For-profit hospitals as anchor institutions in the United States: a study of organizational stability.
For-profit hospitals as anchor institutions in the United States: a study of organizational stability.
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DOI：
10.1186/s12913-021-07307-1
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发表时间：
2021-12-11
影响因子：
2.8
通讯作者：
Hall MT
中科院分区：
文献类型：
--
作者：
Franz B;Cronin CE;Rodriguez V;Choyke K;Simon JE;Hall MT
根据定义，锚定机构在当地社区内长期存在，但营利医院是否符合这一定义尚不确定；迄今为止，大多数关于锚定机构的研究都局限于医院和大学等非营利组织。因此，本研究旨在确定营利性医院是否足够稳定，能够通过在社区的长期存在来履行锚定机构的角色，这可能有助于稳定当地经济。这项纵向研究分析了2008年至2017年间的国家二级数据，这些数据来自达特茅斯医疗保健地图集、美国医院协会年度调查和县健康排名。我们使用描述性统计来计算不同所有制医院的关闭和合并数量，以及人员配备水平。在控制组织和社区因素的情况下，我们还使用逻辑回归评估了营利性医院是否有更高的关闭和合并几率。我们发现营利性医院比公立和非营利性医院更不稳定，随着时间的推移，它们经历了不成比例的关闭和合并，多变量分析显示了统计学上显著的差异。此外，与其他所有制类型的医院相比，营利性医院的全职员工相对于其规模更少，工资支出总额也更低。研究结果表明，就费用而言，营利性医院的运作效率更高，但这也可能转化为通过就业和采购举措对周围社区的经济贡献水平较低。营利性医院也可能不具备作为长期锚定机构所需的稳定性。未来的研究应该考虑营利性医院是否会进行其他类型的社区投资来抵消这些赤字，以及是否可以采用政策变化来鼓励医院等当地企业的锚定活动。
Anchor institutions, by definition, have a long-term presence within their local communities, but it is uncertain as to whether for-profit hospitals meet this definition; most research on anchor institutions to date has been limited to nonprofit organizations such as hospitals and universities. Accordingly, this study aims to determine whether for-profit hospitals are stable enough to fulfill the role of anchor institutions through a long-term presence in communities which may help to stabilize local economies. This longitudinal study analyzes national, secondary data between 2008 and 2017 compiled from the Dartmouth Atlas of Health Care, the American Hospital Association Annual Survey, and County Health Rankings. We use descriptive statistics to calculate the number of closures and mergers of hospitals of different ownership type, as well as staffing levels. Using logistic regression, we also assessed whether for-profit hospitals had higher odds of closing and merging, controlling for both organization and community factors. We found for-profit hospitals to be less stable than their public and nonprofit hospital counterparts, experiencing disproportionately more closures and mergers over time, with a multivariable analysis indicating a statistically significant difference. Furthermore, for-profit hospitals have fewer full-time employees relative to their size than hospitals of other ownership types, as well as lower total payroll expenditures. Study findings suggest that for-profit hospitals operate more efficiently in terms of expenses, but this also may translate into a lower level of economic contributions to the surrounding community through employment and purchasing initiatives. For-profit hospitals may also not have the stability required to serve as long-standing anchor institutions. Future studies should consider whether for-profit hospitals make other types of community investments to offset these deficits and whether policy changes can be employed to encourage anchor activities from local businesses such as hospitals.
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影响因子：
9.7
作者：
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通讯作者：
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影响因子：
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