Structural Determinants of Hospital Closure

Dados Bibliográficos

ID9101031
AutoresDaniel R Longo (0000-0002-9949-6354, Joint Commission, autor correspondente), Gary A Chase (Johns Hopkins University)
Ano1984
Volume22
Fascículo5
Páginas388-402
Data de publicação1984-05-01
Peer ReviewedSim
Open AccessNão
TipoARTICLE
PeriódicoMedical Care (JOURNAL)
Identificadores do periódicoISSN: 0025-7079 • E-ISSN: 1537-1948
EditoraOvid Technologies (Wolters Kluwer Health) (PUBLISHER)
DOI10.1097/00005650-198405000-00003
PMID6717119
OpenAlexW2075982254
IdiomaEN
Citações recebidas17
Referências citadas3

In a retrospective case-control study, structural characteristics of hospitals that closed during the years 1976-1980 were contrasted with three comparison groups: hospitals that were acquired in a merger; hospitals that joined a multihospital system; and hospitals that remained autonomously opened, to investigate these characteristics as predictors of closure. Characteristics investigated included environmental, structural, and process variables. The independent variables were measured 5 years prior to outcome. Findings indicate that closed hospitals resemble hospitals acquired in a merger ("failure"), and likewise autonomous hospitals resemble hospitals that join a multihospital system ("success"). The most important predictors of hospital failure were the physician-to-population ratio, the East North Central and West North Central census regions, the level of diversification, low occupancy rate, location in a standard metropolitan statistical area, the chief executive officer's lack of affiliation in the American College of Hospital Administrators, profit status, bed size of less than 50, and presence in a state with a rate-setting agency. Surprisingly, this study shows the bed-to-population ratio to be unrelated to closure. In addition, the findings strongly support the open-system perspective, which, unlike the closed-system perspective, is concerned with the vulnerability of the organization to the uncontrollable and often unpredictable influences of the environment

Business · Census · Closure (psychology) · Economics · Environmental health · Geography · Metropolitan area · Occupancy · Officer · Operations management · Political science · Population · Sociology · Demography · Engineering · Healthcare Policy and Management · Medicine · Patient Satisfaction in Healthcare · Primary Care and Health Outcomes