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Independent versus systemaffiliated hospitals a comparative analysis of financial performance, cost, and productivity..pdf英文资料.pdf

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Independent versus System-Affiliated Hospitals: A Comparative Analysis of Financial Performance, Cost, and Productivity Gary S. Levitz and Paul P. Brooke, Jr. This article analyzes differences in thefinancial performance, cost, andproductiv- ity between system-affiliated and independent hospitals. Data for the study were obtainedfrom the 1981 American HospitalAssociation (AHA)Annual Survey of Hospitals for the Stae of Iowa and included 94 nonstate or nonfederal short-term hospitals without long-term care units. An interpretation of the results indicated that system-affiliated hospitals are more profitable, have better accss to capital markets, are more effective price setters, and experience higher costs per case which are related to longer lengths ofstay and less productive use ofplant and equipment in generating revenues. INTRODUCTION The rapid growth and development ofmultihospital systems has repre- sented a major restructuring of the American hospital industry [1]. Some have viewed this organizational change as part of a process of industrialization [2], similar in many respects to the corporate consol- This research is based on a project supported by the Department of Health and Human Services, Health Care Financing Administration, Grant No. 18-P-97703. Gary S. Levitz, Ph.D. is Assistant to the Director, University of Iowa Hospitals and Clinics. Paul P. Brooke, Jr., MHA, MMAS, Lt. Col. U.S. Army Medical Service Corps, is a Doctoral Candidate in the Graduate Program in Hospital and Health Administration, The University of Iowa. Address all correspondence and requests for reprints to Gary S. Levitz, Ph.D., Assistant to the Director, University of Iowa Hospitals and Clinics, Iowa City, IA 52242. 316 Health Services Research 20:3 (August 1985) idation and resource accumulation which occurred during the develop- ment of other U.S. industries, in strategic response to changing market environments [3]. Gro