Jeffrey Harrison, Aaron Spaulding and Debra A. Harrison
The purpose of this paper is to assess the community dynamics and organizational characteristics of US hospitals that participate in accountable care organizations (ACO).
Abstract
Purpose
The purpose of this paper is to assess the community dynamics and organizational characteristics of US hospitals that participate in accountable care organizations (ACO).
Design/methodology/approach
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.
Findings
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.
Practical implications
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.
Originality/value
This research found ACOs with hospital and physician networks are an effective mechanism to control healthcare costs and reduce medical errors.
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Jeffrey P. Carpenter, Glenn W. Harrison and John A. List
There are several ways to define words. One is to ascertain the formal definition by looking it up in the dictionary. Another is to identify what it is that you want the…
Jeffrey P. Harrison and Louis R. Lambiase
This study evaluates the efficiency of teaching hospitals using a variable returns to scale, input oriented, Data Envelopment Analysis (DEA) methodology. Hospital executives…
Abstract
This study evaluates the efficiency of teaching hospitals using a variable returns to scale, input oriented, Data Envelopment Analysis (DEA) methodology. Hospital executives, healthcare policy-makers, taxpayers and graduate medical education benefit from studies that look to improve the efficiency of teaching hospitals. Data for 164 University Health Consortium Hospitals (UHC) in 1998 and 154 in 2001 were analyzed using DEA. The results indicate that efficiency in UHC Hospitals improved from 64.8% in 1998 to 69.6% in 2001 for an increase of 7.4%. From a management perspective, it shows opportunities for improved management and the realignment of resources to better meet demand. From a policy perspective, the research highlights the problems associated with improving efficiency while providing graduate medical education.
Andrew C. Wicks and Jeffrey S. Harrison
This chapter highlights some of the tensions and most promising points of convergence between the strategic management and stakeholder theory literatures. We briefly examine the…
Abstract
This chapter highlights some of the tensions and most promising points of convergence between the strategic management and stakeholder theory literatures. We briefly examine the early development of both areas, identifying some of the background assumptions and choices that informed how the fields evolved, and how these factors led the two fields to engage in scholarly pursuits that seldom intersected for a period of years, followed by a renewal of interest among strategists in themes that are central to stakeholder theory. From this discussion, we develop a larger agenda with specific topics as examples of areas that offer promise for integrative research that can advance knowledge in both fields. Our vision of the future is one in which the larger aspirations of scholars in strategy and stakeholder theory are more fully realized with human purposes, broadly defined, as the focal point.
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Juan Camilo Cardenas and Jeffrey P. Carpenter
We discuss the following three themes on the use of field experiments to study economic development: (1) We summarize the arguments for and against using experiments to gather…
Abstract
We discuss the following three themes on the use of field experiments to study economic development: (1) We summarize the arguments for and against using experiments to gather behavioral data in the field; (2) We argue and illustrate that field experiments can provide data on behavior that can be used in subsequent analyses of the effect of behavioral social capital on economic outcomes; and (3) We illustrate that field experiments can be used as a development tool on their own to teach communities about incentives and strategic interaction.
If we are to examine the role of “controls” in different experimental settings, it is appropriate that the word be defined carefully. The Oxford English Dictionary (Second Edition…
Abstract
If we are to examine the role of “controls” in different experimental settings, it is appropriate that the word be defined carefully. The Oxford English Dictionary (Second Edition) defines the verb “control” in the following manner: “To exercise restraint or direction upon the free action of; to hold sway over, exercise power or authority over; to dominate, command.” So the word means something more active and interventionist than is suggested by it’s colloquial clinical usage. Control can include such mundane things as ensuring sterile equipment in a chemistry lab, to restrain the free flow of germs and unwanted particles that might contaminate some test.
Glenn W. Harrison, Morten Igel Lau, Elisabet E. Rutström and Melonie B. Sullivan
We design experiments to jointly elicit risk and time preferences for the adult Danish population. The experimental procedures build on laboratory experiments that have used…
Abstract
We design experiments to jointly elicit risk and time preferences for the adult Danish population. The experimental procedures build on laboratory experiments that have used traditional subject pools. The field experiments utilize field sampling designs that we developed, and procedures that were chosen to be relatively transparent in the field with non-standard subject pools. Our overall design was also intended to be a general template for such field experiments in other countries. We examine the characterization of risk over a wider domain for each subject than previous experiments, allowing more precise estimates of risk attitudes. We also examine individual discount rates over six time horizons, as the first stage in a panel experiment in which we revisit subjects to test consistency and stability of responses over time. Risk and time preferences are heterogeneous, varying by observable individual characteristics. On a methodological level, we implement a refinement of existing procedures which elicits much more precise estimates, and also mitigates framing effects.
Jeffrey P. Harrison and Emily D. Ferguson
Emergency services are critical for high‐quality healthcare service provision to support acute illness, trauma and disaster response. The greater availability of emergency…
Abstract
Purpose
Emergency services are critical for high‐quality healthcare service provision to support acute illness, trauma and disaster response. The greater availability of emergency services decreases waiting time, improves clinical outcomes and enhances local community well being. This study aims to assess United States (US) acute care hospital staff's ability to provide emergency medical services by evaluating the number of emergency departments and trauma centers.
Design/methodology/approach
Data were obtained from the 2003 and 2007 American Hospital Association (AHA) annual surveys, which included over 5,000 US hospitals and provided extensive information on their infrastructure and healthcare capabilities.
Findings
US acute care hospital numbers decreased by 59 or 1.1 percent from 2003 to 2007. Similarly, US emergency rooms and trauma centers declined by 125, or 3 percent. The results indicate that US hospital staff's ability to respond to traumatic injury and disasters has declined. Therefore, US hospital managers need to increase their investment in emergency department beds as well as provide state‐of‐the‐art clinical technology to improve emergency service quality. These investments, when linked to other clinical information systems and the electronic medical record, support further healthcare quality improvement.
Research limitations/implications
This research uses the AHA annual surveys, which represent self‐reported data by individual hospital staff. However, the AHA expends significant resources to validate reported information and the annual survey data are widely used for hospital research.
Practical implications
The declining US emergency rooms and trauma centers have negative implications for patients needing emergency services. More importantly, this research has significant policy implications because it documents a decline in the US emergency healthcare service infrastructure.
Originality/value
This article has important information on US emergency service availability in the hospital industry.
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Jeffrey P. Harrison and Geoffrey M. McDowell
The purpose of this study was to evaluate the status of US hospital Laboratory Information Systems. Laboratory Information Systems are critical to high quality healthcare service…
Abstract
Purpose
The purpose of this study was to evaluate the status of US hospital Laboratory Information Systems. Laboratory Information Systems are critical to high quality healthcare service provision. Data show that the need for these systems is growing to meet accompanying technological and workload demands. Additionally, laboratory tests provide the majority of information for clinical decision‐making. Laboratory processes automation, including patient result verification, has greatly improved laboratory test throughput while decreasing turn‐around‐times, enabling critical results to reach physicians rapidly for improved clinical outcomes.
Design/methodology/approach
Data were drawn from the 2007 Healthcare Information and Management Systems Society (HIMSS) Analytics Database, which includes over 5,000 US healthcare organizations and provides extensive data on the hardware, software, and information technology infrastructure within healthcare organizations.
Findings
US hospitals are actively involved in laboratory systems planning to improve health service quality. Specifically, data show 76 new laboratory information systems are currently being installed in 2007 with another 399 under contract for future installation. As a result, increasing investment in laboratory information systems is providing state‐of‐the‐art clinical laboratory support, which enhances clinical care processes and improves quality. These state‐of‐the‐art Laboratory Information Systems, when linked with other clinical information systems such as Computerized Physician Order Entry and Electronic Medical Record, will support further healthcare quality improvement.
Originality/value
This article includes the most current information available on the US hospital laboratory information system applications.