 1):1011–1135.
35.
RundallT.G. and SchaufflerH.H., (1997). “Health Promotion and Disease Prevention in Integrated Delivery Systems: The Role of Market Forces.” American Journal of Preventive Medicine13(4):244–250.
36.
ShortellA.M.. (1995). “Reinventing the American Hospital.” Milbank Quarterly73(2):131–160.
37.
ShortellA.M.. (1986). “The Effects of Hospital Ownership on Nontraditional Services.” Health Affairs5(4):97–111.
38.
ShortellA.M.. (1987). “Diversification of Health Care Services: The Effects of Ownership, Environments, and Strategy.” Advances in Health Economics and Health Services Research7:3–40, 111–114.
39.
SpetzJ. and BakerL. (1999). “Has Managed Care Affected the Availability of Medical Technology?”San Francisco: Public Policy Institute of California.
