Impact of Health System Affiliation on Hospital Resource Use Intensity and Quality of Care

Henke, Rachel Mosher; Karaca, Zeynal; Moore, Brian J.; Cutler, Eli; Liu, Henry; Marder, William D.; Wong, Herbert S.

doi:10.1111/1475-6773.12631

Cited by 31 publications

(40 citation statements)

References 31 publications

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“…This finding is likely indicative of the mimetic effect of system membership; because hospitals within systems are able to diffuse ideas between members . Additionally, system hospitals tend to be better resourced and have better quality of care indicators …”

Section: Discussionmentioning

confidence: 99%

“…43 Additionally, system hospitals tend to be better resourced and have better quality of care indicators. [44][45][46] Hospital-specific issues are likely compounded by the nationwide shortages of MH providers. 41 It is possible that smaller or more rural transplant centers simply have difficulty attracting and hiring MH and CD services providers.…”

Section: Discussionmentioning

confidence: 99%

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Mental health and chemical dependency services at US transplant centers

Niazi

Spaulding

Vargas

et al. 2020

American Journal of Transplantation

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The purpose of this study was to assess the availability of mental health (MH) and chemical dependency (CD) services at US transplant centers, because appropriate psychosocial assessment and care is associated with better transplant outcomes. We used the 2017‐2018 American Hospital Association survey, Area Health Resource File, and Centers for Medicare & Medicaid Services Hospital Compare databases to quantify availability of services and examined associations of hospital‐ and health services area‐level characteristics with odds of offering services with generalized linear mixed models. We found that 15% of transplant centers did not offer MH services and 62% did not offer CD services. Hospitals were more likely to offer MH services if they were larger (OR [95% CI]: 1.03 [1.01, 1.06]) and had a lower rate of uninsured patients in the health services area (OR [95% CI]: 0.89 [0.80, 0.99]) and were more likely to offer CD services if they were larger (OR [95% CI]: 1.02 [1.01, 1.03]) or were members of a system (OR [95% CI]: 2.31 [1.26, 4.24]). Additional research is needed to understand whether lack of MH or CD services at transplant centers affects patients’ ability to access comprehensive psychosocial care and whether this affects patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Mental health and chemical dependency services at US transplant centers

Niazi

Spaulding

Vargas

et al. 2020

American Journal of Transplantation

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“…This is an interesting finding. Our literature suggests that system member hospitals have more robust information and communication technologies because they have more substantial resources to invest in technology and infrastructure . Thus, one would assume that they are not constrained by resources for their websites (they share the costs of building and maintaining the websites within the system).…”

Section: Discussionmentioning

confidence: 99%

“…Most likely, system member hospitals are sharing the cost of communication professionals to produce regular newsletters and create enhanced media on their websites (such as videos, features home page stories, and interactive sliders). In addition, higher engagement might also be a reaction from system member hospitals that are reportedly out‐of‐touch or “may not be as responsive to local needs.” (p65)…”

Section: Discussionmentioning

confidence: 99%

“…By engaging in joint ventures or other strategic relationships, organizations reduce uncertainty and interdependence by decreasing transaction costs . A body of research suggests that system member hospitals rely on a managing organization to make decisions on health information technology, are more likely to use information technology systems, are more likely to invest in high technology services, engage in interoperable data sharing, and have higher rates of electronic medical records adoption, health information systems adoption, and electronic health records adoption . It is possible to assume that since system member hospitals tend to have more robust information and communication technologies, they will be likely to have more robust OAP:H7 System member hospitals are more likely to have higher online accountability practice scores.…”

Section: Literature Reviewmentioning

confidence: 99%

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Predictors of online accountability practices in US hospitals: An exploratory investigation

Cooley

2019

Health Planning & Management

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35:e178-e wileyonlinelibrary.com/journal/hpm e195. e K E Y W O R D S disclosure, hospitals, online accountability, website | INTRODUCTIONUS health care is one of the fastest-growing areas of the economy that is extensive, highly institutionalized, adheres to multiple regulatory forces, and is marked by high levels of professionalism. 1 Parties involved in health care (regulatory agencies, legislature, hospitals, insurance companies, medical providers, etc.) are faced with ever-growing pressures to provide health services more effectively, efficiently, and equitably. Previous solutions to providing better health care included reforms that focus on downsizing, privatization, performance measurements, competition in service delivery, and citizen participation. 2 All these approaches have one thing in common: a strong emphasis on accountability in improving health care performance.Health care accountability has several purposes. It helps to reduce fraud and abuse, 2 which is estimated at $60 billion per year by the National Health Care Anti-Fraud Association. 3 It also assists in ensuring compliance with procedures and standards as well as revealing gaps requiring policy attention. 2 Also, accountability contributes to improving performance and learning (such as generating a system-wide perspective on health sector reforms). 2 Hospitals play the most extensive role in the US health care industry, accounting roughly for a third of health care expenditures. 4 Being on the forefront of medical development and innovation, US hospitals (regardless of ownership) are at the forefront of improving public health. 5 When reviewing the literature on hospital accountability, we find a rather narrow focus of studies, mostly on health care delivery outcomes, such as readmission rates 6,7 and quality-of-care. 8 Some studies move beyond health care delivery outcomes and look at hospital financial outcomes 9 in terms of hospital accountability. Others focus on one particular type of hospital-nonprofit hospitals-while researching accountability practices. 10-12 While these are all important topics, they rarely address how hospitals meet the demands of a broader group of stakeholders-the public at large (patients, families, community members, etc.). For many, an organizational website is a first and most trusted resource they turn to when in need of information about a hospital. Online accountability (OA) practices are how hospitals address these expectations. OA is one of the critical dimensions of overall accountability efforts in hospitals, and not much research is available on this subject. Thus, hospital OA is a topic of this research paper.The existing empirical evidence sheds light on variations in online accountability practices (OAP) within the nonprofit sector 13-17 but not within health care organizations. This study aims to fill these research gaps by exploring variations in OAP in the US hospitals and identifying key determinants of robust OAP. The particular contribution of this research project to the scholarly community...

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Assessment of Costs and Care Quality Associated With Major Surgical Procedures After Implementation of Maryland’s Capitated Budget Model

et al. 2021

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IMPORTANCEIn 2014, Maryland implemented the all-payer model, a distinct hospital funding policy that applied caps on annual hospital expenditures and mandated reductions in avoidable complications. Expansion of this model to other states is currently being considered; therefore, it is important to evaluate whether Maryland's all-payer model is achieving the desired goals among surgical patients, who are an at-risk population for most potentially preventable complications.OBJECTIVE To examine the association between the implementation of Maryland's all-payer model and the incidence of avoidable complications and resource use among adult surgical patients. DESIGN, SETTING, AND PARTICIPANTSThis comparative effectiveness study used hospital discharge records from the Healthcare Cost and Utilization Project state inpatient databases to conduct a difference-in-differences analysis comparing the incidence of avoidable complications and the intensity of health resource use before and after implementation of the all-payer model in Maryland. The analytical sample included 2 983 411 adult patients who received coronary artery bypass grafting (CABG), carotid endarterectomy (CEA), spinal fusion, hip or knee arthroplasty,

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Impact of Health System Affiliation on Hospital Resource Use Intensity and Quality of Care

Cited by 31 publications

References 31 publications

Mental health and chemical dependency services at US transplant centers

Mental health and chemical dependency services at US transplant centers

Predictors of online accountability practices in US hospitals: An exploratory investigation

Assessment of Costs and Care Quality Associated With Major Surgical Procedures After Implementation of Maryland’s Capitated Budget Model

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