U.S. Hospital Industry Restructuring and the Hospital Safety Net
The U.S. hospital industry was reshaped during the 1990s, with many hospitals becoming members of health systems and networks. Our research examines whether safety net hospitals (SNHs) were generally included or excluded from these arrangements, and the factors associated with their involvement. Our...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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SAGE Publishing
2003-02-01
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| Series: | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| Online Access: | https://doi.org/10.5034/inquiryjrnl_40.1.6 |
| _version_ | 1828784451268640768 |
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| author | Gloria J. Bazzoli Larry M. Manheim Teresa M. Waters |
| author_facet | Gloria J. Bazzoli Larry M. Manheim Teresa M. Waters |
| author_sort | Gloria J. Bazzoli |
| collection | DOAJ |
| description | The U.S. hospital industry was reshaped during the 1990s, with many hospitals becoming members of health systems and networks. Our research examines whether safety net hospitals (SNHs) were generally included or excluded from these arrangements, and the factors associated with their involvement. Our analysis draws on the earlier work of Alexander and Morrisey (1988), and not only studies factors affecting SNH participation in multihospital arrangements but also updates their earlier study. We constructed measures for hospital market conditions, management, and mission, and examined network and system affiliation patterns between 1994 and 1998. Our findings suggest that larger and more technically advanced hospitals joined systems in the 1990s, which contrasts with 1980s findings that smaller, financially weak institutions joined systems. Further, SNH participation in networks and systems was more common when hospitals faced less market pressure and where only a limited number of unaffiliated hospitals remained. If networks and systems are key parties in negotiating with private payers, SNHs may be going it alone in these negotiations in highly competitive markets. |
| first_indexed | 2024-12-11T23:30:48Z |
| format | Article |
| id | doaj.art-def7d562eda142ecb83947ecdcd3834f |
| institution | Directory Open Access Journal |
| issn | 0046-9580 |
| language | English |
| last_indexed | 2024-12-11T23:30:48Z |
| publishDate | 2003-02-01 |
| publisher | SAGE Publishing |
| record_format | Article |
| series | Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| spelling | doaj.art-def7d562eda142ecb83947ecdcd3834f2022-12-22T00:46:02ZengSAGE PublishingInquiry: The Journal of Health Care Organization, Provision, and Financing0046-95802003-02-014010.5034/inquiryjrnl_40.1.6U.S. Hospital Industry Restructuring and the Hospital Safety NetGloria J. BazzoliLarry M. ManheimTeresa M. WatersThe U.S. hospital industry was reshaped during the 1990s, with many hospitals becoming members of health systems and networks. Our research examines whether safety net hospitals (SNHs) were generally included or excluded from these arrangements, and the factors associated with their involvement. Our analysis draws on the earlier work of Alexander and Morrisey (1988), and not only studies factors affecting SNH participation in multihospital arrangements but also updates their earlier study. We constructed measures for hospital market conditions, management, and mission, and examined network and system affiliation patterns between 1994 and 1998. Our findings suggest that larger and more technically advanced hospitals joined systems in the 1990s, which contrasts with 1980s findings that smaller, financially weak institutions joined systems. Further, SNH participation in networks and systems was more common when hospitals faced less market pressure and where only a limited number of unaffiliated hospitals remained. If networks and systems are key parties in negotiating with private payers, SNHs may be going it alone in these negotiations in highly competitive markets.https://doi.org/10.5034/inquiryjrnl_40.1.6 |
| spellingShingle | Gloria J. Bazzoli Larry M. Manheim Teresa M. Waters U.S. Hospital Industry Restructuring and the Hospital Safety Net Inquiry: The Journal of Health Care Organization, Provision, and Financing |
| title | U.S. Hospital Industry Restructuring and the Hospital Safety Net |
| title_full | U.S. Hospital Industry Restructuring and the Hospital Safety Net |
| title_fullStr | U.S. Hospital Industry Restructuring and the Hospital Safety Net |
| title_full_unstemmed | U.S. Hospital Industry Restructuring and the Hospital Safety Net |
| title_short | U.S. Hospital Industry Restructuring and the Hospital Safety Net |
| title_sort | u s hospital industry restructuring and the hospital safety net |
| url | https://doi.org/10.5034/inquiryjrnl_40.1.6 |
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