CINXE.COM

<!DOCTYPE html> <html lang="en" xmlns:fb="http://www.facebook.com/2008/fbml" class="wf-loading"> <head prefix="og: https://ogp.me/ns# fb: https://ogp.me/ns/fb# academia: https://ogp.me/ns/fb/academia#"> <meta charset="utf-8"> <meta name=viewport content="width=device-width, initial-scale=1"> <meta rel="search" type="application/opensearchdescription+xml" href="/open_search.xml" title="Academia.edu"> <title>Gloria Bazzoli | Virginia Commonwealth University - Academia.edu</title>  <link href="//a.academia-assets.com/images/favicons/favicon-production.ico" rel="shortcut icon" type="image/vnd.microsoft.icon"> <link rel="apple-touch-icon" sizes="57x57" href="//a.academia-assets.com/images/favicons/apple-touch-icon-57x57.png"> <link rel="apple-touch-icon" sizes="60x60" href="//a.academia-assets.com/images/favicons/apple-touch-icon-60x60.png"> <link rel="apple-touch-icon" sizes="72x72" href="//a.academia-assets.com/images/favicons/apple-touch-icon-72x72.png"> <link rel="apple-touch-icon" sizes="76x76" href="//a.academia-assets.com/images/favicons/apple-touch-icon-76x76.png"> <link rel="apple-touch-icon" sizes="114x114" href="//a.academia-assets.com/images/favicons/apple-touch-icon-114x114.png"> <link rel="apple-touch-icon" sizes="120x120" href="//a.academia-assets.com/images/favicons/apple-touch-icon-120x120.png"> <link rel="apple-touch-icon" sizes="144x144" href="//a.academia-assets.com/images/favicons/apple-touch-icon-144x144.png"> <link rel="apple-touch-icon" sizes="152x152" href="//a.academia-assets.com/images/favicons/apple-touch-icon-152x152.png"> <link rel="apple-touch-icon" sizes="180x180" href="//a.academia-assets.com/images/favicons/apple-touch-icon-180x180.png"> <link rel="icon" type="image/png" href="//a.academia-assets.com/images/favicons/favicon-32x32.png" sizes="32x32"> <link rel="icon" type="image/png" href="//a.academia-assets.com/images/favicons/favicon-194x194.png" sizes="194x194"> <link rel="icon" type="image/png" href="//a.academia-assets.com/images/favicons/favicon-96x96.png" sizes="96x96"> <link rel="icon" type="image/png" href="//a.academia-assets.com/images/favicons/android-chrome-192x192.png" sizes="192x192"> <link rel="icon" type="image/png" href="//a.academia-assets.com/images/favicons/favicon-16x16.png" sizes="16x16"> <link rel="manifest" href="//a.academia-assets.com/images/favicons/manifest.json"> <meta name="msapplication-TileColor" content="#2b5797"> <meta name="msapplication-TileImage" content="//a.academia-assets.com/images/favicons/mstile-144x144.png"> <meta name="theme-color" content="#ffffff"> <script> window.performance && window.performance.measure && window.performance.measure("Time To First Byte", "requestStart", "responseStart"); </script> <script> (function() { if (!window.URLSearchParams || !window.history || !window.history.replaceState) { return; } var searchParams = new URLSearchParams(window.location.search); var paramsToDelete = [ 'fs', 'sm', 'swp', 'iid', 'nbs', 'rcc', // related content category 'rcpos', // related content carousel position 'rcpg', // related carousel page 'rchid', // related content hit id 'f_ri', // research interest id, for SEO tracking 'f_fri', // featured research interest, for SEO tracking (param key without value) 'f_rid', // from research interest directory for SEO tracking 'f_loswp', // from research interest pills on LOSWP sidebar for SEO tracking 'rhid', // referrring hit id ]; if (paramsToDelete.every((key) => searchParams.get(key) === null)) { return; } paramsToDelete.forEach((key) => { searchParams.delete(key); }); var cleanUrl = new URL(window.location.href); cleanUrl.search = searchParams.toString(); history.replaceState({}, document.title, cleanUrl); })(); </script> <script async src="https://www.googletagmanager.com/gtag/js?id=G-5VKX33P2DS"></script> <script> window.dataLayer = window.dataLayer || []; function gtag(){dataLayer.push(arguments);} gtag('js', new Date()); gtag('config', 'G-5VKX33P2DS', { cookie_domain: 'academia.edu', send_page_view: false, }); gtag('event', 'page_view', { 'controller': "profiles/works", 'action': "summary", 'controller_action': 'profiles/works#summary', 'logged_in': 'false', 'edge': 'unknown', // Send nil if there is no A/B test bucket, in case some records get logged // with missing data - that way we can distinguish between the two cases. // ab_test_bucket should be of the form <ab_test_name>:<bucket> 'ab_test_bucket': null, }) </script> <script type="text/javascript"> window.sendUserTiming = function(timingName) { if (!(window.performance && window.performance.measure)) return; var entries = window.performance.getEntriesByName(timingName, "measure"); if (entries.length !== 1) return; var timingValue = Math.round(entries[0].duration); gtag('event', 'timing_complete', { name: timingName, value: timingValue, event_category: 'User-centric', }); }; window.sendUserTiming("Time To First Byte"); </script> <meta name="csrf-param" content="authenticity_token" /> <meta name="csrf-token" content="-zI8LGS6EjbFYIft1beKWollB2iphcPlLKDcmD2VdswJIJkj1_hxNE_3hBKtSrSRg5KZKV3vZ3E4xbaS795I_Q" /> <link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/wow-3d36c19b4875b226bfed0fcba1dcea3f2fe61148383d97c0465c016b8c969290.css" /><link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/social/home-79e78ce59bef0a338eb6540ec3d93b4a7952115b56c57f1760943128f4544d42.css" /><link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/single_work_page/figure_carousel-2004283e0948681916eefa74772df54f56cb5c7413d82b160212231c2f474bb3.css" /><script type="application/ld+json">{"@context":"https://schema.org","@type":"ProfilePage","mainEntity":{"@context":"https://schema.org","@type":"Person","name":"Gloria Bazzoli","url":"https://vcu.academia.edu/GloriaBazzoli","sameAs":[]},"dateCreated":"2015-07-29T13:43:50-07:00","dateModified":"2020-08-28T11:21:23-07:00","name":"Gloria Bazzoli","description":"Gloria Bazzoli","sameAs":[],"relatedLink":"https://www.academia.edu/17825798/Impact_of_HMO_market_structure_on_physician_hospital_strategic_alliances"}</script><link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/design_system/heading-95367dc03b794f6737f30123738a886cf53b7a65cdef98a922a98591d60063e3.css" /><link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/design_system/button-8c9ae4b5c8a2531640c354d92a1f3579c8ff103277ef74913e34c8a76d4e6c00.css" /><link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/design_system/body-170d1319f0e354621e81ca17054bb147da2856ec0702fe440a99af314a6338c5.css" /><link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/single_work_page/figure_carousel-2004283e0948681916eefa74772df54f56cb5c7413d82b160212231c2f474bb3.css" /><style type="text/css">@media(max-width: 567px){:root{--token-mode: Parity;--dropshadow: 0 2px 4px 0 #22223340;--primary-brand: #0645b1;--error-dark: #b60000;--success-dark: #05b01c;--inactive-fill: #ebebee;--hover: #0c3b8d;--pressed: #082f75;--button-primary-fill-inactive: #ebebee;--button-primary-fill: #0645b1;--button-primary-text: #ffffff;--button-primary-fill-hover: #0c3b8d;--button-primary-fill-press: #082f75;--button-primary-icon: #ffffff;--button-primary-fill-inverse: #ffffff;--button-primary-text-inverse: #082f75;--button-primary-icon-inverse: #0645b1;--button-primary-fill-inverse-hover: #cddaef;--button-primary-stroke-inverse-pressed: #0645b1;--button-secondary-stroke-inactive: #b1b1ba;--button-secondary-fill: #eef2f9;--button-secondary-text: #082f75;--button-secondary-fill-press: #cddaef;--button-secondary-fill-inactive: #ebebee;--button-secondary-stroke: #cddaef;--button-secondary-stroke-hover: #386ac1;--button-secondary-stroke-press: #0645b1;--button-secondary-text-inactive: #b1b1ba;--button-secondary-icon: #082f75;--button-secondary-fill-hover: #e6ecf7;--button-secondary-stroke-inverse: #ffffff;--button-secondary-fill-inverse: rgba(255, 255, 255, 0);--button-secondary-icon-inverse: #ffffff;--button-secondary-icon-hover: #082f75;--button-secondary-icon-press: #082f75;--button-secondary-text-inverse: #ffffff;--button-secondary-text-hover: #082f75;--button-secondary-text-press: #082f75;--button-secondary-fill-inverse-hover: #043059;--button-xs-stroke: #141413;--button-xs-stroke-hover: #0c3b8d;--button-xs-stroke-press: #082f75;--button-xs-stroke-inactive: #ebebee;--button-xs-text: #141413;--button-xs-text-hover: #0c3b8d;--button-xs-text-press: #082f75;--button-xs-text-inactive: #91919e;--button-xs-icon: #141413;--button-xs-icon-hover: #0c3b8d;--button-xs-icon-press: #082f75;--button-xs-icon-inactive: #91919e;--button-xs-fill: #ffffff;--button-xs-fill-hover: #f4f7fc;--button-xs-fill-press: #eef2f9;--buttons-button-text-inactive: #91919e;--buttons-button-focus: #0645b1;--buttons-button-icon-inactive: #91919e;--buttons-small-buttons-corner-radius: 8px;--buttons-small-buttons-l-r-padding: 12px;--buttons-small-buttons-height: 44px;--buttons-small-buttons-gap: 8px;--buttons-small-buttons-icon-only-width: 44px;--buttons-small-buttons-icon-size: 20px;--buttons-small-buttons-stroke-default: 1px;--buttons-small-buttons-stroke-thick: 2px;--buttons-large-buttons-l-r-padding: 20px;--buttons-large-buttons-height: 54px;--buttons-large-buttons-icon-only-width: 54px;--buttons-large-buttons-icon-size: 20px;--buttons-large-buttons-gap: 8px;--buttons-large-buttons-corner-radius: 8px;--buttons-large-buttons-stroke-default: 1px;--buttons-large-buttons-stroke-thick: 2px;--buttons-extra-small-buttons-l-r-padding: 8px;--buttons-extra-small-buttons-height: 32px;--buttons-extra-small-buttons-icon-size: 16px;--buttons-extra-small-buttons-gap: 4px;--buttons-extra-small-buttons-corner-radius: 8px;--buttons-stroke-default: 1px;--buttons-stroke-thick: 2px;--background-beige: #f9f7f4;--error-light: #fff2f2;--text-placeholder: #6d6d7d;--stroke-dark: #141413;--stroke-light: #dddde2;--stroke-medium: #535366;--accent-green: #ccffd4;--accent-turquoise: #ccf7ff;--accent-yellow: #f7ffcc;--accent-peach: #ffd4cc;--accent-violet: #f7ccff;--accent-purple: #f4f7fc;--text-primary: #141413;--secondary-brand: #141413;--text-hover: #0c3b8d;--text-white: #ffffff;--text-link: #0645b1;--text-press: #082f75;--success-light: #f0f8f1;--background-light-blue: #eef2f9;--background-white: #ffffff;--premium-dark: #877440;--premium-light: #f9f6ed;--stroke-white: #ffffff;--inactive-content: #b1b1ba;--annotate-light: #a35dff;--annotate-dark: #824acc;--grid: #eef2f9;--inactive-stroke: #ebebee;--shadow: rgba(34, 34, 51, 0.25);--text-inactive: #6d6d7d;--text-error: #b60000;--stroke-error: #b60000;--background-error: #fff2f2;--background-black: #141413;--icon-default: #141413;--icon-blue: #0645b1;--background-grey: #dddde2;--icon-grey: #b1b1ba;--text-focus: #082f75;--brand-colors-neutral-black: #141413;--brand-colors-neutral-900: #535366;--brand-colors-neutral-800: #6d6d7d;--brand-colors-neutral-700: #91919e;--brand-colors-neutral-600: #b1b1ba;--brand-colors-neutral-500: #c8c8cf;--brand-colors-neutral-400: #dddde2;--brand-colors-neutral-300: #ebebee;--brand-colors-neutral-200: #f8f8fb;--brand-colors-neutral-100: #fafafa;--brand-colors-neutral-white: #ffffff;--brand-colors-blue-900: #043059;--brand-colors-blue-800: #082f75;--brand-colors-blue-700: #0c3b8d;--brand-colors-blue-600: #0645b1;--brand-colors-blue-500: #386ac1;--brand-colors-blue-400: #cddaef;--brand-colors-blue-300: #e6ecf7;--brand-colors-blue-200: #eef2f9;--brand-colors-blue-100: #f4f7fc;--brand-colors-gold-500: #877440;--brand-colors-gold-400: #e9e3d4;--brand-colors-gold-300: #f2efe8;--brand-colors-gold-200: #f9f6ed;--brand-colors-gold-100: #f9f7f4;--brand-colors-error-900: #920000;--brand-colors-error-500: #b60000;--brand-colors-success-900: #035c0f;--brand-colors-green: #ccffd4;--brand-colors-turquoise: #ccf7ff;--brand-colors-yellow: #f7ffcc;--brand-colors-peach: #ffd4cc;--brand-colors-violet: #f7ccff;--brand-colors-error-100: #fff2f2;--brand-colors-success-500: #05b01c;--brand-colors-success-100: #f0f8f1;--text-secondary: #535366;--icon-white: #ffffff;--background-beige-darker: #f2efe8;--icon-dark-grey: #535366;--type-font-family-sans-serif: Roboto;--type-font-family-serif: Georgia;--type-font-family-mono: IBM Plex Mono;--type-weights-300: 300;--type-weights-400: 400;--type-weights-500: 500;--type-weights-700: 700;--type-sizes-12: 12px;--type-sizes-14: 14px;--type-sizes-16: 16px;--type-sizes-18: 18px;--type-sizes-20: 20px;--type-sizes-22: 22px;--type-sizes-24: 24px;--type-sizes-28: 28px;--type-sizes-30: 30px;--type-sizes-32: 32px;--type-sizes-40: 40px;--type-sizes-42: 42px;--type-sizes-48-2: 48px;--type-line-heights-16: 16px;--type-line-heights-20: 20px;--type-line-heights-23: 23px;--type-line-heights-24: 24px;--type-line-heights-25: 25px;--type-line-heights-26: 26px;--type-line-heights-29: 29px;--type-line-heights-30: 30px;--type-line-heights-32: 32px;--type-line-heights-34: 34px;--type-line-heights-35: 35px;--type-line-heights-36: 36px;--type-line-heights-38: 38px;--type-line-heights-40: 40px;--type-line-heights-46: 46px;--type-line-heights-48: 48px;--type-line-heights-52: 52px;--type-line-heights-58: 58px;--type-line-heights-68: 68px;--type-line-heights-74: 74px;--type-line-heights-82: 82px;--type-paragraph-spacings-0: 0px;--type-paragraph-spacings-4: 4px;--type-paragraph-spacings-8: 8px;--type-paragraph-spacings-16: 16px;--type-sans-serif-xl-font-weight: 400;--type-sans-serif-xl-size: 32px;--type-sans-serif-xl-line-height: 46px;--type-sans-serif-xl-paragraph-spacing: 16px;--type-sans-serif-lg-font-weight: 400;--type-sans-serif-lg-size: 30px;--type-sans-serif-lg-line-height: 36px;--type-sans-serif-lg-paragraph-spacing: 16px;--type-sans-serif-md-font-weight: 400;--type-sans-serif-md-line-height: 30px;--type-sans-serif-md-paragraph-spacing: 16px;--type-sans-serif-md-size: 24px;--type-sans-serif-xs-font-weight: 700;--type-sans-serif-xs-line-height: 24px;--type-sans-serif-xs-paragraph-spacing: 0px;--type-sans-serif-xs-size: 18px;--type-sans-serif-sm-font-weight: 400;--type-sans-serif-sm-line-height: 32px;--type-sans-serif-sm-paragraph-spacing: 16px;--type-sans-serif-sm-size: 20px;--type-body-xl-font-weight: 400;--type-body-xl-size: 24px;--type-body-xl-line-height: 36px;--type-body-xl-paragraph-spacing: 0px;--type-body-sm-font-weight: 400;--type-body-sm-size: 14px;--type-body-sm-line-height: 20px;--type-body-sm-paragraph-spacing: 8px;--type-body-xs-font-weight: 400;--type-body-xs-size: 12px;--type-body-xs-line-height: 16px;--type-body-xs-paragraph-spacing: 0px;--type-body-md-font-weight: 400;--type-body-md-size: 16px;--type-body-md-line-height: 20px;--type-body-md-paragraph-spacing: 4px;--type-body-lg-font-weight: 400;--type-body-lg-size: 20px;--type-body-lg-line-height: 26px;--type-body-lg-paragraph-spacing: 16px;--type-body-lg-medium-font-weight: 500;--type-body-lg-medium-size: 20px;--type-body-lg-medium-line-height: 32px;--type-body-lg-medium-paragraph-spacing: 16px;--type-body-md-medium-font-weight: 500;--type-body-md-medium-size: 16px;--type-body-md-medium-line-height: 20px;--type-body-md-medium-paragraph-spacing: 4px;--type-body-sm-bold-font-weight: 700;--type-body-sm-bold-size: 14px;--type-body-sm-bold-line-height: 20px;--type-body-sm-bold-paragraph-spacing: 8px;--type-body-sm-medium-font-weight: 500;--type-body-sm-medium-size: 14px;--type-body-sm-medium-line-height: 20px;--type-body-sm-medium-paragraph-spacing: 8px;--type-serif-md-font-weight: 400;--type-serif-md-size: 32px;--type-serif-md-paragraph-spacing: 0px;--type-serif-md-line-height: 40px;--type-serif-sm-font-weight: 400;--type-serif-sm-size: 24px;--type-serif-sm-paragraph-spacing: 0px;--type-serif-sm-line-height: 26px;--type-serif-lg-font-weight: 400;--type-serif-lg-size: 48px;--type-serif-lg-paragraph-spacing: 0px;--type-serif-lg-line-height: 52px;--type-serif-xs-font-weight: 400;--type-serif-xs-size: 18px;--type-serif-xs-line-height: 24px;--type-serif-xs-paragraph-spacing: 0px;--type-serif-xl-font-weight: 400;--type-serif-xl-size: 48px;--type-serif-xl-paragraph-spacing: 0px;--type-serif-xl-line-height: 58px;--type-mono-md-font-weight: 400;--type-mono-md-size: 22px;--type-mono-md-line-height: 24px;--type-mono-md-paragraph-spacing: 0px;--type-mono-lg-font-weight: 400;--type-mono-lg-size: 40px;--type-mono-lg-line-height: 40px;--type-mono-lg-paragraph-spacing: 0px;--type-mono-sm-font-weight: 400;--type-mono-sm-size: 14px;--type-mono-sm-line-height: 24px;--type-mono-sm-paragraph-spacing: 0px;--spacing-xs-4: 4px;--spacing-xs-8: 8px;--spacing-xs-16: 16px;--spacing-sm-24: 24px;--spacing-sm-32: 32px;--spacing-md-40: 40px;--spacing-md-48: 48px;--spacing-lg-64: 64px;--spacing-lg-80: 80px;--spacing-xlg-104: 104px;--spacing-xlg-152: 152px;--spacing-xs-12: 12px;--spacing-page-section: 80px;--spacing-card-list-spacing: 48px;--spacing-text-section-spacing: 64px;--spacing-md-xs-headings: 40px;--corner-radius-radius-lg: 16px;--corner-radius-radius-sm: 4px;--corner-radius-radius-md: 8px;--corner-radius-radius-round: 104px}}@media(min-width: 568px)and (max-width: 1279px){:root{--token-mode: Parity;--dropshadow: 0 2px 4px 0 #22223340;--primary-brand: #0645b1;--error-dark: #b60000;--success-dark: #05b01c;--inactive-fill: #ebebee;--hover: #0c3b8d;--pressed: #082f75;--button-primary-fill-inactive: #ebebee;--button-primary-fill: #0645b1;--button-primary-text: #ffffff;--button-primary-fill-hover: #0c3b8d;--button-primary-fill-press: #082f75;--button-primary-icon: #ffffff;--button-primary-fill-inverse: #ffffff;--button-primary-text-inverse: #082f75;--button-primary-icon-inverse: #0645b1;--button-primary-fill-inverse-hover: #cddaef;--button-primary-stroke-inverse-pressed: #0645b1;--button-secondary-stroke-inactive: #b1b1ba;--button-secondary-fill: #eef2f9;--button-secondary-text: #082f75;--button-secondary-fill-press: #cddaef;--button-secondary-fill-inactive: #ebebee;--button-secondary-stroke: #cddaef;--button-secondary-stroke-hover: #386ac1;--button-secondary-stroke-press: #0645b1;--button-secondary-text-inactive: #b1b1ba;--button-secondary-icon: #082f75;--button-secondary-fill-hover: #e6ecf7;--button-secondary-stroke-inverse: #ffffff;--button-secondary-fill-inverse: rgba(255, 255, 255, 0);--button-secondary-icon-inverse: #ffffff;--button-secondary-icon-hover: #082f75;--button-secondary-icon-press: #082f75;--button-secondary-text-inverse: #ffffff;--button-secondary-text-hover: #082f75;--button-secondary-text-press: #082f75;--button-secondary-fill-inverse-hover: #043059;--button-xs-stroke: #141413;--button-xs-stroke-hover: #0c3b8d;--button-xs-stroke-press: #082f75;--button-xs-stroke-inactive: #ebebee;--button-xs-text: #141413;--button-xs-text-hover: #0c3b8d;--button-xs-text-press: #082f75;--button-xs-text-inactive: #91919e;--button-xs-icon: #141413;--button-xs-icon-hover: #0c3b8d;--button-xs-icon-press: #082f75;--button-xs-icon-inactive: #91919e;--button-xs-fill: #ffffff;--button-xs-fill-hover: #f4f7fc;--button-xs-fill-press: #eef2f9;--buttons-button-text-inactive: #91919e;--buttons-button-focus: #0645b1;--buttons-button-icon-inactive: #91919e;--buttons-small-buttons-corner-radius: 8px;--buttons-small-buttons-l-r-padding: 12px;--buttons-small-buttons-height: 44px;--buttons-small-buttons-gap: 8px;--buttons-small-buttons-icon-only-width: 44px;--buttons-small-buttons-icon-size: 20px;--buttons-small-buttons-stroke-default: 1px;--buttons-small-buttons-stroke-thick: 2px;--buttons-large-buttons-l-r-padding: 20px;--buttons-large-buttons-height: 54px;--buttons-large-buttons-icon-only-width: 54px;--buttons-large-buttons-icon-size: 20px;--buttons-large-buttons-gap: 8px;--buttons-large-buttons-corner-radius: 8px;--buttons-large-buttons-stroke-default: 1px;--buttons-large-buttons-stroke-thick: 2px;--buttons-extra-small-buttons-l-r-padding: 8px;--buttons-extra-small-buttons-height: 32px;--buttons-extra-small-buttons-icon-size: 16px;--buttons-extra-small-buttons-gap: 4px;--buttons-extra-small-buttons-corner-radius: 8px;--buttons-stroke-default: 1px;--buttons-stroke-thick: 2px;--background-beige: #f9f7f4;--error-light: #fff2f2;--text-placeholder: #6d6d7d;--stroke-dark: #141413;--stroke-light: #dddde2;--stroke-medium: #535366;--accent-green: #ccffd4;--accent-turquoise: #ccf7ff;--accent-yellow: #f7ffcc;--accent-peach: #ffd4cc;--accent-violet: #f7ccff;--accent-purple: #f4f7fc;--text-primary: #141413;--secondary-brand: #141413;--text-hover: #0c3b8d;--text-white: #ffffff;--text-link: #0645b1;--text-press: #082f75;--success-light: #f0f8f1;--background-light-blue: #eef2f9;--background-white: #ffffff;--premium-dark: #877440;--premium-light: #f9f6ed;--stroke-white: #ffffff;--inactive-content: #b1b1ba;--annotate-light: #a35dff;--annotate-dark: #824acc;--grid: #eef2f9;--inactive-stroke: #ebebee;--shadow: rgba(34, 34, 51, 0.25);--text-inactive: #6d6d7d;--text-error: #b60000;--stroke-error: #b60000;--background-error: #fff2f2;--background-black: #141413;--icon-default: #141413;--icon-blue: #0645b1;--background-grey: #dddde2;--icon-grey: #b1b1ba;--text-focus: #082f75;--brand-colors-neutral-black: #141413;--brand-colors-neutral-900: #535366;--brand-colors-neutral-800: #6d6d7d;--brand-colors-neutral-700: #91919e;--brand-colors-neutral-600: #b1b1ba;--brand-colors-neutral-500: #c8c8cf;--brand-colors-neutral-400: #dddde2;--brand-colors-neutral-300: #ebebee;--brand-colors-neutral-200: #f8f8fb;--brand-colors-neutral-100: #fafafa;--brand-colors-neutral-white: #ffffff;--brand-colors-blue-900: #043059;--brand-colors-blue-800: #082f75;--brand-colors-blue-700: #0c3b8d;--brand-colors-blue-600: #0645b1;--brand-colors-blue-500: #386ac1;--brand-colors-blue-400: #cddaef;--brand-colors-blue-300: #e6ecf7;--brand-colors-blue-200: #eef2f9;--brand-colors-blue-100: #f4f7fc;--brand-colors-gold-500: #877440;--brand-colors-gold-400: #e9e3d4;--brand-colors-gold-300: #f2efe8;--brand-colors-gold-200: #f9f6ed;--brand-colors-gold-100: #f9f7f4;--brand-colors-error-900: #920000;--brand-colors-error-500: #b60000;--brand-colors-success-900: #035c0f;--brand-colors-green: #ccffd4;--brand-colors-turquoise: #ccf7ff;--brand-colors-yellow: #f7ffcc;--brand-colors-peach: #ffd4cc;--brand-colors-violet: #f7ccff;--brand-colors-error-100: #fff2f2;--brand-colors-success-500: #05b01c;--brand-colors-success-100: #f0f8f1;--text-secondary: #535366;--icon-white: #ffffff;--background-beige-darker: #f2efe8;--icon-dark-grey: #535366;--type-font-family-sans-serif: Roboto;--type-font-family-serif: Georgia;--type-font-family-mono: IBM Plex Mono;--type-weights-300: 300;--type-weights-400: 400;--type-weights-500: 500;--type-weights-700: 700;--type-sizes-12: 12px;--type-sizes-14: 14px;--type-sizes-16: 16px;--type-sizes-18: 18px;--type-sizes-20: 20px;--type-sizes-22: 22px;--type-sizes-24: 24px;--type-sizes-28: 28px;--type-sizes-30: 30px;--type-sizes-32: 32px;--type-sizes-40: 40px;--type-sizes-42: 42px;--type-sizes-48-2: 48px;--type-line-heights-16: 16px;--type-line-heights-20: 20px;--type-line-heights-23: 23px;--type-line-heights-24: 24px;--type-line-heights-25: 25px;--type-line-heights-26: 26px;--type-line-heights-29: 29px;--type-line-heights-30: 30px;--type-line-heights-32: 32px;--type-line-heights-34: 34px;--type-line-heights-35: 35px;--type-line-heights-36: 36px;--type-line-heights-38: 38px;--type-line-heights-40: 40px;--type-line-heights-46: 46px;--type-line-heights-48: 48px;--type-line-heights-52: 52px;--type-line-heights-58: 58px;--type-line-heights-68: 68px;--type-line-heights-74: 74px;--type-line-heights-82: 82px;--type-paragraph-spacings-0: 0px;--type-paragraph-spacings-4: 4px;--type-paragraph-spacings-8: 8px;--type-paragraph-spacings-16: 16px;--type-sans-serif-xl-font-weight: 400;--type-sans-serif-xl-size: 42px;--type-sans-serif-xl-line-height: 46px;--type-sans-serif-xl-paragraph-spacing: 16px;--type-sans-serif-lg-font-weight: 400;--type-sans-serif-lg-size: 32px;--type-sans-serif-lg-line-height: 36px;--type-sans-serif-lg-paragraph-spacing: 16px;--type-sans-serif-md-font-weight: 400;--type-sans-serif-md-line-height: 34px;--type-sans-serif-md-paragraph-spacing: 16px;--type-sans-serif-md-size: 28px;--type-sans-serif-xs-font-weight: 700;--type-sans-serif-xs-line-height: 25px;--type-sans-serif-xs-paragraph-spacing: 0px;--type-sans-serif-xs-size: 20px;--type-sans-serif-sm-font-weight: 400;--type-sans-serif-sm-line-height: 30px;--type-sans-serif-sm-paragraph-spacing: 16px;--type-sans-serif-sm-size: 24px;--type-body-xl-font-weight: 400;--type-body-xl-size: 24px;--type-body-xl-line-height: 36px;--type-body-xl-paragraph-spacing: 0px;--type-body-sm-font-weight: 400;--type-body-sm-size: 14px;--type-body-sm-line-height: 20px;--type-body-sm-paragraph-spacing: 8px;--type-body-xs-font-weight: 400;--type-body-xs-size: 12px;--type-body-xs-line-height: 16px;--type-body-xs-paragraph-spacing: 0px;--type-body-md-font-weight: 400;--type-body-md-size: 16px;--type-body-md-line-height: 20px;--type-body-md-paragraph-spacing: 4px;--type-body-lg-font-weight: 400;--type-body-lg-size: 20px;--type-body-lg-line-height: 26px;--type-body-lg-paragraph-spacing: 16px;--type-body-lg-medium-font-weight: 500;--type-body-lg-medium-size: 20px;--type-body-lg-medium-line-height: 32px;--type-body-lg-medium-paragraph-spacing: 16px;--type-body-md-medium-font-weight: 500;--type-body-md-medium-size: 16px;--type-body-md-medium-line-height: 20px;--type-body-md-medium-paragraph-spacing: 4px;--type-body-sm-bold-font-weight: 700;--type-body-sm-bold-size: 14px;--type-body-sm-bold-line-height: 20px;--type-body-sm-bold-paragraph-spacing: 8px;--type-body-sm-medium-font-weight: 500;--type-body-sm-medium-size: 14px;--type-body-sm-medium-line-height: 20px;--type-body-sm-medium-paragraph-spacing: 8px;--type-serif-md-font-weight: 400;--type-serif-md-size: 40px;--type-serif-md-paragraph-spacing: 0px;--type-serif-md-line-height: 48px;--type-serif-sm-font-weight: 400;--type-serif-sm-size: 28px;--type-serif-sm-paragraph-spacing: 0px;--type-serif-sm-line-height: 32px;--type-serif-lg-font-weight: 400;--type-serif-lg-size: 58px;--type-serif-lg-paragraph-spacing: 0px;--type-serif-lg-line-height: 68px;--type-serif-xs-font-weight: 400;--type-serif-xs-size: 18px;--type-serif-xs-line-height: 24px;--type-serif-xs-paragraph-spacing: 0px;--type-serif-xl-font-weight: 400;--type-serif-xl-size: 74px;--type-serif-xl-paragraph-spacing: 0px;--type-serif-xl-line-height: 82px;--type-mono-md-font-weight: 400;--type-mono-md-size: 22px;--type-mono-md-line-height: 24px;--type-mono-md-paragraph-spacing: 0px;--type-mono-lg-font-weight: 400;--type-mono-lg-size: 40px;--type-mono-lg-line-height: 40px;--type-mono-lg-paragraph-spacing: 0px;--type-mono-sm-font-weight: 400;--type-mono-sm-size: 14px;--type-mono-sm-line-height: 24px;--type-mono-sm-paragraph-spacing: 0px;--spacing-xs-4: 4px;--spacing-xs-8: 8px;--spacing-xs-16: 16px;--spacing-sm-24: 24px;--spacing-sm-32: 32px;--spacing-md-40: 40px;--spacing-md-48: 48px;--spacing-lg-64: 64px;--spacing-lg-80: 80px;--spacing-xlg-104: 104px;--spacing-xlg-152: 152px;--spacing-xs-12: 12px;--spacing-page-section: 104px;--spacing-card-list-spacing: 48px;--spacing-text-section-spacing: 80px;--spacing-md-xs-headings: 40px;--corner-radius-radius-lg: 16px;--corner-radius-radius-sm: 4px;--corner-radius-radius-md: 8px;--corner-radius-radius-round: 104px}}@media(min-width: 1280px){:root{--token-mode: Parity;--dropshadow: 0 2px 4px 0 #22223340;--primary-brand: #0645b1;--error-dark: #b60000;--success-dark: #05b01c;--inactive-fill: #ebebee;--hover: #0c3b8d;--pressed: #082f75;--button-primary-fill-inactive: #ebebee;--button-primary-fill: #0645b1;--button-primary-text: #ffffff;--button-primary-fill-hover: #0c3b8d;--button-primary-fill-press: #082f75;--button-primary-icon: #ffffff;--button-primary-fill-inverse: #ffffff;--button-primary-text-inverse: #082f75;--button-primary-icon-inverse: #0645b1;--button-primary-fill-inverse-hover: #cddaef;--button-primary-stroke-inverse-pressed: #0645b1;--button-secondary-stroke-inactive: #b1b1ba;--button-secondary-fill: #eef2f9;--button-secondary-text: #082f75;--button-secondary-fill-press: #cddaef;--button-secondary-fill-inactive: #ebebee;--button-secondary-stroke: #cddaef;--button-secondary-stroke-hover: #386ac1;--button-secondary-stroke-press: #0645b1;--button-secondary-text-inactive: #b1b1ba;--button-secondary-icon: #082f75;--button-secondary-fill-hover: #e6ecf7;--button-secondary-stroke-inverse: #ffffff;--button-secondary-fill-inverse: rgba(255, 255, 255, 0);--button-secondary-icon-inverse: #ffffff;--button-secondary-icon-hover: #082f75;--button-secondary-icon-press: #082f75;--button-secondary-text-inverse: #ffffff;--button-secondary-text-hover: #082f75;--button-secondary-text-press: #082f75;--button-secondary-fill-inverse-hover: #043059;--button-xs-stroke: #141413;--button-xs-stroke-hover: #0c3b8d;--button-xs-stroke-press: #082f75;--button-xs-stroke-inactive: #ebebee;--button-xs-text: #141413;--button-xs-text-hover: #0c3b8d;--button-xs-text-press: #082f75;--button-xs-text-inactive: #91919e;--button-xs-icon: #141413;--button-xs-icon-hover: #0c3b8d;--button-xs-icon-press: #082f75;--button-xs-icon-inactive: #91919e;--button-xs-fill: #ffffff;--button-xs-fill-hover: #f4f7fc;--button-xs-fill-press: #eef2f9;--buttons-button-text-inactive: #91919e;--buttons-button-focus: #0645b1;--buttons-button-icon-inactive: #91919e;--buttons-small-buttons-corner-radius: 8px;--buttons-small-buttons-l-r-padding: 12px;--buttons-small-buttons-height: 44px;--buttons-small-buttons-gap: 8px;--buttons-small-buttons-icon-only-width: 44px;--buttons-small-buttons-icon-size: 20px;--buttons-small-buttons-stroke-default: 1px;--buttons-small-buttons-stroke-thick: 2px;--buttons-large-buttons-l-r-padding: 20px;--buttons-large-buttons-height: 54px;--buttons-large-buttons-icon-only-width: 54px;--buttons-large-buttons-icon-size: 20px;--buttons-large-buttons-gap: 8px;--buttons-large-buttons-corner-radius: 8px;--buttons-large-buttons-stroke-default: 1px;--buttons-large-buttons-stroke-thick: 2px;--buttons-extra-small-buttons-l-r-padding: 8px;--buttons-extra-small-buttons-height: 32px;--buttons-extra-small-buttons-icon-size: 16px;--buttons-extra-small-buttons-gap: 4px;--buttons-extra-small-buttons-corner-radius: 8px;--buttons-stroke-default: 1px;--buttons-stroke-thick: 2px;--background-beige: #f9f7f4;--error-light: #fff2f2;--text-placeholder: #6d6d7d;--stroke-dark: #141413;--stroke-light: #dddde2;--stroke-medium: #535366;--accent-green: #ccffd4;--accent-turquoise: #ccf7ff;--accent-yellow: #f7ffcc;--accent-peach: #ffd4cc;--accent-violet: #f7ccff;--accent-purple: #f4f7fc;--text-primary: #141413;--secondary-brand: #141413;--text-hover: #0c3b8d;--text-white: #ffffff;--text-link: #0645b1;--text-press: #082f75;--success-light: #f0f8f1;--background-light-blue: #eef2f9;--background-white: #ffffff;--premium-dark: #877440;--premium-light: #f9f6ed;--stroke-white: #ffffff;--inactive-content: #b1b1ba;--annotate-light: #a35dff;--annotate-dark: #824acc;--grid: #eef2f9;--inactive-stroke: #ebebee;--shadow: rgba(34, 34, 51, 0.25);--text-inactive: #6d6d7d;--text-error: #b60000;--stroke-error: #b60000;--background-error: #fff2f2;--background-black: #141413;--icon-default: #141413;--icon-blue: #0645b1;--background-grey: #dddde2;--icon-grey: #b1b1ba;--text-focus: #082f75;--brand-colors-neutral-black: #141413;--brand-colors-neutral-900: #535366;--brand-colors-neutral-800: #6d6d7d;--brand-colors-neutral-700: #91919e;--brand-colors-neutral-600: #b1b1ba;--brand-colors-neutral-500: #c8c8cf;--brand-colors-neutral-400: #dddde2;--brand-colors-neutral-300: #ebebee;--brand-colors-neutral-200: #f8f8fb;--brand-colors-neutral-100: #fafafa;--brand-colors-neutral-white: #ffffff;--brand-colors-blue-900: #043059;--brand-colors-blue-800: #082f75;--brand-colors-blue-700: #0c3b8d;--brand-colors-blue-600: #0645b1;--brand-colors-blue-500: #386ac1;--brand-colors-blue-400: #cddaef;--brand-colors-blue-300: #e6ecf7;--brand-colors-blue-200: #eef2f9;--brand-colors-blue-100: #f4f7fc;--brand-colors-gold-500: #877440;--brand-colors-gold-400: #e9e3d4;--brand-colors-gold-300: #f2efe8;--brand-colors-gold-200: #f9f6ed;--brand-colors-gold-100: #f9f7f4;--brand-colors-error-900: #920000;--brand-colors-error-500: #b60000;--brand-colors-success-900: #035c0f;--brand-colors-green: #ccffd4;--brand-colors-turquoise: #ccf7ff;--brand-colors-yellow: #f7ffcc;--brand-colors-peach: #ffd4cc;--brand-colors-violet: #f7ccff;--brand-colors-error-100: #fff2f2;--brand-colors-success-500: #05b01c;--brand-colors-success-100: #f0f8f1;--text-secondary: #535366;--icon-white: #ffffff;--background-beige-darker: #f2efe8;--icon-dark-grey: #535366;--type-font-family-sans-serif: Roboto;--type-font-family-serif: Georgia;--type-font-family-mono: IBM Plex Mono;--type-weights-300: 300;--type-weights-400: 400;--type-weights-500: 500;--type-weights-700: 700;--type-sizes-12: 12px;--type-sizes-14: 14px;--type-sizes-16: 16px;--type-sizes-18: 18px;--type-sizes-20: 20px;--type-sizes-22: 22px;--type-sizes-24: 24px;--type-sizes-28: 28px;--type-sizes-30: 30px;--type-sizes-32: 32px;--type-sizes-40: 40px;--type-sizes-42: 42px;--type-sizes-48-2: 48px;--type-line-heights-16: 16px;--type-line-heights-20: 20px;--type-line-heights-23: 23px;--type-line-heights-24: 24px;--type-line-heights-25: 25px;--type-line-heights-26: 26px;--type-line-heights-29: 29px;--type-line-heights-30: 30px;--type-line-heights-32: 32px;--type-line-heights-34: 34px;--type-line-heights-35: 35px;--type-line-heights-36: 36px;--type-line-heights-38: 38px;--type-line-heights-40: 40px;--type-line-heights-46: 46px;--type-line-heights-48: 48px;--type-line-heights-52: 52px;--type-line-heights-58: 58px;--type-line-heights-68: 68px;--type-line-heights-74: 74px;--type-line-heights-82: 82px;--type-paragraph-spacings-0: 0px;--type-paragraph-spacings-4: 4px;--type-paragraph-spacings-8: 8px;--type-paragraph-spacings-16: 16px;--type-sans-serif-xl-font-weight: 400;--type-sans-serif-xl-size: 42px;--type-sans-serif-xl-line-height: 46px;--type-sans-serif-xl-paragraph-spacing: 16px;--type-sans-serif-lg-font-weight: 400;--type-sans-serif-lg-size: 32px;--type-sans-serif-lg-line-height: 38px;--type-sans-serif-lg-paragraph-spacing: 16px;--type-sans-serif-md-font-weight: 400;--type-sans-serif-md-line-height: 34px;--type-sans-serif-md-paragraph-spacing: 16px;--type-sans-serif-md-size: 28px;--type-sans-serif-xs-font-weight: 700;--type-sans-serif-xs-line-height: 25px;--type-sans-serif-xs-paragraph-spacing: 0px;--type-sans-serif-xs-size: 20px;--type-sans-serif-sm-font-weight: 400;--type-sans-serif-sm-line-height: 30px;--type-sans-serif-sm-paragraph-spacing: 16px;--type-sans-serif-sm-size: 24px;--type-body-xl-font-weight: 400;--type-body-xl-size: 24px;--type-body-xl-line-height: 36px;--type-body-xl-paragraph-spacing: 0px;--type-body-sm-font-weight: 400;--type-body-sm-size: 14px;--type-body-sm-line-height: 20px;--type-body-sm-paragraph-spacing: 8px;--type-body-xs-font-weight: 400;--type-body-xs-size: 12px;--type-body-xs-line-height: 16px;--type-body-xs-paragraph-spacing: 0px;--type-body-md-font-weight: 400;--type-body-md-size: 16px;--type-body-md-line-height: 20px;--type-body-md-paragraph-spacing: 4px;--type-body-lg-font-weight: 400;--type-body-lg-size: 20px;--type-body-lg-line-height: 26px;--type-body-lg-paragraph-spacing: 16px;--type-body-lg-medium-font-weight: 500;--type-body-lg-medium-size: 20px;--type-body-lg-medium-line-height: 32px;--type-body-lg-medium-paragraph-spacing: 16px;--type-body-md-medium-font-weight: 500;--type-body-md-medium-size: 16px;--type-body-md-medium-line-height: 20px;--type-body-md-medium-paragraph-spacing: 4px;--type-body-sm-bold-font-weight: 700;--type-body-sm-bold-size: 14px;--type-body-sm-bold-line-height: 20px;--type-body-sm-bold-paragraph-spacing: 8px;--type-body-sm-medium-font-weight: 500;--type-body-sm-medium-size: 14px;--type-body-sm-medium-line-height: 20px;--type-body-sm-medium-paragraph-spacing: 8px;--type-serif-md-font-weight: 400;--type-serif-md-size: 40px;--type-serif-md-paragraph-spacing: 0px;--type-serif-md-line-height: 48px;--type-serif-sm-font-weight: 400;--type-serif-sm-size: 28px;--type-serif-sm-paragraph-spacing: 0px;--type-serif-sm-line-height: 32px;--type-serif-lg-font-weight: 400;--type-serif-lg-size: 58px;--type-serif-lg-paragraph-spacing: 0px;--type-serif-lg-line-height: 68px;--type-serif-xs-font-weight: 400;--type-serif-xs-size: 18px;--type-serif-xs-line-height: 24px;--type-serif-xs-paragraph-spacing: 0px;--type-serif-xl-font-weight: 400;--type-serif-xl-size: 74px;--type-serif-xl-paragraph-spacing: 0px;--type-serif-xl-line-height: 82px;--type-mono-md-font-weight: 400;--type-mono-md-size: 22px;--type-mono-md-line-height: 24px;--type-mono-md-paragraph-spacing: 0px;--type-mono-lg-font-weight: 400;--type-mono-lg-size: 40px;--type-mono-lg-line-height: 40px;--type-mono-lg-paragraph-spacing: 0px;--type-mono-sm-font-weight: 400;--type-mono-sm-size: 14px;--type-mono-sm-line-height: 24px;--type-mono-sm-paragraph-spacing: 0px;--spacing-xs-4: 4px;--spacing-xs-8: 8px;--spacing-xs-16: 16px;--spacing-sm-24: 24px;--spacing-sm-32: 32px;--spacing-md-40: 40px;--spacing-md-48: 48px;--spacing-lg-64: 64px;--spacing-lg-80: 80px;--spacing-xlg-104: 104px;--spacing-xlg-152: 152px;--spacing-xs-12: 12px;--spacing-page-section: 152px;--spacing-card-list-spacing: 48px;--spacing-text-section-spacing: 80px;--spacing-md-xs-headings: 40px;--corner-radius-radius-lg: 16px;--corner-radius-radius-sm: 4px;--corner-radius-radius-md: 8px;--corner-radius-radius-round: 104px}}</style><link crossorigin="" href="https://fonts.gstatic.com/" rel="preconnect" /><link href="https://fonts.googleapis.com/css2?family=DM+Sans:ital,opsz,wght@0,9..40,100..1000;1,9..40,100..1000&family=Gupter:wght@400;500;700&family=IBM+Plex+Mono:wght@300;400&family=Material+Symbols+Outlined:opsz,wght,FILL,GRAD@20,400,0,0&display=swap" rel="stylesheet" /><link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/design_system/common-57f9da13cef3fd4e2a8b655342c6488eded3e557e823fe67571f2ac77acd7b6f.css" /> <meta name="author" content="gloria bazzoli" /> <meta name="description" content="Gloria Bazzoli, Virginia Commonwealth University: 68 Followers, 27 Following, 113 Research papers. Research interests: Geriatric medicine, Public Health…" /> <meta name="google-site-verification" content="bKJMBZA7E43xhDOopFZkssMMkBRjvYERV-NaN4R6mrs" /> <script> var $controller_name = 'works'; var $action_name = "summary"; var $rails_env = 'production'; var $app_rev = '1c320c3e0f17b43d3c014aa17fe266f0ee8abad8'; var $domain = 'academia.edu'; var $app_host = "academia.edu"; var $asset_host = "academia-assets.com"; var $start_time = new Date().getTime(); var $recaptcha_key = "6LdxlRMTAAAAADnu_zyLhLg0YF9uACwz78shpjJB"; var $recaptcha_invisible_key = "6Lf3KHUUAAAAACggoMpmGJdQDtiyrjVlvGJ6BbAj"; var $disableClientRecordHit = false; </script> <script> window.Aedu = { hit_data: null }; window.Aedu.SiteStats = {"premium_universities_count":13919,"monthly_visitors":"139 million","monthly_visitor_count":139296536,"monthly_visitor_count_in_millions":139,"user_count":286089727,"paper_count":55203019,"paper_count_in_millions":55,"page_count":432000000,"page_count_in_millions":432,"pdf_count":16500000,"pdf_count_in_millions":16}; window.Aedu.serverRenderTime = new Date(1743438380000); window.Aedu.timeDifference = new Date().getTime() - 1743438380000; window.Aedu.isUsingCssV1 = false; window.Aedu.enableLocalization = true; window.Aedu.activateFullstory = false; window.Aedu.serviceAvailability = { status: {"attention_db":"on","bibliography_db":"on","contacts_db":"on","email_db":"on","indexability_db":"on","mentions_db":"on","news_db":"on","notifications_db":"on","offsite_mentions_db":"on","redshift":"on","redshift_exports_db":"on","related_works_db":"on","ring_db":"on","user_tests_db":"on"}, serviceEnabled: function(service) { return this.status[service] === "on"; }, readEnabled: function(service) { return this.serviceEnabled(service) || this.status[service] === "read_only"; }, }; window.Aedu.viewApmTrace = function() { // Check if x-apm-trace-id meta tag is set, and open the trace in APM // in a new window if it is. var apmTraceId = document.head.querySelector('meta[name="x-apm-trace-id"]'); if (apmTraceId) { var traceId = apmTraceId.content; // Use trace ID to construct URL, an example URL looks like: // https://app.datadoghq.com/apm/traces?query=trace_id%31298410148923562634 var apmUrl = 'https://app.datadoghq.com/apm/traces?query=trace_id%3A' + traceId; window.open(apmUrl, '_blank'); } }; </script>  <link href="https://fonts.googleapis.com/css?family=Roboto:100,100i,300,300i,400,400i,500,500i,700,700i,900,900i" rel="stylesheet"> <link rel="preload" href="//maxcdn.bootstrapcdn.com/font-awesome/4.3.0/css/font-awesome.min.css" as="style" onload="this.rel='stylesheet'"> <link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/libraries-a9675dcb01ec4ef6aa807ba772c7a5a00c1820d3ff661c1038a20f80d06bb4e4.css" /> <link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/academia-9982828ed1de4777566441c35ccf7157c55ca779141fce69380d727ebdbbb926.css" /> <link rel="stylesheet" media="all" href="//a.academia-assets.com/assets/design_system_legacy-056a9113b9a0f5343d013b29ee1929d5a18be35fdcdceb616600b4db8bd20054.css" /> <script src="//a.academia-assets.com/assets/webpack_bundles/runtime-bundle-005434038af4252ca37c527588411a3d6a0eabb5f727fac83f8bbe7fd88d93bb.js"></script> <script src="//a.academia-assets.com/assets/webpack_bundles/webpack_libraries_and_infrequently_changed.wjs-bundle-cf157bca4ef673abcac8051ac68ed1136134beba22a884388e7ed6391572eef4.js"></script> <script src="//a.academia-assets.com/assets/webpack_bundles/core_webpack.wjs-bundle-f96ab8a6334d161855249975a57d3f3d57f65c2e7553c6d20ab43c63efb79575.js"></script> <script src="//a.academia-assets.com/assets/webpack_bundles/sentry.wjs-bundle-5fe03fddca915c8ba0f7edbe64c194308e8ce5abaed7bffe1255ff37549c4808.js"></script> <script> jade = window.jade || {}; jade.helpers = window.$h; jade._ = window._; </script>  <script id="tag-manager-head-root">(function(w,d,s,l,i){w[l]=w[l]||[];w[l].push({'gtm.start': new Date().getTime(),event:'gtm.js'});var f=d.getElementsByTagName(s)[0], j=d.createElement(s),dl=l!='dataLayer'?'&l='+l:'';j.async=true;j.src= 'https://www.googletagmanager.com/gtm.js?id='+i+dl;f.parentNode.insertBefore(j,f); })(window,document,'script','dataLayer_old','GTM-5G9JF7Z');</script>  <script> window.gptadslots = []; window.googletag = window.googletag || {}; window.googletag.cmd = window.googletag.cmd || []; </script> <script type="text/javascript"> // TODO(jacob): This should be defined, may be rare load order problem. // Checking if null is just a quick fix, will default to en if unset. // Better fix is to run this immedietely after I18n is set. if (window.I18n != null) { I18n.defaultLocale = "en"; I18n.locale = "en"; I18n.fallbacks = true; } </script> <link rel="canonical" href="https://vcu.academia.edu/GloriaBazzoli" /> </head>   <body class='c-profiles/works a-summary logged_out'>  <div id="fb-root"></div><script>window.fbAsyncInit = function() { FB.init({ appId: "2369844204", version: "v8.0", status: true, cookie: true, xfbml: true }); // Additional initialization code. if (window.InitFacebook) { // facebook.ts already loaded, set it up. window.InitFacebook(); } else { // Set a flag for facebook.ts to find when it loads. window.academiaAuthReadyFacebook = true; } };</script><script>window.fbAsyncLoad = function() { // Protection against double calling of this function if (window.FB) { return; } (function(d, s, id){ var js, fjs = d.getElementsByTagName(s)[0]; if (d.getElementById(id)) {return;} js = d.createElement(s); js.id = id; js.src = "//connect.facebook.net/en_US/sdk.js"; fjs.parentNode.insertBefore(js, fjs); }(document, 'script', 'facebook-jssdk')); } if (!window.defer_facebook) { // Autoload if not deferred window.fbAsyncLoad(); } else { // Defer loading by 5 seconds setTimeout(function() { window.fbAsyncLoad(); }, 5000); }</script> <div id="google-root"></div><script>window.loadGoogle = function() { if (window.InitGoogle) { // google.ts already loaded, set it up. window.InitGoogle("331998490334-rsn3chp12mbkiqhl6e7lu2q0mlbu0f1b"); } else { // Set a flag for google.ts to use when it loads. window.GoogleClientID = "331998490334-rsn3chp12mbkiqhl6e7lu2q0mlbu0f1b"; } };</script><script>window.googleAsyncLoad = function() { // Protection against double calling of this function (function(d) { var js; var id = 'google-jssdk'; var ref = d.getElementsByTagName('script')[0]; if (d.getElementById(id)) { return; } js = d.createElement('script'); js.id = id; js.async = true; js.onload = loadGoogle; js.src = "https://accounts.google.com/gsi/client" ref.parentNode.insertBefore(js, ref); }(document)); } if (!window.defer_google) { // Autoload if not deferred window.googleAsyncLoad(); } else { // Defer loading by 5 seconds setTimeout(function() { window.googleAsyncLoad(); }, 5000); }</script> <div id="tag-manager-body-root">  <noscript><iframe src="https://www.googletagmanager.com/ns.html?id=GTM-5G9JF7Z" height="0" width="0" style="display:none;visibility:hidden"></iframe></noscript>   <script> window.addEventListener('load', function() { if (document.querySelector('input[name="commit"]')) { document.querySelector('input[name="commit"]').addEventListener('click', function() { gtag('event', 'click', { event_category: 'button', event_label: 'Log In' }) }) } }); </script> </div> <script>var _comscore = _comscore || []; _comscore.push({ c1: "2", c2: "26766707" }); (function() { var s = document.createElement("script"), el = document.getElementsByTagName("script")[0]; s.async = true; s.src = (document.location.protocol == "https:" ? "https://sb" : "http://b") + ".scorecardresearch.com/beacon.js"; el.parentNode.insertBefore(s, el); })();</script><img src="https://sb.scorecardresearch.com/p?c1=2&c2=26766707&cv=2.0&cj=1" style="position: absolute; visibility: hidden" /> <div id='react-modal'></div> <div class='DesignSystem'> <a class='u-showOnFocus' href='#site'> Skip to main content </a> </div> <div id="upgrade_ie_banner" style="display: none;"><p>Academia.edu no longer supports Internet Explorer.</p><p>To browse Academia.edu and the wider internet faster and more securely, please take a few seconds to <a href="https://www.academia.edu/upgrade-browser">upgrade your browser</a>.</p></div><script>// Show this banner for all versions of IE if (!!window.MSInputMethodContext || /(MSIE)/.test(navigator.userAgent)) { document.getElementById('upgrade_ie_banner').style.display = 'block'; }</script> <div class="DesignSystem bootstrap ShrinkableNav"><div class="navbar navbar-default main-header"><div class="container-wrapper" id="main-header-container"><div class="container"><div class="navbar-header"><div class="nav-left-wrapper u-mt0x"><div class="nav-logo"><a data-main-header-link-target="logo_home" href="https://www.academia.edu/"><img class="visible-xs-inline-block" style="height: 24px;" alt="Academia.edu" src="//a.academia-assets.com/images/academia-logo-redesign-2015-A.svg" width="24" height="24" /><img width="145.2" height="18" class="hidden-xs" style="height: 24px;" alt="Academia.edu" src="//a.academia-assets.com/images/academia-logo-redesign-2015.svg" /></a></div><div class="nav-search"><div class="SiteSearch-wrapper select2-no-default-pills"><form class="js-SiteSearch-form DesignSystem" action="https://www.academia.edu/search" accept-charset="UTF-8" method="get"><i class="SiteSearch-icon fa fa-search u-fw700 u-positionAbsolute u-tcGrayDark"></i><input class="js-SiteSearch-form-input SiteSearch-form-input form-control" data-main-header-click-target="search_input" name="q" placeholder="Search" type="text" value="" /></form></div></div></div><div class="nav-right-wrapper pull-right"><ul class="NavLinks js-main-nav list-unstyled"><li class="NavLinks-link"><a class="js-header-login-url Button Button--inverseGray Button--sm u-mb4x" id="nav_log_in" rel="nofollow" href="https://www.academia.edu/login">Log In</a></li><li class="NavLinks-link u-p0x"><a class="Button Button--inverseGray Button--sm u-mb4x" rel="nofollow" href="https://www.academia.edu/signup">Sign Up</a></li></ul><button class="hidden-lg hidden-md hidden-sm u-ml4x navbar-toggle collapsed" data-target=".js-mobile-header-links" data-toggle="collapse" type="button"><span class="icon-bar"></span><span class="icon-bar"></span><span class="icon-bar"></span></button></div></div><div class="collapse navbar-collapse js-mobile-header-links"><ul class="nav navbar-nav"><li class="u-borderColorGrayLight u-borderBottom1"><a rel="nofollow" href="https://www.academia.edu/login">Log In</a></li><li class="u-borderColorGrayLight u-borderBottom1"><a rel="nofollow" href="https://www.academia.edu/signup">Sign Up</a></li><li class="u-borderColorGrayLight u-borderBottom1 js-mobile-nav-expand-trigger"><a href="#">more&nbsp<span class="caret"></span></a></li><li><ul class="js-mobile-nav-expand-section nav navbar-nav u-m0x collapse"><li class="u-borderColorGrayLight u-borderBottom1"><a rel="false" href="https://www.academia.edu/about">About</a></li><li class="u-borderColorGrayLight u-borderBottom1"><a rel="nofollow" href="https://www.academia.edu/press">Press</a></li><li class="u-borderColorGrayLight u-borderBottom1"><a rel="false" href="https://www.academia.edu/documents">Papers</a></li><li class="u-borderColorGrayLight u-borderBottom1"><a rel="nofollow" href="https://www.academia.edu/terms">Terms</a></li><li class="u-borderColorGrayLight u-borderBottom1"><a rel="nofollow" href="https://www.academia.edu/privacy">Privacy</a></li><li class="u-borderColorGrayLight u-borderBottom1"><a rel="nofollow" href="https://www.academia.edu/copyright">Copyright</a></li><li class="u-borderColorGrayLight u-borderBottom1"><a rel="nofollow" href="https://www.academia.edu/hiring"><i class="fa fa-briefcase"></i> We're Hiring!</a></li><li class="u-borderColorGrayLight u-borderBottom1"><a rel="nofollow" href="https://support.academia.edu/hc/en-us"><i class="fa fa-question-circle"></i> Help Center</a></li><li class="js-mobile-nav-collapse-trigger u-borderColorGrayLight u-borderBottom1 dropup" style="display:none"><a href="#">less&nbsp<span class="caret"></span></a></li></ul></li></ul></div></div></div><script>(function(){ var $moreLink = $(".js-mobile-nav-expand-trigger"); var $lessLink = $(".js-mobile-nav-collapse-trigger"); var $section = $('.js-mobile-nav-expand-section'); $moreLink.click(function(ev){ ev.preventDefault(); $moreLink.hide(); $lessLink.show(); $section.collapse('show'); }); $lessLink.click(function(ev){ ev.preventDefault(); $moreLink.show(); $lessLink.hide(); $section.collapse('hide'); }); })() if ($a.is_logged_in() || false) { new Aedu.NavigationController({ el: '.js-main-nav', showHighlightedNotification: false }); } else { $(".js-header-login-url").attr("href", $a.loginUrlWithRedirect()); } Aedu.autocompleteSearch = new AutocompleteSearch({el: '.js-SiteSearch-form'});</script></div></div> <div id='site' class='fixed'> <div id="content" class="clearfix"> <script>document.addEventListener('DOMContentLoaded', function(){ var $dismissible = $(".dismissible_banner"); $dismissible.click(function(ev) { $dismissible.hide(); }); });</script> <script src="//a.academia-assets.com/assets/webpack_bundles/profile.wjs-bundle-091a194a2533e53e1630c5cfd78813a4445aff73d16c70cdba1eafe8c0939f4a.js" defer="defer"></script><script>$viewedUser = Aedu.User.set_viewed( {"id":33441845,"first_name":"Gloria","middle_initials":null,"last_name":"Bazzoli","page_name":"GloriaBazzoli","domain_name":"vcu","created_at":"2015-07-29T13:43:50.332-07:00","display_name":"Gloria Bazzoli","url":"https://vcu.academia.edu/GloriaBazzoli","photo":"/images/s65_no_pic.png","has_photo":false,"department":{"id":467853,"name":"Department of Health Administration","url":"https://vcu.academia.edu/Departments/Department_of_Health_Administration/Documents","university":{"id":1678,"name":"Virginia Commonwealth University","url":"https://vcu.academia.edu/"}},"position":"Faculty Member","position_id":1,"is_analytics_public":false,"interests":[{"id":198685,"name":"Geriatric medicine","url":"https://www.academia.edu/Documents/in/Geriatric_medicine"},{"id":283846,"name":"Public Health Sciences","url":"https://www.academia.edu/Documents/in/Public_Health_Sciences"},{"id":607,"name":"Emergency Medicine","url":"https://www.academia.edu/Documents/in/Emergency_Medicine"},{"id":3058,"name":"Biostatistics","url":"https://www.academia.edu/Documents/in/Biostatistics"}]} ); if ($a.is_logged_in() && $viewedUser.is_current_user()) { $('body').addClass('profile-viewed-by-owner'); } $socialProfiles = []</script><div id="js-react-on-rails-context" style="display:none" data-rails-context="{"inMailer":false,"i18nLocale":"en","i18nDefaultLocale":"en","href":"https://vcu.academia.edu/GloriaBazzoli","location":"/GloriaBazzoli","scheme":"https","host":"vcu.academia.edu","port":null,"pathname":"/GloriaBazzoli","search":null,"httpAcceptLanguage":null,"serverSide":false}"></div> <div class="js-react-on-rails-component" style="display:none" data-component-name="ProfileCheckPaperUpdate" data-props="{}" data-trace="false" data-dom-id="ProfileCheckPaperUpdate-react-component-3fc18b09-3fe8-45fe-8284-ef24c4542a6d"></div> <div id="ProfileCheckPaperUpdate-react-component-3fc18b09-3fe8-45fe-8284-ef24c4542a6d"></div> <div class="DesignSystem"><div class="onsite-ping" id="onsite-ping"></div></div><div class="profile-user-info DesignSystem"><div class="social-profile-container"><div class="left-panel-container"><div class="user-info-component-wrapper"><div class="user-summary-cta-container"><div class="user-summary-container"><div class="social-profile-avatar-container"><img class="profile-avatar u-positionAbsolute" border="0" alt="" src="//a.academia-assets.com/images/s200_no_pic.png" /></div><div class="title-container"><h1 class="ds2-5-heading-sans-serif-sm">Gloria Bazzoli</h1><div class="affiliations-container fake-truncate js-profile-affiliations"><div><a class="u-tcGrayDarker" href="https://vcu.academia.edu/">Virginia Commonwealth University</a>, <a class="u-tcGrayDarker" href="https://vcu.academia.edu/Departments/Department_of_Health_Administration/Documents">Department of Health Administration</a>, <span class="u-tcGrayDarker">Faculty Member</span></div></div></div></div><div class="sidebar-cta-container"><button class="ds2-5-button hidden profile-cta-button grow js-profile-follow-button" data-broccoli-component="user-info.follow-button" data-click-track="profile-user-info-follow-button" data-follow-user-fname="Gloria" data-follow-user-id="33441845" data-follow-user-source="profile_button" data-has-google="false"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">add</span>Follow</button><button class="ds2-5-button hidden profile-cta-button grow js-profile-unfollow-button" data-broccoli-component="user-info.unfollow-button" data-click-track="profile-user-info-unfollow-button" data-unfollow-user-id="33441845"><span class="material-symbols-outlined" style="font-size: 20px" translate="no">done</span>Following</button></div></div><div class="user-stats-container"><a><div class="stat-container js-profile-followers"><p class="label">Followers</p><p class="data">68</p></div></a><a><div class="stat-container js-profile-followees" data-broccoli-component="user-info.followees-count" data-click-track="profile-expand-user-info-following"><p class="label">Following</p><p class="data">27</p></div></a><a><div class="stat-container js-profile-coauthors" data-broccoli-component="user-info.coauthors-count" data-click-track="profile-expand-user-info-coauthors"><p class="label">Co-authors</p><p class="data">27</p></div></a><span><div class="stat-container"><p class="label"><span class="js-profile-total-view-text">Public Views</span></p><p class="data"><span class="js-profile-view-count"></span></p></div></span></div><div class="user-bio-container"><div class="profile-bio fake-truncate js-profile-about" style="margin: 0px;">Gloria Bazzoli<br /><div class="js-profile-less-about u-linkUnstyled u-tcGrayDarker u-textDecorationUnderline u-displayNone">less</div></div></div><div class="suggested-academics-container"><div class="suggested-academics--header"><h3 class="ds2-5-heading-sans-serif-xs">Related Authors</h3></div><ul class="suggested-user-card-list" data-nosnippet="true"><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a data-nosnippet="" href="https://independent.academia.edu/LindaBrewster"><img class="profile-avatar u-positionAbsolute" alt="Linda Brewster related author profile picture" border="0" src="//a.academia-assets.com/images/s200_no_pic.png" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://independent.academia.edu/LindaBrewster">Linda Brewster</a></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a data-nosnippet="" href="https://independent.academia.edu/KDevers"><img class="profile-avatar u-positionAbsolute" alt="K. Devers related author profile picture" border="0" src="//a.academia-assets.com/images/s200_no_pic.png" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://independent.academia.edu/KDevers">K. Devers</a></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a data-nosnippet="" href="https://independent.academia.edu/ValleyDanielle"><img class="profile-avatar u-positionAbsolute" alt="Danielle Valley related author profile picture" border="0" src="//a.academia-assets.com/images/s200_no_pic.png" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://independent.academia.edu/ValleyDanielle">Danielle Valley</a></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a data-nosnippet="" href="https://independent.academia.edu/SimonCarol"><img class="profile-avatar u-positionAbsolute" alt="Carol Simon related author profile picture" border="0" src="//a.academia-assets.com/images/s200_no_pic.png" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://independent.academia.edu/SimonCarol">Carol Simon</a></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a data-nosnippet="" href="https://independent.academia.edu/AskarChukmaitov"><img class="profile-avatar u-positionAbsolute" alt="Askar Chukmaitov related author profile picture" border="0" src="//a.academia-assets.com/images/s200_no_pic.png" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://independent.academia.edu/AskarChukmaitov">Askar Chukmaitov</a></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a data-nosnippet="" href="https://fsu.academia.edu/HenryCarretta"><img class="profile-avatar u-positionAbsolute" alt="Henry Carretta related author profile picture" border="0" onerror="if (this.src != '//a.academia-assets.com/images/s200_no_pic.png') this.src = '//a.academia-assets.com/images/s200_no_pic.png';" width="200" height="200" src="https://0.academia-photos.com/25092276/22027623/21273082/s200_henry.carretta.jpg" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://fsu.academia.edu/HenryCarretta">Henry Carretta</a><p class="suggested-user-card__user-info__subheader ds2-5-body-xs">Florida State University</p></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a data-nosnippet="" href="https://widener.academia.edu/MRosko"><img class="profile-avatar u-positionAbsolute" alt="M. Rosko related author profile picture" border="0" onerror="if (this.src != '//a.academia-assets.com/images/s200_no_pic.png') this.src = '//a.academia-assets.com/images/s200_no_pic.png';" width="200" height="200" src="https://0.academia-photos.com/45316960/12028562/13400639/s200_m..rosko.jpg" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://widener.academia.edu/MRosko">M. Rosko</a><p class="suggested-user-card__user-info__subheader ds2-5-body-xs">Widener University</p></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a data-nosnippet="" href="https://independent.academia.edu/JaneBanaszakholl"><img class="profile-avatar u-positionAbsolute" alt="Jane Banaszak-holl related author profile picture" border="0" src="//a.academia-assets.com/images/s200_no_pic.png" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://independent.academia.edu/JaneBanaszakholl">Jane Banaszak-holl</a></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a data-nosnippet="" href="https://missouri.academia.edu/HarveyJames"><img class="profile-avatar u-positionAbsolute" alt="Harvey James related author profile picture" border="0" onerror="if (this.src != '//a.academia-assets.com/images/s200_no_pic.png') this.src = '//a.academia-assets.com/images/s200_no_pic.png';" width="200" height="200" src="https://0.academia-photos.com/34755864/13359531/87940664/s200_harvey.james.png" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://missouri.academia.edu/HarveyJames">Harvey James</a><p class="suggested-user-card__user-info__subheader ds2-5-body-xs">University of Missouri Columbia</p></div></div><div class="suggested-user-card"><div class="suggested-user-card__avatar social-profile-avatar-container"><a data-nosnippet="" href="https://cmu.academia.edu/MartinGaynor"><img class="profile-avatar u-positionAbsolute" alt="Martin Gaynor related author profile picture" border="0" onerror="if (this.src != '//a.academia-assets.com/images/s200_no_pic.png') this.src = '//a.academia-assets.com/images/s200_no_pic.png';" width="200" height="200" src="https://0.academia-photos.com/51566596/13738709/14855946/s200_martin.gaynor.jpg" /></a></div><div class="suggested-user-card__user-info"><a class="suggested-user-card__user-info__header ds2-5-body-sm-bold ds2-5-body-link" href="https://cmu.academia.edu/MartinGaynor">Martin Gaynor</a><p class="suggested-user-card__user-info__subheader ds2-5-body-xs">Carnegie Mellon University</p></div></div></ul></div><style type="text/css">.suggested-academics--header h3{font-size:16px;font-weight:500;line-height:20px}</style><div class="ri-section"><div class="ri-section-header"><span>Interests</span></div><div class="ri-tags-container"><a data-click-track="profile-user-info-expand-research-interests" data-has-card-for-ri-list="33441845" href="https://www.academia.edu/Documents/in/Geriatric_medicine"><div id="js-react-on-rails-context" style="display:none" data-rails-context="{"inMailer":false,"i18nLocale":"en","i18nDefaultLocale":"en","href":"https://vcu.academia.edu/GloriaBazzoli","location":"/GloriaBazzoli","scheme":"https","host":"vcu.academia.edu","port":null,"pathname":"/GloriaBazzoli","search":null,"httpAcceptLanguage":null,"serverSide":false}"></div> <div class="js-react-on-rails-component" style="display:none" data-component-name="Pill" data-props="{"color":"gray","children":["Geriatric medicine"]}" data-trace="false" data-dom-id="Pill-react-component-accf70ae-bd63-4e4e-877f-90f684edeed6"></div> <div id="Pill-react-component-accf70ae-bd63-4e4e-877f-90f684edeed6"></div> </a><a data-click-track="profile-user-info-expand-research-interests" data-has-card-for-ri-list="33441845" href="https://www.academia.edu/Documents/in/Public_Health_Sciences"><div class="js-react-on-rails-component" style="display:none" data-component-name="Pill" data-props="{"color":"gray","children":["Public Health Sciences"]}" data-trace="false" data-dom-id="Pill-react-component-5f29f2a0-542f-444c-971e-086c03107fe0"></div> <div id="Pill-react-component-5f29f2a0-542f-444c-971e-086c03107fe0"></div> </a><a data-click-track="profile-user-info-expand-research-interests" data-has-card-for-ri-list="33441845" href="https://www.academia.edu/Documents/in/Emergency_Medicine"><div class="js-react-on-rails-component" style="display:none" data-component-name="Pill" data-props="{"color":"gray","children":["Emergency Medicine"]}" data-trace="false" data-dom-id="Pill-react-component-06369b2e-e711-40d2-a4a4-aaf5fa4c99ba"></div> <div id="Pill-react-component-06369b2e-e711-40d2-a4a4-aaf5fa4c99ba"></div> </a></div></div></div></div><div class="right-panel-container"><div class="user-content-wrapper"><div class="uploads-container" id="social-redesign-work-container"><div class="upload-header"><h2 class="ds2-5-heading-sans-serif-xs">Uploads</h2></div><div class="documents-container backbone-social-profile-documents" style="width: 100%;"><div class="u-taCenter"></div><div class="profile--tab_content_container js-tab-pane tab-pane active" id="all"><div class="profile--tab_heading_container js-section-heading" data-section="Papers" id="Papers"><h3 class="profile--tab_heading_container">Papers by Gloria Bazzoli</h3></div><div class="js-work-strip profile--work_container" data-work-id="17825796"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/17825796/Assessing_the_extent_of_integration_achieved_through_physician_hospital_arrangements"><img alt="Research paper thumbnail of Assessing the extent of integration achieved through physician-hospital arrangements" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Assessing the extent of integration achieved through physician-hospital arrangements</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://nku.academia.edu/LindaDynan">Linda Dynan</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Journal of healthcare management / American College of Healthcare Executives</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">In this article we examine management service organizations (MSOs), physician-hospital organizati...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">In this article we examine management service organizations (MSOs), physician-hospital organizations (PHOs), hospital-affiliated independent practice associations (IPAs), and hospital-sponsored &quot;group practices without walls&quot; (GPWWs) that allow physicians to retain their practices and link hospitals and health systems to physicians through contractual arrangements. Also examined were medical foundations (MFs), integrated salary models (ISMs), and integrated health organizations (IHOs) that own the physical assets of physician practices and contract with payors for physician and hospital services. The research provides several new insights for understanding the structure and process of physician-hospital integration. It was found that the extent of processual integration in physician-hospital organizational arrangements can be measured along six dimensions: administrative and practice management services; physician financial risk-sharing; joint ventures to create new servic...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825796"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825796"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825796; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825796]").text(description); $(".js-view-count[data-work-id=17825796]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825796; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825796']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=17825796]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825796,"title":"Assessing the extent of integration achieved through physician-hospital arrangements","translated_title":"","metadata":{"abstract":"In this article we examine management service organizations (MSOs), physician-hospital organizations (PHOs), hospital-affiliated independent practice associations (IPAs), and hospital-sponsored \u0026quot;group practices without walls\u0026quot; (GPWWs) that allow physicians to retain their practices and link hospitals and health systems to physicians through contractual arrangements. Also examined were medical foundations (MFs), integrated salary models (ISMs), and integrated health organizations (IHOs) that own the physical assets of physician practices and contract with payors for physician and hospital services. The research provides several new insights for understanding the structure and process of physician-hospital integration. It was found that the extent of processual integration in physician-hospital organizational arrangements can be measured along six dimensions: administrative and practice management services; physician financial risk-sharing; joint ventures to create new servic...","publication_name":"Journal of healthcare management / American College of Healthcare Executives"},"translated_abstract":"In this article we examine management service organizations (MSOs), physician-hospital organizations (PHOs), hospital-affiliated independent practice associations (IPAs), and hospital-sponsored \u0026quot;group practices without walls\u0026quot; (GPWWs) that allow physicians to retain their practices and link hospitals and health systems to physicians through contractual arrangements. Also examined were medical foundations (MFs), integrated salary models (ISMs), and integrated health organizations (IHOs) that own the physical assets of physician practices and contract with payors for physician and hospital services. The research provides several new insights for understanding the structure and process of physician-hospital integration. It was found that the extent of processual integration in physician-hospital organizational arrangements can be measured along six dimensions: administrative and practice management services; physician financial risk-sharing; joint ventures to create new servic...","internal_url":"https://www.academia.edu/17825796/Assessing_the_extent_of_integration_achieved_through_physician_hospital_arrangements","translated_internal_url":"","created_at":"2015-11-05T14:34:25.924-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745211,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863553,"work_id":17825796,"tagging_user_id":37745211,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Assessing the extent of integration achieved through physician-hospital arrangements"},{"id":8863556,"work_id":17825796,"tagging_user_id":37745211,"tagged_user_id":12614255,"co_author_invite_id":null,"email":"b***l@wharton.upenn.edu","affiliation":"University of Pennsylvania","display_order":4194304,"name":"lawton burns","title":"Assessing the extent of integration achieved through physician-hospital arrangements"},{"id":8863571,"work_id":17825796,"tagging_user_id":37745211,"tagged_user_id":null,"co_author_invite_id":349651,"email":"r***s@anu.edu.au","display_order":6291456,"name":"R. Burns","title":"Assessing the extent of integration achieved through physician-hospital arrangements"}],"downloadable_attachments":[],"slug":"Assessing_the_extent_of_integration_achieved_through_physician_hospital_arrangements","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"In this article we examine management service organizations (MSOs), physician-hospital organizations (PHOs), hospital-affiliated independent practice associations (IPAs), and hospital-sponsored \u0026quot;group practices without walls\u0026quot; (GPWWs) that allow physicians to retain their practices and link hospitals and health systems to physicians through contractual arrangements. Also examined were medical foundations (MFs), integrated salary models (ISMs), and integrated health organizations (IHOs) that own the physical assets of physician practices and contract with payors for physician and hospital services. The research provides several new insights for understanding the structure and process of physician-hospital integration. It was found that the extent of processual integration in physician-hospital organizational arrangements can be measured along six dimensions: administrative and practice management services; physician financial risk-sharing; joint ventures to create new servic...","owner":{"id":37745211,"first_name":"Linda","middle_initials":null,"last_name":"Dynan","page_name":"LindaDynan","domain_name":"nku","created_at":"2015-11-05T14:34:00.827-08:00","display_name":"Linda Dynan","url":"https://nku.academia.edu/LindaDynan"},"attachments":[],"research_interests":[{"id":16635,"name":"Health Services Research","url":"https://www.academia.edu/Documents/in/Health_Services_Research"},{"id":37745,"name":"Systems Integration","url":"https://www.academia.edu/Documents/in/Systems_Integration"},{"id":37925,"name":"Ownership","url":"https://www.academia.edu/Documents/in/Ownership"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":153168,"name":"Data Collection","url":"https://www.academia.edu/Documents/in/Data_Collection"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":2063677,"name":"Group practice","url":"https://www.academia.edu/Documents/in/Group_practice"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17825796-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17825797"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/17825797/Capitated_contracting_of_integrated_health_provider_organizations"><img alt="Research paper thumbnail of Capitated contracting of integrated health provider organizations" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Capitated contracting of integrated health provider organizations</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://nku.academia.edu/LindaDynan">Linda Dynan</a></span></div><div class="wp-workCard_item"><span>Inquiry : a journal of medical care organization, provision and financing</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">This paper examines global capitation of integrated health provider organizations that link physi...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">This paper examines global capitation of integrated health provider organizations that link physicians and hospitals, such as physician-hospital organizations and management service organizations. These organizations have proliferated in recent years, but their contracting activity has not been studied. We develop a conceptual model to understand the capitated contracting bargaining process. Exploratory multivariate analysis suggests that global capitation of these organizations is more common in markets with high health maintenance organization (HMO) market share, greater numbers of HMOs, and fewer physician group practices. Additionally, health provider organizations with more complex case mix, nonprofit status, more affiliated physicians, health system affiliations, and diversity in physician organizational arrangements are more likely to have global capitation. Finally, state regulation of provider contracting with self-insured employers appears to have spillover effects on heal...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825797"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825797"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825797; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825797]").text(description); $(".js-view-count[data-work-id=17825797]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825797; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825797']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=17825797]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825797,"title":"Capitated contracting of integrated health provider organizations","translated_title":"","metadata":{"abstract":"This paper examines global capitation of integrated health provider organizations that link physicians and hospitals, such as physician-hospital organizations and management service organizations. These organizations have proliferated in recent years, but their contracting activity has not been studied. We develop a conceptual model to understand the capitated contracting bargaining process. Exploratory multivariate analysis suggests that global capitation of these organizations is more common in markets with high health maintenance organization (HMO) market share, greater numbers of HMOs, and fewer physician group practices. Additionally, health provider organizations with more complex case mix, nonprofit status, more affiliated physicians, health system affiliations, and diversity in physician organizational arrangements are more likely to have global capitation. Finally, state regulation of provider contracting with self-insured employers appears to have spillover effects on heal...","publication_name":"Inquiry : a journal of medical care organization, provision and financing"},"translated_abstract":"This paper examines global capitation of integrated health provider organizations that link physicians and hospitals, such as physician-hospital organizations and management service organizations. These organizations have proliferated in recent years, but their contracting activity has not been studied. We develop a conceptual model to understand the capitated contracting bargaining process. Exploratory multivariate analysis suggests that global capitation of these organizations is more common in markets with high health maintenance organization (HMO) market share, greater numbers of HMOs, and fewer physician group practices. Additionally, health provider organizations with more complex case mix, nonprofit status, more affiliated physicians, health system affiliations, and diversity in physician organizational arrangements are more likely to have global capitation. Finally, state regulation of provider contracting with self-insured employers appears to have spillover effects on heal...","internal_url":"https://www.academia.edu/17825797/Capitated_contracting_of_integrated_health_provider_organizations","translated_internal_url":"","created_at":"2015-11-05T14:34:26.014-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745211,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863552,"work_id":17825797,"tagging_user_id":37745211,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Capitated contracting of integrated health provider organizations"},{"id":8863555,"work_id":17825797,"tagging_user_id":37745211,"tagged_user_id":12614255,"co_author_invite_id":null,"email":"b***l@wharton.upenn.edu","affiliation":"University of Pennsylvania","display_order":4194304,"name":"lawton burns","title":"Capitated contracting of integrated health provider organizations"}],"downloadable_attachments":[],"slug":"Capitated_contracting_of_integrated_health_provider_organizations","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"This paper examines global capitation of integrated health provider organizations that link physicians and hospitals, such as physician-hospital organizations and management service organizations. These organizations have proliferated in recent years, but their contracting activity has not been studied. We develop a conceptual model to understand the capitated contracting bargaining process. Exploratory multivariate analysis suggests that global capitation of these organizations is more common in markets with high health maintenance organization (HMO) market share, greater numbers of HMOs, and fewer physician group practices. Additionally, health provider organizations with more complex case mix, nonprofit status, more affiliated physicians, health system affiliations, and diversity in physician organizational arrangements are more likely to have global capitation. Finally, state regulation of provider contracting with self-insured employers appears to have spillover effects on heal...","owner":{"id":37745211,"first_name":"Linda","middle_initials":null,"last_name":"Dynan","page_name":"LindaDynan","domain_name":"nku","created_at":"2015-11-05T14:34:00.827-08:00","display_name":"Linda Dynan","url":"https://nku.academia.edu/LindaDynan"},"attachments":[],"research_interests":[{"id":41482,"name":"Multivariate Analysis","url":"https://www.academia.edu/Documents/in/Multivariate_Analysis"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":579119,"name":"Marketing of Health Services","url":"https://www.academia.edu/Documents/in/Marketing_of_Health_Services"},{"id":2063677,"name":"Group practice","url":"https://www.academia.edu/Documents/in/Group_practice"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17825797-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17825798"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/17825798/Impact_of_HMO_market_structure_on_physician_hospital_strategic_alliances"><img alt="Research paper thumbnail of Impact of HMO market structure on physician-hospital strategic alliances" class="work-thumbnail" src="https://attachments.academia-assets.com/41945415/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/17825798/Impact_of_HMO_market_structure_on_physician_hospital_strategic_alliances">Impact of HMO market structure on physician-hospital strategic alliances</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://nku.academia.edu/LindaDynan">Linda Dynan</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Health services research</span><span>, 2000</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">To assess the impact of HMO market structure on the formation of physician-hospital strategic all...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">To assess the impact of HMO market structure on the formation of physician-hospital strategic alliances from 1993 through 1995. The two trends, managed care and physician-hospital integration have been prominent in reshaping insurance and provider markets over the past decade. Pooled cross-sectional data from the InterStudy HMO Census and the Annual Survey conducted by the American Hospital Association (AHA) between 1993 and the end of 1995 to examine the effects of HMO penetration and HMO numbers in a market on the formation of hospital-sponsored alliances with physicians. Because prior research has found nonlinear effects of HMOs on a variety of dependent variables, we operationalized HMO market structure two ways: using a Taylor series expansion and cross-classifying quartile distributions of HMO penetration and numbers into 16 dummy indicators. Alliance formation was operationalized using the presence of any alliance model (IPA, PHO, MSO, and foundation) and the sum of the four ...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="fc11328134454f7c9197a5b9377257d2" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":41945415,"asset_id":17825798,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/41945415/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825798"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825798"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825798; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825798]").text(description); $(".js-view-count[data-work-id=17825798]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825798; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825798']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "fc11328134454f7c9197a5b9377257d2" } } $('.js-work-strip[data-work-id=17825798]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825798,"title":"Impact of HMO market structure on physician-hospital strategic alliances","translated_title":"","metadata":{"abstract":"To assess the impact of HMO market structure on the formation of physician-hospital strategic alliances from 1993 through 1995. The two trends, managed care and physician-hospital integration have been prominent in reshaping insurance and provider markets over the past decade. Pooled cross-sectional data from the InterStudy HMO Census and the Annual Survey conducted by the American Hospital Association (AHA) between 1993 and the end of 1995 to examine the effects of HMO penetration and HMO numbers in a market on the formation of hospital-sponsored alliances with physicians. Because prior research has found nonlinear effects of HMOs on a variety of dependent variables, we operationalized HMO market structure two ways: using a Taylor series expansion and cross-classifying quartile distributions of HMO penetration and numbers into 16 dummy indicators. Alliance formation was operationalized using the presence of any alliance model (IPA, PHO, MSO, and foundation) and the sum of the four ...","publication_date":{"day":null,"month":null,"year":2000,"errors":{}},"publication_name":"Health services research"},"translated_abstract":"To assess the impact of HMO market structure on the formation of physician-hospital strategic alliances from 1993 through 1995. The two trends, managed care and physician-hospital integration have been prominent in reshaping insurance and provider markets over the past decade. Pooled cross-sectional data from the InterStudy HMO Census and the Annual Survey conducted by the American Hospital Association (AHA) between 1993 and the end of 1995 to examine the effects of HMO penetration and HMO numbers in a market on the formation of hospital-sponsored alliances with physicians. Because prior research has found nonlinear effects of HMOs on a variety of dependent variables, we operationalized HMO market structure two ways: using a Taylor series expansion and cross-classifying quartile distributions of HMO penetration and numbers into 16 dummy indicators. Alliance formation was operationalized using the presence of any alliance model (IPA, PHO, MSO, and foundation) and the sum of the four ...","internal_url":"https://www.academia.edu/17825798/Impact_of_HMO_market_structure_on_physician_hospital_strategic_alliances","translated_internal_url":"","created_at":"2015-11-05T14:34:26.096-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745211,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863551,"work_id":17825798,"tagging_user_id":37745211,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Impact of HMO market structure on physician-hospital strategic alliances"},{"id":8863554,"work_id":17825798,"tagging_user_id":37745211,"tagged_user_id":12614255,"co_author_invite_id":null,"email":"b***l@wharton.upenn.edu","affiliation":"University of Pennsylvania","display_order":4194304,"name":"lawton burns","title":"Impact of HMO market structure on physician-hospital strategic alliances"}],"downloadable_attachments":[{"id":41945415,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/41945415/thumbnails/1.jpg","file_name":"Impact_of_HMO_Market_Structure_on_Physic20160203-30232-1o3c66w.pdf","download_url":"https://www.academia.edu/attachments/41945415/download_file","bulk_download_file_name":"Impact_of_HMO_market_structure_on_physic.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/41945415/Impact_of_HMO_Market_Structure_on_Physic20160203-30232-1o3c66w-libre.pdf?1454504939=\u0026response-content-disposition=attachment%3B+filename%3DImpact_of_HMO_market_structure_on_physic.pdf\u0026Expires=1743441979\u0026Signature=QF0B8FgbxNh9zu2aaJ5zSb-bIZ5vaA0-iM2j6nmTj75lRFJNLX9OgN4alJAa3cqdjeB1K~8~HpmlEA9whRQFoQj3qOauVwNfozBIqQ7vCG2pFCYGcaujW3yn0Ytx7lRmCZQG2sfXGWR6sPvoWbwsTtVUXzx7sNHQBbg3e7b4fnw-GT6ZJ7LcIxwiggjVhmPp4KW1MELmIauico2EOpGrVaKdDvB0Mi0wIySSmfZ-Us~9Ozqzi~sxuS64cOotvEqqHg9idtSbASciZTxs4Mc-bgDnePxBI2n65iHaUPLpcoyPW40LFWc01ERNZiOrx3nUEdGLlXlF6XXfs896zUKBNg__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Impact_of_HMO_market_structure_on_physician_hospital_strategic_alliances","translated_slug":"","page_count":32,"language":"en","content_type":"Work","summary":"To assess the impact of HMO market structure on the formation of physician-hospital strategic alliances from 1993 through 1995. The two trends, managed care and physician-hospital integration have been prominent in reshaping insurance and provider markets over the past decade. Pooled cross-sectional data from the InterStudy HMO Census and the Annual Survey conducted by the American Hospital Association (AHA) between 1993 and the end of 1995 to examine the effects of HMO penetration and HMO numbers in a market on the formation of hospital-sponsored alliances with physicians. Because prior research has found nonlinear effects of HMOs on a variety of dependent variables, we operationalized HMO market structure two ways: using a Taylor series expansion and cross-classifying quartile distributions of HMO penetration and numbers into 16 dummy indicators. Alliance formation was operationalized using the presence of any alliance model (IPA, PHO, MSO, and foundation) and the sum of the four ...","owner":{"id":37745211,"first_name":"Linda","middle_initials":null,"last_name":"Dynan","page_name":"LindaDynan","domain_name":"nku","created_at":"2015-11-05T14:34:00.827-08:00","display_name":"Linda Dynan","url":"https://nku.academia.edu/LindaDynan"},"attachments":[{"id":41945415,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/41945415/thumbnails/1.jpg","file_name":"Impact_of_HMO_Market_Structure_on_Physic20160203-30232-1o3c66w.pdf","download_url":"https://www.academia.edu/attachments/41945415/download_file","bulk_download_file_name":"Impact_of_HMO_market_structure_on_physic.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/41945415/Impact_of_HMO_Market_Structure_on_Physic20160203-30232-1o3c66w-libre.pdf?1454504939=\u0026response-content-disposition=attachment%3B+filename%3DImpact_of_HMO_market_structure_on_physic.pdf\u0026Expires=1743441979\u0026Signature=QF0B8FgbxNh9zu2aaJ5zSb-bIZ5vaA0-iM2j6nmTj75lRFJNLX9OgN4alJAa3cqdjeB1K~8~HpmlEA9whRQFoQj3qOauVwNfozBIqQ7vCG2pFCYGcaujW3yn0Ytx7lRmCZQG2sfXGWR6sPvoWbwsTtVUXzx7sNHQBbg3e7b4fnw-GT6ZJ7LcIxwiggjVhmPp4KW1MELmIauico2EOpGrVaKdDvB0Mi0wIySSmfZ-Us~9Ozqzi~sxuS64cOotvEqqHg9idtSbASciZTxs4Mc-bgDnePxBI2n65iHaUPLpcoyPW40LFWc01ERNZiOrx3nUEdGLlXlF6XXfs896zUKBNg__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":16635,"name":"Health Services Research","url":"https://www.academia.edu/Documents/in/Health_Services_Research"},{"id":28850,"name":"Linear models","url":"https://www.academia.edu/Documents/in/Linear_models"},{"id":83471,"name":"Health Services","url":"https://www.academia.edu/Documents/in/Health_Services"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":579119,"name":"Marketing of Health Services","url":"https://www.academia.edu/Documents/in/Marketing_of_Health_Services"},{"id":901876,"name":"Sensitivity and Specificity","url":"https://www.academia.edu/Documents/in/Sensitivity_and_Specificity"}],"urls":[{"id":6337474,"url":"https://www.researchgate.net/profile/Linda_Dynan/publication/12537578_Impact_of_HMO_Market_Structure_on_PhysicianHospital_Strategic_Alliances/links/0046351c2ef1c13ae3000000.pdf"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17825798-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17825704"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/17825704/Does_Loss_of_Safety_Net_Hospitals_in_a_Community_Disproportionately_Affect_Racial_and_Ethnic_Minority_Groups"><img alt="Research paper thumbnail of Does Loss of Safety Net Hospitals in a Community Disproportionately Affect Racial and Ethnic Minority Groups?" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Does Loss of Safety Net Hospitals in a Community Disproportionately Affect Racial and Ethnic Minority Groups?</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/HuiminHsieh">Hui-min Hsieh</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Research Objective: Safety net hospitals (SNHs) are thought to play a critical role in the U.S. h...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Research Objective: Safety net hospitals (SNHs) are thought to play a critical role in the U.S. health system by providing health care services for vulnerable populations. SNHs also frequently offer a variety of social and outreach services, which could potentially reduce disparities among ethnic and racial minority groups. This may be especially true for minority individuals living near an SNH because they will have ready access to these facilitating services. Our study examined whether closure or ownership conversions of nearby SNHs had a disproportionate effect on uninsured and Medicaid patients, especially for non-Hispanic black and Hispanic individuals. Study Design: Hospital discharge data for the states of Arizona, California, Florida, and Wisconsin were examined from the early 1990s to 2003. Our primary access measure was distance traveled by patients to hospitals for inpatient care. Both closure and for-profit conversion represent events that reduce safety net resources ava...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825704"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825704"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825704; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825704]").text(description); $(".js-view-count[data-work-id=17825704]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825704; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825704']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=17825704]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825704,"title":"Does Loss of Safety Net Hospitals in a Community Disproportionately Affect Racial and Ethnic Minority Groups?","translated_title":"","metadata":{"abstract":"Research Objective: Safety net hospitals (SNHs) are thought to play a critical role in the U.S. health system by providing health care services for vulnerable populations. SNHs also frequently offer a variety of social and outreach services, which could potentially reduce disparities among ethnic and racial minority groups. This may be especially true for minority individuals living near an SNH because they will have ready access to these facilitating services. Our study examined whether closure or ownership conversions of nearby SNHs had a disproportionate effect on uninsured and Medicaid patients, especially for non-Hispanic black and Hispanic individuals. Study Design: Hospital discharge data for the states of Arizona, California, Florida, and Wisconsin were examined from the early 1990s to 2003. Our primary access measure was distance traveled by patients to hospitals for inpatient care. Both closure and for-profit conversion represent events that reduce safety net resources ava..."},"translated_abstract":"Research Objective: Safety net hospitals (SNHs) are thought to play a critical role in the U.S. health system by providing health care services for vulnerable populations. SNHs also frequently offer a variety of social and outreach services, which could potentially reduce disparities among ethnic and racial minority groups. This may be especially true for minority individuals living near an SNH because they will have ready access to these facilitating services. Our study examined whether closure or ownership conversions of nearby SNHs had a disproportionate effect on uninsured and Medicaid patients, especially for non-Hispanic black and Hispanic individuals. Study Design: Hospital discharge data for the states of Arizona, California, Florida, and Wisconsin were examined from the early 1990s to 2003. Our primary access measure was distance traveled by patients to hospitals for inpatient care. Both closure and for-profit conversion represent events that reduce safety net resources ava...","internal_url":"https://www.academia.edu/17825704/Does_Loss_of_Safety_Net_Hospitals_in_a_Community_Disproportionately_Affect_Racial_and_Ethnic_Minority_Groups","translated_internal_url":"","created_at":"2015-11-05T14:31:17.483-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745062,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863439,"work_id":17825704,"tagging_user_id":37745062,"tagged_user_id":null,"co_author_invite_id":2001862,"email":"l***y@rti.org","display_order":0,"name":"Lee Mobley","title":"Does Loss of Safety Net Hospitals in a Community Disproportionately Affect Racial and Ethnic Minority Groups?"},{"id":8863465,"work_id":17825704,"tagging_user_id":37745062,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":4194304,"name":"Gloria Bazzoli","title":"Does Loss of Safety Net Hospitals in a Community Disproportionately Affect Racial and Ethnic Minority Groups?"}],"downloadable_attachments":[],"slug":"Does_Loss_of_Safety_Net_Hospitals_in_a_Community_Disproportionately_Affect_Racial_and_Ethnic_Minority_Groups","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Research Objective: Safety net hospitals (SNHs) are thought to play a critical role in the U.S. health system by providing health care services for vulnerable populations. SNHs also frequently offer a variety of social and outreach services, which could potentially reduce disparities among ethnic and racial minority groups. This may be especially true for minority individuals living near an SNH because they will have ready access to these facilitating services. Our study examined whether closure or ownership conversions of nearby SNHs had a disproportionate effect on uninsured and Medicaid patients, especially for non-Hispanic black and Hispanic individuals. Study Design: Hospital discharge data for the states of Arizona, California, Florida, and Wisconsin were examined from the early 1990s to 2003. Our primary access measure was distance traveled by patients to hospitals for inpatient care. Both closure and for-profit conversion represent events that reduce safety net resources ava...","owner":{"id":37745062,"first_name":"Hui-min","middle_initials":null,"last_name":"Hsieh","page_name":"HuiminHsieh","domain_name":"independent","created_at":"2015-11-05T14:30:24.279-08:00","display_name":"Hui-min Hsieh","url":"https://independent.academia.edu/HuiminHsieh"},"attachments":[],"research_interests":[],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17825704-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17825693"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/17825693/Impacts_of_market_and_organizational_characteristics_on_hospital_efficiency_and_uncompensated_care"><img alt="Research paper thumbnail of Impacts of market and organizational characteristics on hospital efficiency and uncompensated care" class="work-thumbnail" src="https://attachments.academia-assets.com/39731105/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/17825693/Impacts_of_market_and_organizational_characteristics_on_hospital_efficiency_and_uncompensated_care">Impacts of market and organizational characteristics on hospital efficiency and uncompensated care</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/HuiminHsieh">Hui-min Hsieh</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Health Care Management Review</span><span>, 2010</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background: Hospitals have confronted a difficult financial environment given many factors, inclu...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background: Hospitals have confronted a difficult financial environment given many factors, including expansion of managed care, changes in public policy, growing market competition for certain services, and growth in the number of uninsured. Policy makers have expressed concern that hospitals may forgo providing care to the indigent as a means to reduce costs and become more efficient when faced with financial pressures. Purpose: This article examined the effects of environmental pressures on two dimensions of hospital performance: hospital efficiency and uncompensated care provision. Methodology/Approach: Longitudinal data for the Commonwealth of Virginia from 1998 to 2004 were analyzed. Data Envelopment Analysis and bivariate probit were used to examine the factors associated with efficiency and uncompensated care. Findings: The results indicated that a positive relationship between hospital efficiency and uncompensated care provision exists. That is, hospitals that are categorized as efficient are likely to provide more uncompensated care. We also found that hospitals tended to provide more uncompensated care when increased demand for these services occurred in a market. Increases in Medicare or Medicaid patient share reduced the provision of uncompensated care. In relation to hospital efficiency, the results indicated that HMO penetration and Medicaid patient share reduced hospital efficiency. Practice Implications: This study found that efficient hospitals tend to provide more uncompensated care over time. The findings also suggest that hospitals alter their efficiency and provision of uncompensated care in response to a number of environmental pressures, but it may depend on the type of pressures or uncertainties encountered.</span></div><div class="wp-workCard_item"><div class="carousel-container carousel-container--sm" id="profile-work-17825693-figures"><div class="prev-slide-container js-prev-button-container"><button aria-label="Previous" class="carousel-navigation-button js-profile-work-17825693-figures-prev"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">arrow_back_ios</span></button></div><div class="slides-container js-slides-container"><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/53618274/table-3-note-total-hospital-sample-from-to-in-this-study-msa"><img alt="Note. Total hospital sample from 1998 to 2004 in this study: N = 501. MSA = metropolitan statistical area. " class="figure-slide-image" src="https://figures.academia-assets.com/39731105/table_003.jpg" /></a></figure><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/53618283/table-4-note-lr-likelihood-ratio-chi-square-value-of-rho"><img alt="Note. ***p < .01; **p < .05; *p < .1. LR c? = Likelihood-ratio chi-square value of rho. " class="figure-slide-image" src="https://figures.academia-assets.com/39731105/table_004.jpg" /></a></figure><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/53618253/table-1-note-total-hospital-sample-from-to-in-this-study"><img alt="Note. Total hospital sample from 1998 to 2004 in this study: N = 501. " class="figure-slide-image" src="https://figures.academia-assets.com/39731105/table_001.jpg" /></a></figure><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/53618263/table-2-descriptive-statistics-of-dependent-variables"><img alt="Descriptive statistics of dependent variables, 1998-2004 Efficient is 1 if efficiency score is equal to 1. " class="figure-slide-image" src="https://figures.academia-assets.com/39731105/table_002.jpg" /></a></figure></div><div class="next-slide-container js-next-button-container"><button aria-label="Next" class="carousel-navigation-button js-profile-work-17825693-figures-next"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">arrow_forward_ios</span></button></div></div></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="3a5f59bf595d74e8426ad5632a94aa38" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":39731105,"asset_id":17825693,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/39731105/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825693"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825693"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825693; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825693]").text(description); $(".js-view-count[data-work-id=17825693]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825693; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825693']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "3a5f59bf595d74e8426ad5632a94aa38" } } $('.js-work-strip[data-work-id=17825693]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825693,"title":"Impacts of market and organizational characteristics on hospital efficiency and uncompensated care","translated_title":"","metadata":{"grobid_abstract":"Background: Hospitals have confronted a difficult financial environment given many factors, including expansion of managed care, changes in public policy, growing market competition for certain services, and growth in the number of uninsured. Policy makers have expressed concern that hospitals may forgo providing care to the indigent as a means to reduce costs and become more efficient when faced with financial pressures. Purpose: This article examined the effects of environmental pressures on two dimensions of hospital performance: hospital efficiency and uncompensated care provision. Methodology/Approach: Longitudinal data for the Commonwealth of Virginia from 1998 to 2004 were analyzed. Data Envelopment Analysis and bivariate probit were used to examine the factors associated with efficiency and uncompensated care. Findings: The results indicated that a positive relationship between hospital efficiency and uncompensated care provision exists. That is, hospitals that are categorized as efficient are likely to provide more uncompensated care. We also found that hospitals tended to provide more uncompensated care when increased demand for these services occurred in a market. Increases in Medicare or Medicaid patient share reduced the provision of uncompensated care. In relation to hospital efficiency, the results indicated that HMO penetration and Medicaid patient share reduced hospital efficiency. Practice Implications: This study found that efficient hospitals tend to provide more uncompensated care over time. The findings also suggest that hospitals alter their efficiency and provision of uncompensated care in response to a number of environmental pressures, but it may depend on the type of pressures or uncertainties encountered.","publication_date":{"day":null,"month":null,"year":2010,"errors":{}},"publication_name":"Health Care Management Review","grobid_abstract_attachment_id":39731105},"translated_abstract":null,"internal_url":"https://www.academia.edu/17825693/Impacts_of_market_and_organizational_characteristics_on_hospital_efficiency_and_uncompensated_care","translated_internal_url":"","created_at":"2015-11-05T14:31:16.096-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745062,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863464,"work_id":17825693,"tagging_user_id":37745062,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Impacts of market and organizational characteristics on hospital efficiency and uncompensated care"}],"downloadable_attachments":[{"id":39731105,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731105/thumbnails/1.jpg","file_name":"Impacts_of_market_and_organizational_cha20151105-31821-1lubqy6.pdf","download_url":"https://www.academia.edu/attachments/39731105/download_file","bulk_download_file_name":"Impacts_of_market_and_organizational_cha.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731105/Impacts_of_market_and_organizational_cha20151105-31821-1lubqy6-libre.pdf?1446762859=\u0026response-content-disposition=attachment%3B+filename%3DImpacts_of_market_and_organizational_cha.pdf\u0026Expires=1743441979\u0026Signature=VGC7thGMh54Abi2ecB3cuiuTWU3mRJV1~WSOYofQOiZAVstp~IuLTfRUM5zKfJGFrydwWW5gTAXqBHeDEvA1BHfzbgmfi9eW5MEvtxqdKgZ1-Pe7VP5EPt3v6xIB-FNDED8JyiaKKJPwRQNT5vCQnUcH1DiPDtYRie8Tq2M9oVi7giW6jDPkRFb8tfnbXuH99h-ur5IK3hgfAs-dnVdOiCUGy2RLN6h2sXg8FKvoIj2KwzSVd3Ymczpba8IrkIV5HHvSl-UqMUoXI-Xijb~8AhxrAQIAyGLxgMV7PN6khAC7Bc8QESG5li3XB9h2uGCnG5KBed8WX5zJS9StJVAriw__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Impacts_of_market_and_organizational_characteristics_on_hospital_efficiency_and_uncompensated_care","translated_slug":"","page_count":11,"language":"en","content_type":"Work","summary":"Background: Hospitals have confronted a difficult financial environment given many factors, including expansion of managed care, changes in public policy, growing market competition for certain services, and growth in the number of uninsured. Policy makers have expressed concern that hospitals may forgo providing care to the indigent as a means to reduce costs and become more efficient when faced with financial pressures. Purpose: This article examined the effects of environmental pressures on two dimensions of hospital performance: hospital efficiency and uncompensated care provision. Methodology/Approach: Longitudinal data for the Commonwealth of Virginia from 1998 to 2004 were analyzed. Data Envelopment Analysis and bivariate probit were used to examine the factors associated with efficiency and uncompensated care. Findings: The results indicated that a positive relationship between hospital efficiency and uncompensated care provision exists. That is, hospitals that are categorized as efficient are likely to provide more uncompensated care. We also found that hospitals tended to provide more uncompensated care when increased demand for these services occurred in a market. Increases in Medicare or Medicaid patient share reduced the provision of uncompensated care. In relation to hospital efficiency, the results indicated that HMO penetration and Medicaid patient share reduced hospital efficiency. Practice Implications: This study found that efficient hospitals tend to provide more uncompensated care over time. The findings also suggest that hospitals alter their efficiency and provision of uncompensated care in response to a number of environmental pressures, but it may depend on the type of pressures or uncertainties encountered.","owner":{"id":37745062,"first_name":"Hui-min","middle_initials":null,"last_name":"Hsieh","page_name":"HuiminHsieh","domain_name":"independent","created_at":"2015-11-05T14:30:24.279-08:00","display_name":"Hui-min Hsieh","url":"https://independent.academia.edu/HuiminHsieh"},"attachments":[{"id":39731105,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731105/thumbnails/1.jpg","file_name":"Impacts_of_market_and_organizational_cha20151105-31821-1lubqy6.pdf","download_url":"https://www.academia.edu/attachments/39731105/download_file","bulk_download_file_name":"Impacts_of_market_and_organizational_cha.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731105/Impacts_of_market_and_organizational_cha20151105-31821-1lubqy6-libre.pdf?1446762859=\u0026response-content-disposition=attachment%3B+filename%3DImpacts_of_market_and_organizational_cha.pdf\u0026Expires=1743441979\u0026Signature=VGC7thGMh54Abi2ecB3cuiuTWU3mRJV1~WSOYofQOiZAVstp~IuLTfRUM5zKfJGFrydwWW5gTAXqBHeDEvA1BHfzbgmfi9eW5MEvtxqdKgZ1-Pe7VP5EPt3v6xIB-FNDED8JyiaKKJPwRQNT5vCQnUcH1DiPDtYRie8Tq2M9oVi7giW6jDPkRFb8tfnbXuH99h-ur5IK3hgfAs-dnVdOiCUGy2RLN6h2sXg8FKvoIj2KwzSVd3Ymczpba8IrkIV5HHvSl-UqMUoXI-Xijb~8AhxrAQIAyGLxgMV7PN6khAC7Bc8QESG5li3XB9h2uGCnG5KBed8WX5zJS9StJVAriw__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":21559,"name":"Health Care Management","url":"https://www.academia.edu/Documents/in/Health_Care_Management"},{"id":73149,"name":"Business and Management","url":"https://www.academia.edu/Documents/in/Business_and_Management"},{"id":84107,"name":"Hospital administration","url":"https://www.academia.edu/Documents/in/Hospital_administration"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":218342,"name":"Medicare","url":"https://www.academia.edu/Documents/in/Medicare"},{"id":235072,"name":"Medicaid","url":"https://www.academia.edu/Documents/in/Medicaid"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (true) { Aedu.setUpFigureCarousel('profile-work-17825693-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17825696"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/17825696/Did_Budget_Cuts_in_Medicaid_Disproportionate_Share_Hospital_Payment_Affect_Hospital_Quality_of_Care"><img alt="Research paper thumbnail of Did Budget Cuts in Medicaid Disproportionate Share Hospital Payment Affect Hospital Quality of Care?" class="work-thumbnail" src="https://attachments.academia-assets.com/39731102/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/17825696/Did_Budget_Cuts_in_Medicaid_Disproportionate_Share_Hospital_Payment_Affect_Hospital_Quality_of_Care">Did Budget Cuts in Medicaid Disproportionate Share Hospital Payment Affect Hospital Quality of Care?</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/HuiminHsieh">Hui-min Hsieh</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Medical Care</span><span>, 2014</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background: Medicaid Disproportionate Share Hospital (DSH) payments are one of the major sources ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background: Medicaid Disproportionate Share Hospital (DSH) payments are one of the major sources of financial support for hospitals providing care to low-income patients. However, Medicaid DSH payments will be redirected from hospitals to subsidize individual health insurance purchase through US national health reform.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="0eec5a8bc49efd866a5ad8f25a9ea449" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":39731102,"asset_id":17825696,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/39731102/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825696"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825696"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825696; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825696]").text(description); $(".js-view-count[data-work-id=17825696]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825696; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825696']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "0eec5a8bc49efd866a5ad8f25a9ea449" } } $('.js-work-strip[data-work-id=17825696]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825696,"title":"Did Budget Cuts in Medicaid Disproportionate Share Hospital Payment Affect Hospital Quality of Care?","translated_title":"","metadata":{"ai_title_tag":"Impact of Medicaid DSH Cuts on Hospital Care","grobid_abstract":"Background: Medicaid Disproportionate Share Hospital (DSH) payments are one of the major sources of financial support for hospitals providing care to low-income patients. However, Medicaid DSH payments will be redirected from hospitals to subsidize individual health insurance purchase through US national health reform.","publication_date":{"day":null,"month":null,"year":2014,"errors":{}},"publication_name":"Medical Care","grobid_abstract_attachment_id":39731102},"translated_abstract":null,"internal_url":"https://www.academia.edu/17825696/Did_Budget_Cuts_in_Medicaid_Disproportionate_Share_Hospital_Payment_Affect_Hospital_Quality_of_Care","translated_internal_url":"","created_at":"2015-11-05T14:31:16.525-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745062,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863437,"work_id":17825696,"tagging_user_id":37745062,"tagged_user_id":null,"co_author_invite_id":1960824,"email":"h***n@unthsc.edu","display_order":0,"name":"Hsueh-fen Chen","title":"Did Budget Cuts in Medicaid Disproportionate Share Hospital Payment Affect Hospital Quality of Care?"},{"id":8863463,"work_id":17825696,"tagging_user_id":37745062,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":4194304,"name":"Gloria Bazzoli","title":"Did Budget Cuts in Medicaid Disproportionate Share Hospital Payment Affect Hospital Quality of Care?"}],"downloadable_attachments":[{"id":39731102,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731102/thumbnails/1.jpg","file_name":"Did_Budget_Cuts_in_Medicaid_Disproportio20151105-31826-iwy7np.pdf","download_url":"https://www.academia.edu/attachments/39731102/download_file","bulk_download_file_name":"Did_Budget_Cuts_in_Medicaid_Disproportio.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731102/Did_Budget_Cuts_in_Medicaid_Disproportio20151105-31826-iwy7np-libre.pdf?1446762858=\u0026response-content-disposition=attachment%3B+filename%3DDid_Budget_Cuts_in_Medicaid_Disproportio.pdf\u0026Expires=1743441979\u0026Signature=PzvLGtx37DhH06A0yup8KdUkrpmeWm2ZoGrp-Izx7Sma0rQH-GhJ-0-E~chuRSy8kicLwoYtrSXOhKFDjjFKgvEstN02SgeKNUqig8gTAVRoq~DGBTusZoWFWvNr2HolVEyOnAJai5UCoHj8I2cgynlp34NVYYmqQWBVbG01uKZfDPqihYJSJDiUQTynaiFXesxZHymUN~JHyYzVQnSWbaC8zuHRN4RBc6uIp-YpbyHgm7fINh-di~~SFcAUUMgolrMNqY86zvbDi3WF0IdK9yB7VFDhK8As9YUMY2wNSkLlmL0v6qOsrTr6mFmweSn1dOpN-4dCF8c8w2sdjBPuUw__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Did_Budget_Cuts_in_Medicaid_Disproportionate_Share_Hospital_Payment_Affect_Hospital_Quality_of_Care","translated_slug":"","page_count":7,"language":"en","content_type":"Work","summary":"Background: Medicaid Disproportionate Share Hospital (DSH) payments are one of the major sources of financial support for hospitals providing care to low-income patients. However, Medicaid DSH payments will be redirected from hospitals to subsidize individual health insurance purchase through US national health reform.","owner":{"id":37745062,"first_name":"Hui-min","middle_initials":null,"last_name":"Hsieh","page_name":"HuiminHsieh","domain_name":"independent","created_at":"2015-11-05T14:30:24.279-08:00","display_name":"Hui-min Hsieh","url":"https://independent.academia.edu/HuiminHsieh"},"attachments":[{"id":39731102,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731102/thumbnails/1.jpg","file_name":"Did_Budget_Cuts_in_Medicaid_Disproportio20151105-31826-iwy7np.pdf","download_url":"https://www.academia.edu/attachments/39731102/download_file","bulk_download_file_name":"Did_Budget_Cuts_in_Medicaid_Disproportio.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731102/Did_Budget_Cuts_in_Medicaid_Disproportio20151105-31826-iwy7np-libre.pdf?1446762858=\u0026response-content-disposition=attachment%3B+filename%3DDid_Budget_Cuts_in_Medicaid_Disproportio.pdf\u0026Expires=1743441979\u0026Signature=PzvLGtx37DhH06A0yup8KdUkrpmeWm2ZoGrp-Izx7Sma0rQH-GhJ-0-E~chuRSy8kicLwoYtrSXOhKFDjjFKgvEstN02SgeKNUqig8gTAVRoq~DGBTusZoWFWvNr2HolVEyOnAJai5UCoHj8I2cgynlp34NVYYmqQWBVbG01uKZfDPqihYJSJDiUQTynaiFXesxZHymUN~JHyYzVQnSWbaC8zuHRN4RBc6uIp-YpbyHgm7fINh-di~~SFcAUUMgolrMNqY86zvbDi3WF0IdK9yB7VFDhK8As9YUMY2wNSkLlmL0v6qOsrTr6mFmweSn1dOpN-4dCF8c8w2sdjBPuUw__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":8974,"name":"Quality of Mental Health Care","url":"https://www.academia.edu/Documents/in/Quality_of_Mental_Health_Care"},{"id":16635,"name":"Health Services Research","url":"https://www.academia.edu/Documents/in/Health_Services_Research"},{"id":27659,"name":"Applied Economics","url":"https://www.academia.edu/Documents/in/Applied_Economics"},{"id":37925,"name":"Ownership","url":"https://www.academia.edu/Documents/in/Ownership"},{"id":50113,"name":"California","url":"https://www.academia.edu/Documents/in/California"},{"id":84107,"name":"Hospital administration","url":"https://www.academia.edu/Documents/in/Hospital_administration"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":219645,"name":"Medical Care","url":"https://www.academia.edu/Documents/in/Medical_Care"},{"id":235072,"name":"Medicaid","url":"https://www.academia.edu/Documents/in/Medicaid"},{"id":386976,"name":"Budgets","url":"https://www.academia.edu/Documents/in/Budgets"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17825696-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17825694"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/17825694/The_Effects_of_Safety_Net_Hospital_Closures_and_Conversions_on_Patient_Travel_Distance_to_Hospital_Services"><img alt="Research paper thumbnail of The Effects of Safety Net Hospital Closures and Conversions on Patient Travel Distance to Hospital Services" class="work-thumbnail" src="https://attachments.academia-assets.com/39731101/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/17825694/The_Effects_of_Safety_Net_Hospital_Closures_and_Conversions_on_Patient_Travel_Distance_to_Hospital_Services">The Effects of Safety Net Hospital Closures and Conversions on Patient Travel Distance to Hospital Services</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/HuiminHsieh">Hui-min Hsieh</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Health Services Research</span><span>, 2012</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Objective-To examine the effects of safety net hospital (SNH) closure and for-profit conversion o...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Objective-To examine the effects of safety net hospital (SNH) closure and for-profit conversion on uninsured, Medicaid, and racial/ethnic minorities.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="3bbfc96fd32626bb2cf8b5c533797da0" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":39731101,"asset_id":17825694,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/39731101/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825694"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825694"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825694; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825694]").text(description); $(".js-view-count[data-work-id=17825694]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825694; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825694']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "3bbfc96fd32626bb2cf8b5c533797da0" } } $('.js-work-strip[data-work-id=17825694]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825694,"title":"The Effects of Safety Net Hospital Closures and Conversions on Patient Travel Distance to Hospital Services","translated_title":"","metadata":{"ai_title_tag":"Impact of Safety Net Hospital Closures on Patient Access","grobid_abstract":"Objective-To examine the effects of safety net hospital (SNH) closure and for-profit conversion on uninsured, Medicaid, and racial/ethnic minorities.","publication_date":{"day":null,"month":null,"year":2012,"errors":{}},"publication_name":"Health Services Research","grobid_abstract_attachment_id":39731101},"translated_abstract":null,"internal_url":"https://www.academia.edu/17825694/The_Effects_of_Safety_Net_Hospital_Closures_and_Conversions_on_Patient_Travel_Distance_to_Hospital_Services","translated_internal_url":"","created_at":"2015-11-05T14:31:16.198-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745062,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863438,"work_id":17825694,"tagging_user_id":37745062,"tagged_user_id":null,"co_author_invite_id":2001862,"email":"l***y@rti.org","display_order":0,"name":"Lee Mobley","title":"The Effects of Safety Net Hospital Closures and Conversions on Patient Travel Distance to Hospital Services"},{"id":8863462,"work_id":17825694,"tagging_user_id":37745062,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":4194304,"name":"Gloria Bazzoli","title":"The Effects of Safety Net Hospital Closures and Conversions on Patient Travel Distance to Hospital Services"}],"downloadable_attachments":[{"id":39731101,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731101/thumbnails/1.jpg","file_name":"The_Effects_of_Safety_Net_Hospital_Closu20151105-863-d9cbx8.pdf","download_url":"https://www.academia.edu/attachments/39731101/download_file","bulk_download_file_name":"The_Effects_of_Safety_Net_Hospital_Closu.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731101/The_Effects_of_Safety_Net_Hospital_Closu20151105-863-d9cbx8-libre.pdf?1446762861=\u0026response-content-disposition=attachment%3B+filename%3DThe_Effects_of_Safety_Net_Hospital_Closu.pdf\u0026Expires=1743441979\u0026Signature=f1bA4nkBuoZDThgruxZGzBR8Rk30HaIpGPOGRZMF8H1WVsy7RLAtYQnSoj~ymc~cmVcaBPJ7H-ubUaWxbYbijcmS1cfd0649GT11gYH159e6BSRJyTZY4eIawt9aC4IYv8ZfiaZPezGj2SSNvzwle3GfXzVPzrgTM3OU1CZ-DSofDWsdnPygpbqeH9ZUy4~8~JepL2Vz~pAJ8aVlGzxC74I00mrYngX4A0TBnMkPsw2Xu5-i6FhaFnpAFKypNXvMcehQ~D~UVVJjLz~xUhELcJl901P94HsXBjXNZP7H0fKeaXeI5BklBEbDnir~R0aU-2m6z24daorh1Z5JpuNhTQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"The_Effects_of_Safety_Net_Hospital_Closures_and_Conversions_on_Patient_Travel_Distance_to_Hospital_Services","translated_slug":"","page_count":20,"language":"en","content_type":"Work","summary":"Objective-To examine the effects of safety net hospital (SNH) closure and for-profit conversion on uninsured, Medicaid, and racial/ethnic minorities.","owner":{"id":37745062,"first_name":"Hui-min","middle_initials":null,"last_name":"Hsieh","page_name":"HuiminHsieh","domain_name":"independent","created_at":"2015-11-05T14:30:24.279-08:00","display_name":"Hui-min Hsieh","url":"https://independent.academia.edu/HuiminHsieh"},"attachments":[{"id":39731101,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731101/thumbnails/1.jpg","file_name":"The_Effects_of_Safety_Net_Hospital_Closu20151105-863-d9cbx8.pdf","download_url":"https://www.academia.edu/attachments/39731101/download_file","bulk_download_file_name":"The_Effects_of_Safety_Net_Hospital_Closu.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731101/The_Effects_of_Safety_Net_Hospital_Closu20151105-863-d9cbx8-libre.pdf?1446762861=\u0026response-content-disposition=attachment%3B+filename%3DThe_Effects_of_Safety_Net_Hospital_Closu.pdf\u0026Expires=1743441979\u0026Signature=f1bA4nkBuoZDThgruxZGzBR8Rk30HaIpGPOGRZMF8H1WVsy7RLAtYQnSoj~ymc~cmVcaBPJ7H-ubUaWxbYbijcmS1cfd0649GT11gYH159e6BSRJyTZY4eIawt9aC4IYv8ZfiaZPezGj2SSNvzwle3GfXzVPzrgTM3OU1CZ-DSofDWsdnPygpbqeH9ZUy4~8~JepL2Vz~pAJ8aVlGzxC74I00mrYngX4A0TBnMkPsw2Xu5-i6FhaFnpAFKypNXvMcehQ~D~UVVJjLz~xUhELcJl901P94HsXBjXNZP7H0fKeaXeI5BklBEbDnir~R0aU-2m6z24daorh1Z5JpuNhTQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":37772,"name":"Hospitals","url":"https://www.academia.edu/Documents/in/Hospitals"},{"id":41482,"name":"Multivariate Analysis","url":"https://www.academia.edu/Documents/in/Multivariate_Analysis"},{"id":83471,"name":"Health Services","url":"https://www.academia.edu/Documents/in/Health_Services"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":235072,"name":"Medicaid","url":"https://www.academia.edu/Documents/in/Medicaid"},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17825694-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17825692"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/17825692/Hospital_Financial_Conditions_and_the_Provision_of_Unprofitable_Services"><img alt="Research paper thumbnail of Hospital Financial Conditions and the Provision of Unprofitable Services" class="work-thumbnail" src="https://attachments.academia-assets.com/39731140/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/17825692/Hospital_Financial_Conditions_and_the_Provision_of_Unprofitable_Services">Hospital Financial Conditions and the Provision of Unprofitable Services</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/HuiminHsieh">Hui-min Hsieh</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Atlantic Economic Journal</span><span>, 2009</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Increases in hospital financial pressure resulting from public and private payment policy may sub...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Increases in hospital financial pressure resulting from public and private payment policy may substantially reduce a hospital's ability to provide certain services that are not well compensated or are frequently used by the uninsured. The objective of this study is to examine the impact of hospital financial condition on the provision of these unprofitable services for the insured and uninsured. Economic theory provides the conceptual underpinnings for the analysis, and a longitudinal empirical analysis is conducted for an eight-year study period. The results indicate that not-for-profit hospitals with strong financial performance provide more unprofitable services for the insured and uninsured than do not-for-profit hospitals with weaker condition. Forprofit hospital provision of these services is not influenced by their financial condition and instead may reflect actions to meet community expectations or to offer a sufficiently broad service array to maintain the business of insured patients.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="d344c1f5ccda6f475247b1b05430f32e" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":39731140,"asset_id":17825692,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/39731140/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825692"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825692"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825692; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825692]").text(description); $(".js-view-count[data-work-id=17825692]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825692; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825692']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "d344c1f5ccda6f475247b1b05430f32e" } } $('.js-work-strip[data-work-id=17825692]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825692,"title":"Hospital Financial Conditions and the Provision of Unprofitable Services","translated_title":"","metadata":{"grobid_abstract":"Increases in hospital financial pressure resulting from public and private payment policy may substantially reduce a hospital's ability to provide certain services that are not well compensated or are frequently used by the uninsured. The objective of this study is to examine the impact of hospital financial condition on the provision of these unprofitable services for the insured and uninsured. Economic theory provides the conceptual underpinnings for the analysis, and a longitudinal empirical analysis is conducted for an eight-year study period. The results indicate that not-for-profit hospitals with strong financial performance provide more unprofitable services for the insured and uninsured than do not-for-profit hospitals with weaker condition. Forprofit hospital provision of these services is not influenced by their financial condition and instead may reflect actions to meet community expectations or to offer a sufficiently broad service array to maintain the business of insured patients.","publication_date":{"day":null,"month":null,"year":2009,"errors":{}},"publication_name":"Atlantic Economic Journal","grobid_abstract_attachment_id":39731140},"translated_abstract":null,"internal_url":"https://www.academia.edu/17825692/Hospital_Financial_Conditions_and_the_Provision_of_Unprofitable_Services","translated_internal_url":"","created_at":"2015-11-05T14:31:15.991-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745062,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863436,"work_id":17825692,"tagging_user_id":37745062,"tagged_user_id":null,"co_author_invite_id":1960824,"email":"h***n@unthsc.edu","display_order":0,"name":"Hsueh-fen Chen","title":"Hospital Financial Conditions and the Provision of Unprofitable Services"},{"id":8863461,"work_id":17825692,"tagging_user_id":37745062,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":4194304,"name":"Gloria Bazzoli","title":"Hospital Financial Conditions and the Provision of Unprofitable Services"}],"downloadable_attachments":[{"id":39731140,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731140/thumbnails/1.jpg","file_name":"Hospital_Financial_Conditions_and_the_Pr20151105-20592-1a5zih8.pdf","download_url":"https://www.academia.edu/attachments/39731140/download_file","bulk_download_file_name":"Hospital_Financial_Conditions_and_the_Pr.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731140/Hospital_Financial_Conditions_and_the_Pr20151105-20592-1a5zih8-libre.pdf?1446764887=\u0026response-content-disposition=attachment%3B+filename%3DHospital_Financial_Conditions_and_the_Pr.pdf\u0026Expires=1743441979\u0026Signature=LZJ8KCn7tudMEuRudW3xOkvkzp9i8mIMvZ3AedPRY1dKoLJe104FzT39K6lrSTIB8iTQHg4FN9ezA0xVR6JzVjXeRjQAioUalpdTXPvoM4nMwhslVrHzr86~sJOxMl71p6rodtSmIir7tPxNvY5eoD7nDLe9dvU1raM1gNMH7E-jczft9YzpVMASteRFDAo6t8C3gbhEdTMUzVqtxrLbOlvIy1TGKXCul11c5y98c6~vRsr1QTO9~yy8yNxrXv6qONjMPedrrJOliWCKYSIaVdOU5bu~viLY9lwDgR5Uo4VtVr7uJWtF0meVevFqe6luT9FI8Pj8TpqnvlFhVjplqQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Hospital_Financial_Conditions_and_the_Provision_of_Unprofitable_Services","translated_slug":"","page_count":19,"language":"en","content_type":"Work","summary":"Increases in hospital financial pressure resulting from public and private payment policy may substantially reduce a hospital's ability to provide certain services that are not well compensated or are frequently used by the uninsured. The objective of this study is to examine the impact of hospital financial condition on the provision of these unprofitable services for the insured and uninsured. Economic theory provides the conceptual underpinnings for the analysis, and a longitudinal empirical analysis is conducted for an eight-year study period. The results indicate that not-for-profit hospitals with strong financial performance provide more unprofitable services for the insured and uninsured than do not-for-profit hospitals with weaker condition. Forprofit hospital provision of these services is not influenced by their financial condition and instead may reflect actions to meet community expectations or to offer a sufficiently broad service array to maintain the business of insured patients.","owner":{"id":37745062,"first_name":"Hui-min","middle_initials":null,"last_name":"Hsieh","page_name":"HuiminHsieh","domain_name":"independent","created_at":"2015-11-05T14:30:24.279-08:00","display_name":"Hui-min Hsieh","url":"https://independent.academia.edu/HuiminHsieh"},"attachments":[{"id":39731140,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731140/thumbnails/1.jpg","file_name":"Hospital_Financial_Conditions_and_the_Pr20151105-20592-1a5zih8.pdf","download_url":"https://www.academia.edu/attachments/39731140/download_file","bulk_download_file_name":"Hospital_Financial_Conditions_and_the_Pr.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731140/Hospital_Financial_Conditions_and_the_Pr20151105-20592-1a5zih8-libre.pdf?1446764887=\u0026response-content-disposition=attachment%3B+filename%3DHospital_Financial_Conditions_and_the_Pr.pdf\u0026Expires=1743441979\u0026Signature=LZJ8KCn7tudMEuRudW3xOkvkzp9i8mIMvZ3AedPRY1dKoLJe104FzT39K6lrSTIB8iTQHg4FN9ezA0xVR6JzVjXeRjQAioUalpdTXPvoM4nMwhslVrHzr86~sJOxMl71p6rodtSmIir7tPxNvY5eoD7nDLe9dvU1raM1gNMH7E-jczft9YzpVMASteRFDAo6t8C3gbhEdTMUzVqtxrLbOlvIy1TGKXCul11c5y98c6~vRsr1QTO9~yy8yNxrXv6qONjMPedrrJOliWCKYSIaVdOU5bu~viLY9lwDgR5Uo4VtVr7uJWtF0meVevFqe6luT9FI8Pj8TpqnvlFhVjplqQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":724,"name":"Economics","url":"https://www.academia.edu/Documents/in/Economics"},{"id":6208,"name":"Economic Theory","url":"https://www.academia.edu/Documents/in/Economic_Theory"},{"id":184586,"name":"Financial Performance","url":"https://www.academia.edu/Documents/in/Financial_Performance"},{"id":395436,"name":"Not for profit","url":"https://www.academia.edu/Documents/in/Not_for_profit"},{"id":993329,"name":"Empirical Analysis","url":"https://www.academia.edu/Documents/in/Empirical_Analysis"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17825692-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17815064"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/17815064/The_effect_of_changing_state_health_policy_on_hospital_uncompensated_care"><img alt="Research paper thumbnail of The effect of changing state health policy on hospital uncompensated care" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">The effect of changing state health policy on hospital uncompensated care</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenZuckerman">Stephen Zuckerman</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Inquiry : a journal of medical care organization, provision and financing</span><span>, 2000</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">This paper examines the effect of changing state policy, such as Medicaid eligibility, payment ge...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">This paper examines the effect of changing state policy, such as Medicaid eligibility, payment generosity, and HMO enrollment on provision of hospital uncompensated care. Using national data from the American Hospital Association for the period 1990 through 1995, we find that not-for-profit and public hospitals&#39; uncompensated care levels respond positively to Medicaid payment generosity, although the magnitude of the effect is small. Not-for-profit hospitals respond negatively to Medicaid HMO penetration. Public and for-profit hospitals respond negatively to increases in Medicaid eligibility. Results suggest that public insurance payment generosity is an effective but inefficient policy instrument for influencing uncompensated care among not-for-profit hospitals. Further, in localities with high HMO penetration or high penetration of for-profit hospitals, it may be necessary to establish explicit payments for care of the uninsured.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17815064"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17815064"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17815064; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17815064]").text(description); $(".js-view-count[data-work-id=17815064]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17815064; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17815064']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=17815064]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17815064,"title":"The effect of changing state health policy on hospital uncompensated care","translated_title":"","metadata":{"abstract":"This paper examines the effect of changing state policy, such as Medicaid eligibility, payment generosity, and HMO enrollment on provision of hospital uncompensated care. Using national data from the American Hospital Association for the period 1990 through 1995, we find that not-for-profit and public hospitals\u0026#39; uncompensated care levels respond positively to Medicaid payment generosity, although the magnitude of the effect is small. Not-for-profit hospitals respond negatively to Medicaid HMO penetration. Public and for-profit hospitals respond negatively to increases in Medicaid eligibility. Results suggest that public insurance payment generosity is an effective but inefficient policy instrument for influencing uncompensated care among not-for-profit hospitals. Further, in localities with high HMO penetration or high penetration of for-profit hospitals, it may be necessary to establish explicit payments for care of the uninsured.","publication_date":{"day":null,"month":null,"year":2000,"errors":{}},"publication_name":"Inquiry : a journal of medical care organization, provision and financing"},"translated_abstract":"This paper examines the effect of changing state policy, such as Medicaid eligibility, payment generosity, and HMO enrollment on provision of hospital uncompensated care. Using national data from the American Hospital Association for the period 1990 through 1995, we find that not-for-profit and public hospitals\u0026#39; uncompensated care levels respond positively to Medicaid payment generosity, although the magnitude of the effect is small. Not-for-profit hospitals respond negatively to Medicaid HMO penetration. Public and for-profit hospitals respond negatively to increases in Medicaid eligibility. Results suggest that public insurance payment generosity is an effective but inefficient policy instrument for influencing uncompensated care among not-for-profit hospitals. Further, in localities with high HMO penetration or high penetration of for-profit hospitals, it may be necessary to establish explicit payments for care of the uninsured.","internal_url":"https://www.academia.edu/17815064/The_effect_of_changing_state_health_policy_on_hospital_uncompensated_care","translated_internal_url":"","created_at":"2015-11-05T12:18:24.960-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37738526,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8842721,"work_id":17815064,"tagging_user_id":37738526,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"The effect of changing state health policy on hospital uncompensated care"},{"id":8842723,"work_id":17815064,"tagging_user_id":37738526,"tagged_user_id":null,"co_author_invite_id":1996647,"email":"a***f@ahrq.hhs.gov","display_order":4194304,"name":"A. Davidoff","title":"The effect of changing state health policy on hospital uncompensated care"},{"id":8842725,"work_id":17815064,"tagging_user_id":37738526,"tagged_user_id":null,"co_author_invite_id":1960815,"email":"a***s@gmail.com","display_order":6291456,"name":"A. Losasso","title":"The effect of changing state health policy on hospital uncompensated care"}],"downloadable_attachments":[],"slug":"The_effect_of_changing_state_health_policy_on_hospital_uncompensated_care","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"This paper examines the effect of changing state policy, such as Medicaid eligibility, payment generosity, and HMO enrollment on provision of hospital uncompensated care. Using national data from the American Hospital Association for the period 1990 through 1995, we find that not-for-profit and public hospitals\u0026#39; uncompensated care levels respond positively to Medicaid payment generosity, although the magnitude of the effect is small. Not-for-profit hospitals respond negatively to Medicaid HMO penetration. Public and for-profit hospitals respond negatively to increases in Medicaid eligibility. Results suggest that public insurance payment generosity is an effective but inefficient policy instrument for influencing uncompensated care among not-for-profit hospitals. Further, in localities with high HMO penetration or high penetration of for-profit hospitals, it may be necessary to establish explicit payments for care of the uninsured.","owner":{"id":37738526,"first_name":"Stephen","middle_initials":null,"last_name":"Zuckerman","page_name":"StephenZuckerman","domain_name":"independent","created_at":"2015-11-05T12:17:57.305-08:00","display_name":"Stephen Zuckerman","url":"https://independent.academia.edu/StephenZuckerman"},"attachments":[],"research_interests":[{"id":16635,"name":"Health Services Research","url":"https://www.academia.edu/Documents/in/Health_Services_Research"},{"id":17969,"name":"Health Policy","url":"https://www.academia.edu/Documents/in/Health_Policy"},{"id":37925,"name":"Ownership","url":"https://www.academia.edu/Documents/in/Ownership"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":235072,"name":"Medicaid","url":"https://www.academia.edu/Documents/in/Medicaid"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":458190,"name":"Organizational Innovation","url":"https://www.academia.edu/Documents/in/Organizational_Innovation"},{"id":579119,"name":"Marketing of Health Services","url":"https://www.academia.edu/Documents/in/Marketing_of_Health_Services"},{"id":849052,"name":"Public Art Hospitals","url":"https://www.academia.edu/Documents/in/Public_Art_Hospitals"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17815064-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17008511"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/17008511/Variations_in_Inpatient_Mortality_Among_Hospitals_in_Different_System_Types_1995_to_2000"><img alt="Research paper thumbnail of Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/DavidHarless">David Harless</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/AskarChukmaitov">Askar Chukmaitov</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Medical Care</span><span>, 2009</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Relatively few studies focused on the impact of system formation and hospital merger on quality, ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Relatively few studies focused on the impact of system formation and hospital merger on quality, and these studies reported typically little or no quality effect. To study associations among 5 main types of health systems--centralized, centralized physician/insurance, moderately centralized, decentralized, and independent--and inpatient mortality from acute myocardial infarction (AMI), congestive heart failure, stroke, and pneumonia. Panel data (1995-2000) were assembled from 11 states and multiple sources: Agency for Healthcare Research and Quality State Inpatient Database, American Hospital Association Annual Surveys, Area Resource File, HMO InterStudy, and the Centers for Medicare and Medicaid Services. We applied a panel study design with fixed effects models using information on variation within hospitals. We found that centralized health systems are associated with lower AMI, congestive heart failure, and pneumonia mortality. Independent hospital systems had better AMI quality outcomes than centralized physician/insurance and moderately centralized health systems. We found no difference in inpatient mortality among system types for the stroke outcome. Thus, for certain types of clinical service lines and patients, hospital system type matters. Research that focuses only on system membership may mask the impact of system type on the quality of care.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17008511"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17008511"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17008511; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17008511]").text(description); $(".js-view-count[data-work-id=17008511]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17008511; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17008511']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=17008511]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17008511,"title":"Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000","translated_title":"","metadata":{"abstract":"Relatively few studies focused on the impact of system formation and hospital merger on quality, and these studies reported typically little or no quality effect. To study associations among 5 main types of health systems--centralized, centralized physician/insurance, moderately centralized, decentralized, and independent--and inpatient mortality from acute myocardial infarction (AMI), congestive heart failure, stroke, and pneumonia. Panel data (1995-2000) were assembled from 11 states and multiple sources: Agency for Healthcare Research and Quality State Inpatient Database, American Hospital Association Annual Surveys, Area Resource File, HMO InterStudy, and the Centers for Medicare and Medicaid Services. We applied a panel study design with fixed effects models using information on variation within hospitals. We found that centralized health systems are associated with lower AMI, congestive heart failure, and pneumonia mortality. Independent hospital systems had better AMI quality outcomes than centralized physician/insurance and moderately centralized health systems. We found no difference in inpatient mortality among system types for the stroke outcome. Thus, for certain types of clinical service lines and patients, hospital system type matters. Research that focuses only on system membership may mask the impact of system type on the quality of care.","publication_date":{"day":null,"month":null,"year":2009,"errors":{}},"publication_name":"Medical Care"},"translated_abstract":"Relatively few studies focused on the impact of system formation and hospital merger on quality, and these studies reported typically little or no quality effect. To study associations among 5 main types of health systems--centralized, centralized physician/insurance, moderately centralized, decentralized, and independent--and inpatient mortality from acute myocardial infarction (AMI), congestive heart failure, stroke, and pneumonia. Panel data (1995-2000) were assembled from 11 states and multiple sources: Agency for Healthcare Research and Quality State Inpatient Database, American Hospital Association Annual Surveys, Area Resource File, HMO InterStudy, and the Centers for Medicare and Medicaid Services. We applied a panel study design with fixed effects models using information on variation within hospitals. We found that centralized health systems are associated with lower AMI, congestive heart failure, and pneumonia mortality. Independent hospital systems had better AMI quality outcomes than centralized physician/insurance and moderately centralized health systems. We found no difference in inpatient mortality among system types for the stroke outcome. Thus, for certain types of clinical service lines and patients, hospital system type matters. Research that focuses only on system membership may mask the impact of system type on the quality of care.","internal_url":"https://www.academia.edu/17008511/Variations_in_Inpatient_Mortality_Among_Hospitals_in_Different_System_Types_1995_to_2000","translated_internal_url":"","created_at":"2015-10-19T13:32:49.657-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":36547483,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":7563932,"work_id":17008511,"tagging_user_id":36547483,"tagged_user_id":36698468,"co_author_invite_id":1690080,"email":"a***v@vcu.edu","display_order":0,"name":"Askar Chukmaitov","title":"Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000"},{"id":7563935,"work_id":17008511,"tagging_user_id":36547483,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":4194304,"name":"Gloria Bazzoli","title":"Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000"},{"id":7563955,"work_id":17008511,"tagging_user_id":36547483,"tagged_user_id":null,"co_author_invite_id":1690087,"email":"k***s@vcu.edu","display_order":6291456,"name":"K. Devers","title":"Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000"},{"id":7563959,"work_id":17008511,"tagging_user_id":36547483,"tagged_user_id":null,"co_author_invite_id":1690091,"email":"r***y@hsc.vcu.edu","display_order":7340032,"name":"Robert Hurley","title":"Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000"},{"id":7563960,"work_id":17008511,"tagging_user_id":36547483,"tagged_user_id":null,"co_author_invite_id":1690092,"email":"m***o@pku.edu.cn","display_order":7864320,"name":"Mei Zhao","title":"Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000"}],"downloadable_attachments":[],"slug":"Variations_in_Inpatient_Mortality_Among_Hospitals_in_Different_System_Types_1995_to_2000","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Relatively few studies focused on the impact of system formation and hospital merger on quality, and these studies reported typically little or no quality effect. To study associations among 5 main types of health systems--centralized, centralized physician/insurance, moderately centralized, decentralized, and independent--and inpatient mortality from acute myocardial infarction (AMI), congestive heart failure, stroke, and pneumonia. Panel data (1995-2000) were assembled from 11 states and multiple sources: Agency for Healthcare Research and Quality State Inpatient Database, American Hospital Association Annual Surveys, Area Resource File, HMO InterStudy, and the Centers for Medicare and Medicaid Services. We applied a panel study design with fixed effects models using information on variation within hospitals. We found that centralized health systems are associated with lower AMI, congestive heart failure, and pneumonia mortality. Independent hospital systems had better AMI quality outcomes than centralized physician/insurance and moderately centralized health systems. We found no difference in inpatient mortality among system types for the stroke outcome. Thus, for certain types of clinical service lines and patients, hospital system type matters. Research that focuses only on system membership may mask the impact of system type on the quality of care.","owner":{"id":36547483,"first_name":"David","middle_initials":null,"last_name":"Harless","page_name":"DavidHarless","domain_name":"vcu","created_at":"2015-10-19T13:28:04.248-07:00","display_name":"David Harless","url":"https://vcu.academia.edu/DavidHarless"},"attachments":[],"research_interests":[{"id":8974,"name":"Quality of Mental Health Care","url":"https://www.academia.edu/Documents/in/Quality_of_Mental_Health_Care"},{"id":27659,"name":"Applied Economics","url":"https://www.academia.edu/Documents/in/Applied_Economics"},{"id":49633,"name":"Heart Failure","url":"https://www.academia.edu/Documents/in/Heart_Failure"},{"id":61234,"name":"Stroke","url":"https://www.academia.edu/Documents/in/Stroke"},{"id":84107,"name":"Hospital administration","url":"https://www.academia.edu/Documents/in/Hospital_administration"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":111112,"name":"Pneumonia","url":"https://www.academia.edu/Documents/in/Pneumonia"},{"id":219645,"name":"Medical Care","url":"https://www.academia.edu/Documents/in/Medical_Care"},{"id":378016,"name":"Myocardial Infarction","url":"https://www.academia.edu/Documents/in/Myocardial_Infarction"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":901284,"name":"Hospital Mortality","url":"https://www.academia.edu/Documents/in/Hospital_Mortality"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17008511-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17008490"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/17008490/Delivery_system_characteristics_and_their_association_with_quality_and_costs_of_care"><img alt="Research paper thumbnail of Delivery system characteristics and their association with quality and costs of care" class="work-thumbnail" src="https://attachments.academia-assets.com/42360150/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/17008490/Delivery_system_characteristics_and_their_association_with_quality_and_costs_of_care">Delivery system characteristics and their association with quality and costs of care</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/DavidHarless">David Harless</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/AskarChukmaitov">Askar Chukmaitov</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Health Care Management Review</span><span>, 2014</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background Implementation of accountable care organizations (ACOs) is currently underway, but the...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background Implementation of accountable care organizations (ACOs) is currently underway, but there is limited empirical evidence on the merits of the ACO model. Purpose The aim was to study the associations between delivery system characteristics and ACO competencies, including centralization strategies to manage organizations, hospital integration with physicians and outpatient facilities, health information technology, infrastructure to monitor community health and report quality, and risk-adjusted 30-day all-cause mortality and case-mixed-adjusted inpatient costs for the Medicare population. Methodology Panel data (2006Y2009) were assembled from Florida and multiple sources: inpatient hospital discharge, vital statistics, the American Hospital Association, the Healthcare Information and Management Systems Society, and other databases. We applied a panel study design, controlling for hospital and market characteristics. Principal Findings Hospitals that were in centralized health systems or became more centralized over the study period had significantly larger reductions in mortality compared with hospitals that remained freestanding. Surprisingly, tightly integrated hospitalYphysician arrangements were associated with increased mortality; as such, hospitals may wish to proceed cautiously when developing specific types of alignment with local physician organizations. We observed no statistically significant differences in the growth rate of costs across hospitals in any of the health systems studied relative to freestanding hospitals. Although we observed quality improvement in some organizational types, these outcome improvements were not coupled with the additional desired objective of lower cost growth. This implies that additional changes not present during our study period, potentially changes in provider payment approaches, are essential for achieving the ACO objectives of higher quality of care at lower costs. Practice Implications Provider organizations implementing ACOs should consider centralizing service delivery as a viable strategy to improve quality of care, although the strategy did not result in lower cost growth.</span></div><div class="wp-workCard_item"><div class="carousel-container carousel-container--sm" id="profile-work-17008490-figures"><div class="prev-slide-container js-prev-button-container"><button aria-label="Previous" class="carousel-navigation-button js-profile-work-17008490-figures-prev"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">arrow_back_ios</span></button></div><div class="slides-container js-slides-container"><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/33828443/figure-1-percentage-changes-in-mortality-and-cost"><img alt="percentage changes in mortality and cost* " class="figure-slide-image" src="https://figures.academia-assets.com/42360150/figure_001.jpg" /></a></figure><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/33828453/table-1-note-aco-accouncare-organization-hit-health"><img alt="Note. ACO = accountable care organization; HIT = health information technology; EHR = electronic health records. Accountable care organization thought-leaders have sug- gested that integrated delivery systems may serve as effective platforms for ACO development (Devers & Berenson, 2009; Fisher & Shortell, 2010; Fisher et al., 2012; McClellan et al., 2010). However, not all health systems are alike, with some having highly centralized and integrated structures while others are decentralized (Bazzoli Bazzoli, Shortell, Dubbs, Chan, & Kralovec, 1999). Survey research by Alexander, Lee, and Bazzoli (2003) found that governance attributes of centralized health systems (CHSs) were characterized by higher levels of administrative intensity, higher levels of decision-making authority concentrated at the system level, and more board representation of affiliate members when compared with decentralized systems. Centralized decision making and representative governance may allow for more effective management of task interdependence and more coordinated communication across system participants than would arise in decentralized systems. Early evidence from ACO pilots suggested that committed executive leadership and strong governance are major facilitators of ACO for- mation by promoting development of shared aims, resource prioritization, and coordinated response to transformational challenges (Larson et al., 2012). Case studies of ACO pilots showed that hospital systems were engaged in a broad array of care management and care coordination services (Larson etal., 2012). Chukmaitov et al. (2009) found that hospitals in CHSs had lower inpatient mortalities in comparison with hospitals in other system types. As such, more CHSs, due to high levels of administrative capacity and decision- making authority at the system level, may be more effective in coordinating and diffusing disease management protocols across their members. Other mechanisms, such as alignment of economic and noneconomic incentives, adoption of evidence-based medicine, and decisions to develop centers for clinical excellence that improve processes of care deliv- ery, may stem from centralized governance and leadership of hospital-led health systems. As such, more centralized structures may be conducive to achieving ACO goals, and we therefore hypothesize: " class="figure-slide-image" src="https://figures.academia-assets.com/42360150/table_001.jpg" /></a></figure><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/33828463/table-2-note-data-are-presented-as-sd-fh-freestanding"><img alt="Note. Data are presented as M (SD). FH = freestanding hospital; IHS = independent hospital system; DHS = decentralized health system; MCHS moderately centralized health system; CHPIHS = centralized health and physician—insurance system; POA = physician—-organization arrangemer HIT = health information technology; HMO = health management organization; HHI, herfindah|-hirschman index. lote. Data are presented as M (SD). FH = freestanding hospital; IHS = independent hospital system; DHS = decentralized health system; MCHS 1oderately centralized health system; CHPIHS = centralized health and physician—insurance system; POA = physician—-organization arrangemen IT = health information technology; HMO = health management organization; HHI, herfindahl-hirschman index. Column summarizes the results of test of the null hypothesis of equality of means across the five categories of system type for each variable. p <.05. " class="figure-slide-image" src="https://figures.academia-assets.com/42360150/table_002.jpg" /></a></figure><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/33828475/table-4-note-ihs-independent-hospital-system-dhs"><img alt="Note. IHS = independent hospital system; DHS = decentralized health system; MCHS = moderately centralized health system; CHPIHS = centralized health and physician—insurance system; POA = physician-hospital arrangement; HIT = health information technology; HMO = health management organization; HHI, herfindahl-hirschman index. *Consistent with the definitions in Table 4, the binary variables for system status (IHS, DHS, MCHS, and CHPIHS) indicate system status o hospitals that had the same system status in 2009 as in 2006. Similarly, the binary variables more and less indicate whether hospitals ar more or less centralized in 2009 versus 2006. " class="figure-slide-image" src="https://figures.academia-assets.com/42360150/table_003.jpg" /></a></figure></div><div class="next-slide-container js-next-button-container"><button aria-label="Next" class="carousel-navigation-button js-profile-work-17008490-figures-next"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">arrow_forward_ios</span></button></div></div></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="ebc372fc0b4978075e33fc5c22fa586c" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":42360150,"asset_id":17008490,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/42360150/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17008490"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17008490"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17008490; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17008490]").text(description); $(".js-view-count[data-work-id=17008490]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17008490; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17008490']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "ebc372fc0b4978075e33fc5c22fa586c" } } $('.js-work-strip[data-work-id=17008490]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17008490,"title":"Delivery system characteristics and their association with quality and costs of care","translated_title":"","metadata":{"grobid_abstract":"Background Implementation of accountable care organizations (ACOs) is currently underway, but there is limited empirical evidence on the merits of the ACO model. Purpose The aim was to study the associations between delivery system characteristics and ACO competencies, including centralization strategies to manage organizations, hospital integration with physicians and outpatient facilities, health information technology, infrastructure to monitor community health and report quality, and risk-adjusted 30-day all-cause mortality and case-mixed-adjusted inpatient costs for the Medicare population. Methodology Panel data (2006Y2009) were assembled from Florida and multiple sources: inpatient hospital discharge, vital statistics, the American Hospital Association, the Healthcare Information and Management Systems Society, and other databases. We applied a panel study design, controlling for hospital and market characteristics. Principal Findings Hospitals that were in centralized health systems or became more centralized over the study period had significantly larger reductions in mortality compared with hospitals that remained freestanding. Surprisingly, tightly integrated hospitalYphysician arrangements were associated with increased mortality; as such, hospitals may wish to proceed cautiously when developing specific types of alignment with local physician organizations. We observed no statistically significant differences in the growth rate of costs across hospitals in any of the health systems studied relative to freestanding hospitals. Although we observed quality improvement in some organizational types, these outcome improvements were not coupled with the additional desired objective of lower cost growth. This implies that additional changes not present during our study period, potentially changes in provider payment approaches, are essential for achieving the ACO objectives of higher quality of care at lower costs. Practice Implications Provider organizations implementing ACOs should consider centralizing service delivery as a viable strategy to improve quality of care, although the strategy did not result in lower cost growth.","publication_date":{"day":null,"month":null,"year":2014,"errors":{}},"publication_name":"Health Care Management Review","grobid_abstract_attachment_id":42360150},"translated_abstract":null,"internal_url":"https://www.academia.edu/17008490/Delivery_system_characteristics_and_their_association_with_quality_and_costs_of_care","translated_internal_url":"","created_at":"2015-10-19T13:32:47.243-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":36547483,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":7563929,"work_id":17008490,"tagging_user_id":36547483,"tagged_user_id":36698468,"co_author_invite_id":1690080,"email":"a***v@vcu.edu","display_order":0,"name":"Askar Chukmaitov","title":"Delivery system characteristics and their association with quality and costs of care"},{"id":7563933,"work_id":17008490,"tagging_user_id":36547483,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":4194304,"name":"Gloria Bazzoli","title":"Delivery system characteristics and their association with quality and costs of care"},{"id":7563937,"work_id":17008490,"tagging_user_id":36547483,"tagged_user_id":25092276,"co_author_invite_id":null,"email":"h***a@med.fsu.edu","affiliation":"Florida State University","display_order":6291456,"name":"Henry Carretta","title":"Delivery system characteristics and their association with quality and costs of care"},{"id":7563939,"work_id":17008490,"tagging_user_id":36547483,"tagged_user_id":null,"co_author_invite_id":1690081,"email":"s***u@vcu.edu","display_order":7340032,"name":"Umaporn Siangphoe","title":"Delivery system characteristics and their association with quality and costs of care"}],"downloadable_attachments":[{"id":42360150,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/42360150/thumbnails/1.jpg","file_name":"Delivery_system_characteristics_and_thei20160207-17867-1d9t3bd.pdf","download_url":"https://www.academia.edu/attachments/42360150/download_file","bulk_download_file_name":"Delivery_system_characteristics_and_thei.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/42360150/Delivery_system_characteristics_and_thei20160207-17867-1d9t3bd-libre.pdf?1454912263=\u0026response-content-disposition=attachment%3B+filename%3DDelivery_system_characteristics_and_thei.pdf\u0026Expires=1743441980\u0026Signature=gNn~ouovJUI~Zzz3Jgd5wBSpHAM6t7PxBY0w9vK3T2figKZhHlu9zpfcnZLg3sSR2abdNZ4bjTmH2a1QqIczl1qJGxqWzWKZoiSaRjpVWWcgBtahaZGAfV-QnndTgwvUvXNuD5tq0vS1aZXJ8x6Ip9CJ0qhCAo-8qqahU4jRQYsR0HykUBBL1H~5TxHFn5zIETo97XZKZc-2AllLVlq8dZ3IO6TnxdxWh4NJXnH6wMfXWvEQeJIb1w4GfSjQ62w7jAOTT7u5gNBkU19K3JHcEil~mzv~M8UCfPwjcqsgtHpY3byVzo~JtFrQedkzgKVe0ndnmQq4tTI4q7OGBFrtcw__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Delivery_system_characteristics_and_their_association_with_quality_and_costs_of_care","translated_slug":"","page_count":12,"language":"en","content_type":"Work","summary":"Background Implementation of accountable care organizations (ACOs) is currently underway, but there is limited empirical evidence on the merits of the ACO model. Purpose The aim was to study the associations between delivery system characteristics and ACO competencies, including centralization strategies to manage organizations, hospital integration with physicians and outpatient facilities, health information technology, infrastructure to monitor community health and report quality, and risk-adjusted 30-day all-cause mortality and case-mixed-adjusted inpatient costs for the Medicare population. Methodology Panel data (2006Y2009) were assembled from Florida and multiple sources: inpatient hospital discharge, vital statistics, the American Hospital Association, the Healthcare Information and Management Systems Society, and other databases. We applied a panel study design, controlling for hospital and market characteristics. Principal Findings Hospitals that were in centralized health systems or became more centralized over the study period had significantly larger reductions in mortality compared with hospitals that remained freestanding. Surprisingly, tightly integrated hospitalYphysician arrangements were associated with increased mortality; as such, hospitals may wish to proceed cautiously when developing specific types of alignment with local physician organizations. We observed no statistically significant differences in the growth rate of costs across hospitals in any of the health systems studied relative to freestanding hospitals. Although we observed quality improvement in some organizational types, these outcome improvements were not coupled with the additional desired objective of lower cost growth. This implies that additional changes not present during our study period, potentially changes in provider payment approaches, are essential for achieving the ACO objectives of higher quality of care at lower costs. Practice Implications Provider organizations implementing ACOs should consider centralizing service delivery as a viable strategy to improve quality of care, although the strategy did not result in lower cost growth.","owner":{"id":36547483,"first_name":"David","middle_initials":null,"last_name":"Harless","page_name":"DavidHarless","domain_name":"vcu","created_at":"2015-10-19T13:28:04.248-07:00","display_name":"David Harless","url":"https://vcu.academia.edu/DavidHarless"},"attachments":[{"id":42360150,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/42360150/thumbnails/1.jpg","file_name":"Delivery_system_characteristics_and_thei20160207-17867-1d9t3bd.pdf","download_url":"https://www.academia.edu/attachments/42360150/download_file","bulk_download_file_name":"Delivery_system_characteristics_and_thei.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/42360150/Delivery_system_characteristics_and_thei20160207-17867-1d9t3bd-libre.pdf?1454912263=\u0026response-content-disposition=attachment%3B+filename%3DDelivery_system_characteristics_and_thei.pdf\u0026Expires=1743441980\u0026Signature=gNn~ouovJUI~Zzz3Jgd5wBSpHAM6t7PxBY0w9vK3T2figKZhHlu9zpfcnZLg3sSR2abdNZ4bjTmH2a1QqIczl1qJGxqWzWKZoiSaRjpVWWcgBtahaZGAfV-QnndTgwvUvXNuD5tq0vS1aZXJ8x6Ip9CJ0qhCAo-8qqahU4jRQYsR0HykUBBL1H~5TxHFn5zIETo97XZKZc-2AllLVlq8dZ3IO6TnxdxWh4NJXnH6wMfXWvEQeJIb1w4GfSjQ62w7jAOTT7u5gNBkU19K3JHcEil~mzv~M8UCfPwjcqsgtHpY3byVzo~JtFrQedkzgKVe0ndnmQq4tTI4q7OGBFrtcw__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":8974,"name":"Quality of Mental Health Care","url":"https://www.academia.edu/Documents/in/Quality_of_Mental_Health_Care"},{"id":21559,"name":"Health Care Management","url":"https://www.academia.edu/Documents/in/Health_Care_Management"},{"id":24377,"name":"Mortality","url":"https://www.academia.edu/Documents/in/Mortality"},{"id":73149,"name":"Business and Management","url":"https://www.academia.edu/Documents/in/Business_and_Management"},{"id":96680,"name":"Hospital costs","url":"https://www.academia.edu/Documents/in/Hospital_costs"},{"id":110287,"name":"Florida","url":"https://www.academia.edu/Documents/in/Florida"},{"id":405849,"name":"Accountable Care Organizations","url":"https://www.academia.edu/Documents/in/Accountable_Care_Organizations"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":906536,"name":"Health Care Costs","url":"https://www.academia.edu/Documents/in/Health_Care_Costs"}],"urls":[{"id":6552479,"url":"https://www.researchgate.net/profile/Henry_Carretta/publication/260378205_Delivery_system_characteristics_and_their_association_with_quality_and_costs_of_care_Implications_for_accountable_care_organizations/links/54259c730cf26120b7acc547.pdf"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (true) { Aedu.setUpFigureCarousel('profile-work-17008490-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17008499"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/17008499/Is_Quality_of_Cardiac_Hospital_Care_a_Public_or_Private_Good"><img alt="Research paper thumbnail of Is Quality of Cardiac Hospital Care a Public or Private Good?" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Is Quality of Cardiac Hospital Care a Public or Private Good?</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/DavidHarless">David Harless</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Medical Care</span><span>, 2010</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">There are many studies examining the effects of financial pressure from different payment sources...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">There are many studies examining the effects of financial pressure from different payment sources on hospital quality of care, but most have assumed that quality of care is a public good in that payment changes from one payer will affect all hospital patients rather than just those directly associated with the payer. Although quality of hospital care can be either a public or private good, few studies have tested which of these scenarios are more likely to hold. To examine whether the change in the magnitude of in-hospital mortality for Medicare and managed care patients is different based on financial pressure resulting from the Balanced Budget Act and growing managed care market penetration; and to examine what role hospital competition may play in affecting these changes. The unit of analysis for the study was the hospital. Multiple data sources were used including the Agency for Healthcare Research and Quality State Inpatient Databases, American Hospital Association Annual Surveys, Area Resource File, and health maintenance organization data from InterStudy. A difference-in-difference-in-difference model was applied for a 2-period panel design. In general, Balanced Budget Act financial pressure and managed care market share did not magnify the difference in in-hospital mortality rates between Medicare and managed care patients. The results suggest that quality of cardiac care in the hospital setting is more likely to be a public good; however, more investigation using other quality indicators and the role of hospital competition under different payment systems is recommended.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17008499"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17008499"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17008499; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17008499]").text(description); $(".js-view-count[data-work-id=17008499]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17008499; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17008499']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=17008499]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17008499,"title":"Is Quality of Cardiac Hospital Care a Public or Private Good?","translated_title":"","metadata":{"abstract":"There are many studies examining the effects of financial pressure from different payment sources on hospital quality of care, but most have assumed that quality of care is a public good in that payment changes from one payer will affect all hospital patients rather than just those directly associated with the payer. Although quality of hospital care can be either a public or private good, few studies have tested which of these scenarios are more likely to hold. To examine whether the change in the magnitude of in-hospital mortality for Medicare and managed care patients is different based on financial pressure resulting from the Balanced Budget Act and growing managed care market penetration; and to examine what role hospital competition may play in affecting these changes. The unit of analysis for the study was the hospital. Multiple data sources were used including the Agency for Healthcare Research and Quality State Inpatient Databases, American Hospital Association Annual Surveys, Area Resource File, and health maintenance organization data from InterStudy. A difference-in-difference-in-difference model was applied for a 2-period panel design. In general, Balanced Budget Act financial pressure and managed care market share did not magnify the difference in in-hospital mortality rates between Medicare and managed care patients. The results suggest that quality of cardiac care in the hospital setting is more likely to be a public good; however, more investigation using other quality indicators and the role of hospital competition under different payment systems is recommended.","publication_date":{"day":null,"month":null,"year":2010,"errors":{}},"publication_name":"Medical Care"},"translated_abstract":"There are many studies examining the effects of financial pressure from different payment sources on hospital quality of care, but most have assumed that quality of care is a public good in that payment changes from one payer will affect all hospital patients rather than just those directly associated with the payer. Although quality of hospital care can be either a public or private good, few studies have tested which of these scenarios are more likely to hold. To examine whether the change in the magnitude of in-hospital mortality for Medicare and managed care patients is different based on financial pressure resulting from the Balanced Budget Act and growing managed care market penetration; and to examine what role hospital competition may play in affecting these changes. The unit of analysis for the study was the hospital. Multiple data sources were used including the Agency for Healthcare Research and Quality State Inpatient Databases, American Hospital Association Annual Surveys, Area Resource File, and health maintenance organization data from InterStudy. A difference-in-difference-in-difference model was applied for a 2-period panel design. In general, Balanced Budget Act financial pressure and managed care market share did not magnify the difference in in-hospital mortality rates between Medicare and managed care patients. The results suggest that quality of cardiac care in the hospital setting is more likely to be a public good; however, more investigation using other quality indicators and the role of hospital competition under different payment systems is recommended.","internal_url":"https://www.academia.edu/17008499/Is_Quality_of_Cardiac_Hospital_Care_a_Public_or_Private_Good","translated_internal_url":"","created_at":"2015-10-19T13:32:48.204-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":36547483,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":7563934,"work_id":17008499,"tagging_user_id":36547483,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Is Quality of Cardiac Hospital Care a Public or Private Good?"},{"id":7563953,"work_id":17008499,"tagging_user_id":36547483,"tagged_user_id":null,"co_author_invite_id":1626301,"email":"j***t@vcu.edu","display_order":4194304,"name":"Jan Clement","title":"Is Quality of Cardiac Hospital Care a Public or Private Good?"}],"downloadable_attachments":[],"slug":"Is_Quality_of_Cardiac_Hospital_Care_a_Public_or_Private_Good","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"There are many studies examining the effects of financial pressure from different payment sources on hospital quality of care, but most have assumed that quality of care is a public good in that payment changes from one payer will affect all hospital patients rather than just those directly associated with the payer. Although quality of hospital care can be either a public or private good, few studies have tested which of these scenarios are more likely to hold. To examine whether the change in the magnitude of in-hospital mortality for Medicare and managed care patients is different based on financial pressure resulting from the Balanced Budget Act and growing managed care market penetration; and to examine what role hospital competition may play in affecting these changes. The unit of analysis for the study was the hospital. Multiple data sources were used including the Agency for Healthcare Research and Quality State Inpatient Databases, American Hospital Association Annual Surveys, Area Resource File, and health maintenance organization data from InterStudy. A difference-in-difference-in-difference model was applied for a 2-period panel design. In general, Balanced Budget Act financial pressure and managed care market share did not magnify the difference in in-hospital mortality rates between Medicare and managed care patients. The results suggest that quality of cardiac care in the hospital setting is more likely to be a public good; however, more investigation using other quality indicators and the role of hospital competition under different payment systems is recommended.","owner":{"id":36547483,"first_name":"David","middle_initials":null,"last_name":"Harless","page_name":"DavidHarless","domain_name":"vcu","created_at":"2015-10-19T13:28:04.248-07:00","display_name":"David Harless","url":"https://vcu.academia.edu/DavidHarless"},"attachments":[],"research_interests":[{"id":27659,"name":"Applied Economics","url":"https://www.academia.edu/Documents/in/Applied_Economics"},{"id":96680,"name":"Hospital costs","url":"https://www.academia.edu/Documents/in/Hospital_costs"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":218342,"name":"Medicare","url":"https://www.academia.edu/Documents/in/Medicare"},{"id":219645,"name":"Medical Care","url":"https://www.academia.edu/Documents/in/Medical_Care"},{"id":378016,"name":"Myocardial Infarction","url":"https://www.academia.edu/Documents/in/Myocardial_Infarction"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":849052,"name":"Public Art Hospitals","url":"https://www.academia.edu/Documents/in/Public_Art_Hospitals"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17008499-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15629969"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/15629969/Rejoinder_to_Taxonomy_of_Health_Networks_and_Systems_A_Reassessment"><img alt="Research paper thumbnail of Rejoinder to Taxonomy of Health Networks and Systems: A Reassessment" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Rejoinder to Taxonomy of Health Networks and Systems: A Reassessment</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a></span></div><div class="wp-workCard_item"><span>Health Services Research</span><span>, 2006</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15629969"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15629969"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15629969; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15629969]").text(description); $(".js-view-count[data-work-id=15629969]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15629969; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15629969']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=15629969]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15629969,"title":"Rejoinder to Taxonomy of Health Networks and Systems: A Reassessment","translated_title":"","metadata":{"publication_date":{"day":null,"month":null,"year":2006,"errors":{}},"publication_name":"Health Services Research"},"translated_abstract":null,"internal_url":"https://www.academia.edu/15629969/Rejoinder_to_Taxonomy_of_Health_Networks_and_Systems_A_Reassessment","translated_internal_url":"","created_at":"2015-09-12T10:28:54.778-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762509,"work_id":15629969,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Rejoinder to Taxonomy of Health Networks and Systems: A Reassessment"}],"downloadable_attachments":[],"slug":"Rejoinder_to_Taxonomy_of_Health_Networks_and_Systems_A_Reassessment","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":null,"owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[],"research_interests":[{"id":83471,"name":"Health Services","url":"https://www.academia.edu/Documents/in/Health_Services"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":257181,"name":"Hospital Information Systems","url":"https://www.academia.edu/Documents/in/Hospital_Information_Systems"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":936874,"name":"Bias (Epidemiology)","url":"https://www.academia.edu/Documents/in/Bias_Epidemiology_"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15629969-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15630012"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/15630012/A_SOCIAL_CAPITAL_INDEX_FOR_COMMUNITY_PARTNERSHIPS"><img alt="Research paper thumbnail of A SOCIAL CAPITAL INDEX FOR COMMUNITY PARTNERSHIPS" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">A SOCIAL CAPITAL INDEX FOR COMMUNITY PARTNERSHIPS</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>The International Quarterly of Community Health Education</span><span>, 2001</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15630012"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15630012"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15630012; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15630012]").text(description); $(".js-view-count[data-work-id=15630012]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15630012; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15630012']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=15630012]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15630012,"title":"A SOCIAL CAPITAL INDEX FOR COMMUNITY PARTNERSHIPS","translated_title":"","metadata":{"publication_date":{"day":null,"month":null,"year":2001,"errors":{}},"publication_name":"The International Quarterly of Community Health Education"},"translated_abstract":null,"internal_url":"https://www.academia.edu/15630012/A_SOCIAL_CAPITAL_INDEX_FOR_COMMUNITY_PARTNERSHIPS","translated_internal_url":"","created_at":"2015-09-12T10:28:59.560-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762510,"work_id":15630012,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"A SOCIAL CAPITAL INDEX FOR COMMUNITY PARTNERSHIPS"},{"id":5762670,"work_id":15630012,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274837,"email":"r***n@aha.org","display_order":4194304,"name":"Romana Hasnain-wynia","title":"A SOCIAL CAPITAL INDEX FOR COMMUNITY PARTNERSHIPS"}],"downloadable_attachments":[],"slug":"A_SOCIAL_CAPITAL_INDEX_FOR_COMMUNITY_PARTNERSHIPS","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":null,"owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[],"research_interests":[{"id":5745,"name":"Social Capital","url":"https://www.academia.edu/Documents/in/Social_Capital"},{"id":749302,"name":"Indexation","url":"https://www.academia.edu/Documents/in/Indexation"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15630012-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15629966"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/15629966/Reexamining_Organizational_Configurations_An_Update_Validation_and_Expansion_of_the_Taxonomy_of_Health_Networks_and_Systems"><img alt="Research paper thumbnail of Reexamining Organizational Configurations: An Update, Validation, and Expansion of the Taxonomy of Health Networks and Systems" class="work-thumbnail" src="https://attachments.academia-assets.com/43016398/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/15629966/Reexamining_Organizational_Configurations_An_Update_Validation_and_Expansion_of_the_Taxonomy_of_Health_Networks_and_Systems">Reexamining Organizational Configurations: An Update, Validation, and Expansion of the Taxonomy of Health Networks and Systems</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a></span></div><div class="wp-workCard_item"><span>Health Services Research</span><span>, 2004</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Objectives. To (a) assess how the original cluster categories of hospital-led health networks and...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Objectives. To (a) assess how the original cluster categories of hospital-led health networks and systems have changed over time; (b) identify any new patterns of cluster configurations; and (c) demonstrate how additional data can be used to refine and enhance the taxonomy measures. Data Sources. 1994 and 1998 American Hospital Association (AHA) Annual Survey of Hospitals. Study Design. As in the original taxonomy, separate cluster solutions are identified for health networks and health systems by applying three strategic/structural dimensions (differentiation, integration, and centralization) to three components of the health service/product continuum (hospital services, physician arrangements, and providerbased insurance activities). Data Extraction Methods. Factor, cluster, and discriminant analyses are used to analyze the 1998 data. Descriptive and comparative methods are used to analyze the updated 1998 taxonomy relative to the original 1994 version. Principal Findings. The 1998 cluster categories are similar to the original taxonomy, however, they reveal some new organizational configurations. For the health networks, centralization of product/service lines is occurring more selectively than in the past. For the health systems, participation has grown in and dispersed across a more diverse set of decentralized organizational forms. For both networks and systems, the definition of centralization has changed over time.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="f75576ac1d8ac83eba402c3f6a14abd9" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":43016398,"asset_id":15629966,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/43016398/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15629966"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15629966"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15629966; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15629966]").text(description); $(".js-view-count[data-work-id=15629966]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15629966; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15629966']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "f75576ac1d8ac83eba402c3f6a14abd9" } } $('.js-work-strip[data-work-id=15629966]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15629966,"title":"Reexamining Organizational Configurations: An Update, Validation, and Expansion of the Taxonomy of Health Networks and Systems","translated_title":"","metadata":{"grobid_abstract":"Objectives. To (a) assess how the original cluster categories of hospital-led health networks and systems have changed over time; (b) identify any new patterns of cluster configurations; and (c) demonstrate how additional data can be used to refine and enhance the taxonomy measures. Data Sources. 1994 and 1998 American Hospital Association (AHA) Annual Survey of Hospitals. Study Design. As in the original taxonomy, separate cluster solutions are identified for health networks and health systems by applying three strategic/structural dimensions (differentiation, integration, and centralization) to three components of the health service/product continuum (hospital services, physician arrangements, and providerbased insurance activities). Data Extraction Methods. Factor, cluster, and discriminant analyses are used to analyze the 1998 data. Descriptive and comparative methods are used to analyze the updated 1998 taxonomy relative to the original 1994 version. Principal Findings. The 1998 cluster categories are similar to the original taxonomy, however, they reveal some new organizational configurations. For the health networks, centralization of product/service lines is occurring more selectively than in the past. For the health systems, participation has grown in and dispersed across a more diverse set of decentralized organizational forms. For both networks and systems, the definition of centralization has changed over time.","publication_date":{"day":null,"month":null,"year":2004,"errors":{}},"publication_name":"Health Services Research","grobid_abstract_attachment_id":43016398},"translated_abstract":null,"internal_url":"https://www.academia.edu/15629966/Reexamining_Organizational_Configurations_An_Update_Validation_and_Expansion_of_the_Taxonomy_of_Health_Networks_and_Systems","translated_internal_url":"","created_at":"2015-09-12T10:28:54.532-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762508,"work_id":15629966,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Reexamining Organizational Configurations: An Update, Validation, and Expansion of the Taxonomy of Health Networks and Systems"}],"downloadable_attachments":[{"id":43016398,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/43016398/thumbnails/1.jpg","file_name":"Reexamining_Organizational_Configuration20160224-15736-5ids5v.pdf","download_url":"https://www.academia.edu/attachments/43016398/download_file","bulk_download_file_name":"Reexamining_Organizational_Configuration.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/43016398/Reexamining_Organizational_Configuration20160224-15736-5ids5v-libre.pdf?1456335625=\u0026response-content-disposition=attachment%3B+filename%3DReexamining_Organizational_Configuration.pdf\u0026Expires=1743441980\u0026Signature=CXzsfaLlyRCxzMi2HIaV3tfEdIUXyrMidlThVTvqbVe6XeUhx5qkelk4SjDqXW3wzp31gSbhsD2F0acyWNKZShONU5GEgp0-eCVw3qgXSbxg0wT0rE44GwqFsiCXDdwaBS2ltB5tdb5shrSQs3Z2lEUpHKe5vt6tCACKzSi1sVQZFa~KhS4shaAQIzS1e4syaEkYQ7V~kjpShTEL0o7ItfcQk3LM9UWA8x3Kof7zlrabanmnPQ8ldB78EViefeD2sdtlTyqUX2b8sM59RmZqXfA0InLNSW-HZ0Nf1ZNZVIAyQ-UB0Y7Jdtbai616jo63LbXlkBNEo6Notb6oxBGPrg__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Reexamining_Organizational_Configurations_An_Update_Validation_and_Expansion_of_the_Taxonomy_of_Health_Networks_and_Systems","translated_slug":"","page_count":14,"language":"en","content_type":"Work","summary":"Objectives. To (a) assess how the original cluster categories of hospital-led health networks and systems have changed over time; (b) identify any new patterns of cluster configurations; and (c) demonstrate how additional data can be used to refine and enhance the taxonomy measures. Data Sources. 1994 and 1998 American Hospital Association (AHA) Annual Survey of Hospitals. Study Design. As in the original taxonomy, separate cluster solutions are identified for health networks and health systems by applying three strategic/structural dimensions (differentiation, integration, and centralization) to three components of the health service/product continuum (hospital services, physician arrangements, and providerbased insurance activities). Data Extraction Methods. Factor, cluster, and discriminant analyses are used to analyze the 1998 data. Descriptive and comparative methods are used to analyze the updated 1998 taxonomy relative to the original 1994 version. Principal Findings. The 1998 cluster categories are similar to the original taxonomy, however, they reveal some new organizational configurations. For the health networks, centralization of product/service lines is occurring more selectively than in the past. For the health systems, participation has grown in and dispersed across a more diverse set of decentralized organizational forms. For both networks and systems, the definition of centralization has changed over time.","owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[{"id":43016398,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/43016398/thumbnails/1.jpg","file_name":"Reexamining_Organizational_Configuration20160224-15736-5ids5v.pdf","download_url":"https://www.academia.edu/attachments/43016398/download_file","bulk_download_file_name":"Reexamining_Organizational_Configuration.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/43016398/Reexamining_Organizational_Configuration20160224-15736-5ids5v-libre.pdf?1456335625=\u0026response-content-disposition=attachment%3B+filename%3DReexamining_Organizational_Configuration.pdf\u0026Expires=1743441980\u0026Signature=CXzsfaLlyRCxzMi2HIaV3tfEdIUXyrMidlThVTvqbVe6XeUhx5qkelk4SjDqXW3wzp31gSbhsD2F0acyWNKZShONU5GEgp0-eCVw3qgXSbxg0wT0rE44GwqFsiCXDdwaBS2ltB5tdb5shrSQs3Z2lEUpHKe5vt6tCACKzSi1sVQZFa~KhS4shaAQIzS1e4syaEkYQ7V~kjpShTEL0o7ItfcQk3LM9UWA8x3Kof7zlrabanmnPQ8ldB78EViefeD2sdtlTyqUX2b8sM59RmZqXfA0InLNSW-HZ0Nf1ZNZVIAyQ-UB0Y7Jdtbai616jo63LbXlkBNEo6Notb6oxBGPrg__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":7076,"name":"Taxonomy","url":"https://www.academia.edu/Documents/in/Taxonomy"},{"id":16635,"name":"Health Services Research","url":"https://www.academia.edu/Documents/in/Health_Services_Research"},{"id":83471,"name":"Health Services","url":"https://www.academia.edu/Documents/in/Health_Services"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":131237,"name":"Cluster Analysis","url":"https://www.academia.edu/Documents/in/Cluster_Analysis"},{"id":231637,"name":"Organizational Policy","url":"https://www.academia.edu/Documents/in/Organizational_Policy"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":496530,"name":"Community Networks","url":"https://www.academia.edu/Documents/in/Community_Networks"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15629966-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15629975"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/15629975/Evaluating_Partnerships_for_Community_Health_Improvement_Tracking_the_Footprints"><img alt="Research paper thumbnail of Evaluating Partnerships for Community Health Improvement: Tracking the Footprints" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Evaluating Partnerships for Community Health Improvement: Tracking the Footprints</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/DouglasConrad">Douglas Conrad</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/ShoshannaSofaer">Shoshanna Sofaer</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/AnnZukoski">Ann Zukoski</a></span></div><div class="wp-workCard_item"><span>Journal of Health Politics, Policy and Law</span><span>, 2002</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Private-public partnerships are increasingly seen as an important mechanism for improving communi...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Private-public partnerships are increasingly seen as an important mechanism for improving community health. Despite their popularity, traditional evaluations of these efforts have produced negative or mixed results. This is often attributed to weak interventions or an insufficient period of time to observe an impact. This study examines two additional possibilities--the need for a well-articulated shared vision and the governance and management capabilities of the partnership itself. We conducted a midstream process evaluation of twenty-five community partnerships associated with the Community Care Network (CCN) Demonstration Program. We examined how the roles of a common shared vision, strong governance, and effective management influence a partnership&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s ability to achieve its objectives. The findings, based on both qualitative and quantitative analyses, underscore the importance of membership organizations&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceived benefits and costs of participation and management capabilities to the partnership&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s progress toward a vision. Based on the qualitative data, six key governance and management characteristics are identified that separate the top performing partnerships from the lowest performing ones. We explore the implications of this research for future evaluations of public-private community health partnerships.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15629975"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15629975"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15629975; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15629975]").text(description); $(".js-view-count[data-work-id=15629975]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15629975; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15629975']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=15629975]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15629975,"title":"Evaluating Partnerships for Community Health Improvement: Tracking the Footprints","translated_title":"","metadata":{"abstract":"Private-public partnerships are increasingly seen as an important mechanism for improving community health. Despite their popularity, traditional evaluations of these efforts have produced negative or mixed results. This is often attributed to weak interventions or an insufficient period of time to observe an impact. This study examines two additional possibilities--the need for a well-articulated shared vision and the governance and management capabilities of the partnership itself. We conducted a midstream process evaluation of twenty-five community partnerships associated with the Community Care Network (CCN) Demonstration Program. We examined how the roles of a common shared vision, strong governance, and effective management influence a partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s ability to achieve its objectives. The findings, based on both qualitative and quantitative analyses, underscore the importance of membership organizations\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceived benefits and costs of participation and management capabilities to the partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s progress toward a vision. Based on the qualitative data, six key governance and management characteristics are identified that separate the top performing partnerships from the lowest performing ones. We explore the implications of this research for future evaluations of public-private community health partnerships.","publication_date":{"day":null,"month":null,"year":2002,"errors":{}},"publication_name":"Journal of Health Politics, Policy and Law"},"translated_abstract":"Private-public partnerships are increasingly seen as an important mechanism for improving community health. Despite their popularity, traditional evaluations of these efforts have produced negative or mixed results. This is often attributed to weak interventions or an insufficient period of time to observe an impact. This study examines two additional possibilities--the need for a well-articulated shared vision and the governance and management capabilities of the partnership itself. We conducted a midstream process evaluation of twenty-five community partnerships associated with the Community Care Network (CCN) Demonstration Program. We examined how the roles of a common shared vision, strong governance, and effective management influence a partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s ability to achieve its objectives. The findings, based on both qualitative and quantitative analyses, underscore the importance of membership organizations\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceived benefits and costs of participation and management capabilities to the partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s progress toward a vision. Based on the qualitative data, six key governance and management characteristics are identified that separate the top performing partnerships from the lowest performing ones. We explore the implications of this research for future evaluations of public-private community health partnerships.","internal_url":"https://www.academia.edu/15629975/Evaluating_Partnerships_for_Community_Health_Improvement_Tracking_the_Footprints","translated_internal_url":"","created_at":"2015-09-12T10:28:55.494-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762507,"work_id":15629975,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Evaluating Partnerships for Community Health Improvement: Tracking the Footprints"},{"id":5762529,"work_id":15629975,"tagging_user_id":34807327,"tagged_user_id":35004148,"co_author_invite_id":1274799,"email":"d***d@u.washington.edu","display_order":4194304,"name":"Douglas Conrad","title":"Evaluating Partnerships for Community Health Improvement: Tracking the Footprints"},{"id":5762543,"work_id":15629975,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274801,"email":"a***j@email.gwu.edu","display_order":6291456,"name":"Jeffrey Alexander","title":"Evaluating Partnerships for Community Health Improvement: Tracking the Footprints"},{"id":5762552,"work_id":15629975,"tagging_user_id":34807327,"tagged_user_id":34868761,"co_author_invite_id":1274802,"email":"s***r@baruch.cuny.edu","display_order":7340032,"name":"Shoshanna Sofaer","title":"Evaluating Partnerships for Community Health Improvement: Tracking the Footprints"},{"id":5762556,"work_id":15629975,"tagging_user_id":34807327,"tagged_user_id":37738388,"co_author_invite_id":1274803,"email":"a***i@rainbowresearch.org","display_order":7864320,"name":"Ann Zukoski","title":"Evaluating Partnerships for Community Health Improvement: Tracking the Footprints"},{"id":5762669,"work_id":15629975,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274837,"email":"r***n@aha.org","display_order":8126464,"name":"Romana Hasnain-wynia","title":"Evaluating Partnerships for Community Health Improvement: Tracking the Footprints"}],"downloadable_attachments":[],"slug":"Evaluating_Partnerships_for_Community_Health_Improvement_Tracking_the_Footprints","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Private-public partnerships are increasingly seen as an important mechanism for improving community health. Despite their popularity, traditional evaluations of these efforts have produced negative or mixed results. This is often attributed to weak interventions or an insufficient period of time to observe an impact. This study examines two additional possibilities--the need for a well-articulated shared vision and the governance and management capabilities of the partnership itself. We conducted a midstream process evaluation of twenty-five community partnerships associated with the Community Care Network (CCN) Demonstration Program. We examined how the roles of a common shared vision, strong governance, and effective management influence a partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s ability to achieve its objectives. The findings, based on both qualitative and quantitative analyses, underscore the importance of membership organizations\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceived benefits and costs of participation and management capabilities to the partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s progress toward a vision. Based on the qualitative data, six key governance and management characteristics are identified that separate the top performing partnerships from the lowest performing ones. We explore the implications of this research for future evaluations of public-private community health partnerships.","owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[],"research_interests":[{"id":202,"name":"Program Evaluation","url":"https://www.academia.edu/Documents/in/Program_Evaluation"},{"id":534,"name":"Law","url":"https://www.academia.edu/Documents/in/Law"},{"id":981,"name":"Health Promotion","url":"https://www.academia.edu/Documents/in/Health_Promotion"},{"id":2969,"name":"Leadership","url":"https://www.academia.edu/Documents/in/Leadership"},{"id":11435,"name":"Community Health","url":"https://www.academia.edu/Documents/in/Community_Health"},{"id":14406,"name":"Health","url":"https://www.academia.edu/Documents/in/Health"},{"id":16457,"name":"Public sector","url":"https://www.academia.edu/Documents/in/Public_sector"},{"id":40023,"name":"Social Responsibility","url":"https://www.academia.edu/Documents/in/Social_Responsibility"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":232534,"name":"Health Status","url":"https://www.academia.edu/Documents/in/Health_Status"},{"id":380315,"name":"Public Administration and Policy","url":"https://www.academia.edu/Documents/in/Public_Administration_and_Policy"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":466484,"name":"Private Sector","url":"https://www.academia.edu/Documents/in/Private_Sector"},{"id":496530,"name":"Community Networks","url":"https://www.academia.edu/Documents/in/Community_Networks"},{"id":945595,"name":"Pilot Projects","url":"https://www.academia.edu/Documents/in/Pilot_Projects"},{"id":1034177,"name":"Continuity of Patient Care","url":"https://www.academia.edu/Documents/in/Continuity_of_Patient_Care"},{"id":1141653,"name":"Community Health Planning","url":"https://www.academia.edu/Documents/in/Community_Health_Planning"},{"id":1153482,"name":"Cooperative Behavior","url":"https://www.academia.edu/Documents/in/Cooperative_Behavior"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15629975-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15629988"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/15629988/Collaborative_Initiatives_Where_the_Rubber_Meets_the_Road_in_Community_Partnerships"><img alt="Research paper thumbnail of Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/DouglasConrad">Douglas Conrad</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/ShoshannaSofaer">Shoshanna Sofaer</a></span></div><div class="wp-workCard_item"><span>Medical Care Research and Review</span><span>, 2003</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Amajor challenge facing a community partnership is the implementation of its collaborative initia...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Amajor challenge facing a community partnership is the implementation of its collaborative initiatives. This article examines the progress Community Care Networks (CCNs) made in implementing their initiatives and factors that helped or hindered their progress. Study findings suggest that partnership progress is affected by external market and regulatory factors beyond the control of the partnership, the availability of local community resources to support efforts, the scope and intensity of tasks associated with an initiative, expansion of the partnership to include new members, and the balance of work between partners and paid partnership staff. Implications of study findings for community partnerships include (1) recognizing and anticipating dependency on others, (2) acknowledging that the tasks that lie ahead will be more complicated than imagined, (3) maintaining focus on priorities, and (4) learning to be adaptive and creative, given a constantly changing environment.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15629988"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15629988"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15629988; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15629988]").text(description); $(".js-view-count[data-work-id=15629988]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15629988; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15629988']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=15629988]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15629988,"title":"Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships","translated_title":"","metadata":{"abstract":"Amajor challenge facing a community partnership is the implementation of its collaborative initiatives. This article examines the progress Community Care Networks (CCNs) made in implementing their initiatives and factors that helped or hindered their progress. Study findings suggest that partnership progress is affected by external market and regulatory factors beyond the control of the partnership, the availability of local community resources to support efforts, the scope and intensity of tasks associated with an initiative, expansion of the partnership to include new members, and the balance of work between partners and paid partnership staff. Implications of study findings for community partnerships include (1) recognizing and anticipating dependency on others, (2) acknowledging that the tasks that lie ahead will be more complicated than imagined, (3) maintaining focus on priorities, and (4) learning to be adaptive and creative, given a constantly changing environment.","publication_date":{"day":null,"month":null,"year":2003,"errors":{}},"publication_name":"Medical Care Research and Review"},"translated_abstract":"Amajor challenge facing a community partnership is the implementation of its collaborative initiatives. This article examines the progress Community Care Networks (CCNs) made in implementing their initiatives and factors that helped or hindered their progress. Study findings suggest that partnership progress is affected by external market and regulatory factors beyond the control of the partnership, the availability of local community resources to support efforts, the scope and intensity of tasks associated with an initiative, expansion of the partnership to include new members, and the balance of work between partners and paid partnership staff. Implications of study findings for community partnerships include (1) recognizing and anticipating dependency on others, (2) acknowledging that the tasks that lie ahead will be more complicated than imagined, (3) maintaining focus on priorities, and (4) learning to be adaptive and creative, given a constantly changing environment.","internal_url":"https://www.academia.edu/15629988/Collaborative_Initiatives_Where_the_Rubber_Meets_the_Road_in_Community_Partnerships","translated_internal_url":"","created_at":"2015-09-12T10:28:57.267-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762506,"work_id":15629988,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships"},{"id":5762528,"work_id":15629988,"tagging_user_id":34807327,"tagged_user_id":35004148,"co_author_invite_id":1274799,"email":"d***d@u.washington.edu","display_order":4194304,"name":"Douglas Conrad","title":"Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships"},{"id":5762539,"work_id":15629988,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274801,"email":"a***j@email.gwu.edu","display_order":6291456,"name":"Jeffrey Alexander","title":"Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships"},{"id":5762551,"work_id":15629988,"tagging_user_id":34807327,"tagged_user_id":34868761,"co_author_invite_id":1274802,"email":"s***r@baruch.cuny.edu","display_order":7340032,"name":"Shoshanna Sofaer","title":"Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships"},{"id":5762555,"work_id":15629988,"tagging_user_id":34807327,"tagged_user_id":37738388,"co_author_invite_id":1274803,"email":"a***i@rainbowresearch.org","display_order":7864320,"name":"Ann Zukoski","title":"Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships"},{"id":5762668,"work_id":15629988,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274837,"email":"r***n@aha.org","display_order":8126464,"name":"Romana Hasnain-wynia","title":"Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships"}],"downloadable_attachments":[],"slug":"Collaborative_Initiatives_Where_the_Rubber_Meets_the_Road_in_Community_Partnerships","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Amajor challenge facing a community partnership is the implementation of its collaborative initiatives. This article examines the progress Community Care Networks (CCNs) made in implementing their initiatives and factors that helped or hindered their progress. Study findings suggest that partnership progress is affected by external market and regulatory factors beyond the control of the partnership, the availability of local community resources to support efforts, the scope and intensity of tasks associated with an initiative, expansion of the partnership to include new members, and the balance of work between partners and paid partnership staff. Implications of study findings for community partnerships include (1) recognizing and anticipating dependency on others, (2) acknowledging that the tasks that lie ahead will be more complicated than imagined, (3) maintaining focus on priorities, and (4) learning to be adaptive and creative, given a constantly changing environment.","owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[],"research_interests":[{"id":202,"name":"Program Evaluation","url":"https://www.academia.edu/Documents/in/Program_Evaluation"},{"id":3138,"name":"Community-Based Mental Health Services","url":"https://www.academia.edu/Documents/in/Community-Based_Mental_Health_Services"},{"id":73149,"name":"Business and Management","url":"https://www.academia.edu/Documents/in/Business_and_Management"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":123411,"name":"Care","url":"https://www.academia.edu/Documents/in/Care"},{"id":219645,"name":"Medical Care","url":"https://www.academia.edu/Documents/in/Medical_Care"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":496530,"name":"Community Networks","url":"https://www.academia.edu/Documents/in/Community_Networks"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15629988-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15629986"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/15629986/Members_Perceptions_of_Community_Care_Network_Partnerships_Effectiveness"><img alt="Research paper thumbnail of Members’ Perceptions of Community Care Network Partnerships’ Effectiveness" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Members’ Perceptions of Community Care Network Partnerships’ Effectiveness</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/DouglasConrad">Douglas Conrad</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/ShoshannaSofaer">Shoshanna Sofaer</a></span></div><div class="wp-workCard_item"><span>Medical Care Research and Review</span><span>, 2003</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Investment in voluntary partnerships raises important questions: Should we invest in collaboratio...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Investment in voluntary partnerships raises important questions: Should we invest in collaboration in moving toward the goals of health system redesign? What makes collaborative groups effective? Given the voluntary nature of these partnerships, membership perceptions of their experiences and the partnership&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s effectiveness should be important predictors of success. This article provides a preliminary analyses of perceived effectiveness of participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions of their own partnership, particularly focusing on leadership, conflict management, decision-making dynamics, and the breadth and depth of partnership membership. Members&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions that the partnership membership was &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;sufficiently broad to accomplish objectives&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; had a negative and highly significant relationship to perceived effectiveness. Members&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions about leadership being ethical was positively related to perceived effectiveness while perceptions that the leadership was not effective a keeping the group focused was negatively related to perceived effectiveness.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15629986"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15629986"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15629986; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15629986]").text(description); $(".js-view-count[data-work-id=15629986]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15629986; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15629986']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=15629986]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15629986,"title":"Members’ Perceptions of Community Care Network Partnerships’ Effectiveness","translated_title":"","metadata":{"abstract":"Investment in voluntary partnerships raises important questions: Should we invest in collaboration in moving toward the goals of health system redesign? What makes collaborative groups effective? Given the voluntary nature of these partnerships, membership perceptions of their experiences and the partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s effectiveness should be important predictors of success. This article provides a preliminary analyses of perceived effectiveness of participants\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions of their own partnership, particularly focusing on leadership, conflict management, decision-making dynamics, and the breadth and depth of partnership membership. Members\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions that the partnership membership was \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;sufficiently broad to accomplish objectives\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; had a negative and highly significant relationship to perceived effectiveness. Members\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions about leadership being ethical was positively related to perceived effectiveness while perceptions that the leadership was not effective a keeping the group focused was negatively related to perceived effectiveness.","publication_date":{"day":null,"month":null,"year":2003,"errors":{}},"publication_name":"Medical Care Research and Review"},"translated_abstract":"Investment in voluntary partnerships raises important questions: Should we invest in collaboration in moving toward the goals of health system redesign? What makes collaborative groups effective? Given the voluntary nature of these partnerships, membership perceptions of their experiences and the partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s effectiveness should be important predictors of success. This article provides a preliminary analyses of perceived effectiveness of participants\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions of their own partnership, particularly focusing on leadership, conflict management, decision-making dynamics, and the breadth and depth of partnership membership. Members\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions that the partnership membership was \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;sufficiently broad to accomplish objectives\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; had a negative and highly significant relationship to perceived effectiveness. Members\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions about leadership being ethical was positively related to perceived effectiveness while perceptions that the leadership was not effective a keeping the group focused was negatively related to perceived effectiveness.","internal_url":"https://www.academia.edu/15629986/Members_Perceptions_of_Community_Care_Network_Partnerships_Effectiveness","translated_internal_url":"","created_at":"2015-09-12T10:28:57.083-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762504,"work_id":15629986,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Members’ Perceptions of Community Care Network Partnerships’ Effectiveness"},{"id":5762526,"work_id":15629986,"tagging_user_id":34807327,"tagged_user_id":35004148,"co_author_invite_id":1274799,"email":"d***d@u.washington.edu","display_order":4194304,"name":"Douglas Conrad","title":"Members’ Perceptions of Community Care Network Partnerships’ Effectiveness"},{"id":5762537,"work_id":15629986,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274801,"email":"a***j@email.gwu.edu","display_order":6291456,"name":"Jeffrey Alexander","title":"Members’ Perceptions of Community Care Network Partnerships’ Effectiveness"},{"id":5762549,"work_id":15629986,"tagging_user_id":34807327,"tagged_user_id":34868761,"co_author_invite_id":1274802,"email":"s***r@baruch.cuny.edu","display_order":7340032,"name":"Shoshanna Sofaer","title":"Members’ Perceptions of Community Care Network Partnerships’ Effectiveness"},{"id":5762554,"work_id":15629986,"tagging_user_id":34807327,"tagged_user_id":37738388,"co_author_invite_id":1274803,"email":"a***i@rainbowresearch.org","display_order":7864320,"name":"Ann Zukoski","title":"Members’ Perceptions of Community Care Network Partnerships’ Effectiveness"},{"id":5762666,"work_id":15629986,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274837,"email":"r***n@aha.org","display_order":8126464,"name":"Romana Hasnain-wynia","title":"Members’ Perceptions of Community Care Network Partnerships’ Effectiveness"}],"downloadable_attachments":[],"slug":"Members_Perceptions_of_Community_Care_Network_Partnerships_Effectiveness","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Investment in voluntary partnerships raises important questions: Should we invest in collaboration in moving toward the goals of health system redesign? What makes collaborative groups effective? Given the voluntary nature of these partnerships, membership perceptions of their experiences and the partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s effectiveness should be important predictors of success. This article provides a preliminary analyses of perceived effectiveness of participants\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions of their own partnership, particularly focusing on leadership, conflict management, decision-making dynamics, and the breadth and depth of partnership membership. Members\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions that the partnership membership was \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;sufficiently broad to accomplish objectives\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; had a negative and highly significant relationship to perceived effectiveness. Members\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions about leadership being ethical was positively related to perceived effectiveness while perceptions that the leadership was not effective a keeping the group focused was negatively related to perceived effectiveness.","owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[],"research_interests":[{"id":202,"name":"Program Evaluation","url":"https://www.academia.edu/Documents/in/Program_Evaluation"},{"id":73149,"name":"Business and Management","url":"https://www.academia.edu/Documents/in/Business_and_Management"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":219645,"name":"Medical Care","url":"https://www.academia.edu/Documents/in/Medical_Care"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":496530,"name":"Community Networks","url":"https://www.academia.edu/Documents/in/Community_Networks"},{"id":784971,"name":"Community Care","url":"https://www.academia.edu/Documents/in/Community_Care"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15629986-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15629991"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/15629991/Sustainability_of_Collaborative_Capacity_in_Community_Health_Partnerships"><img alt="Research paper thumbnail of Sustainability of Collaborative Capacity in Community Health Partnerships" class="work-thumbnail" src="https://attachments.academia-assets.com/43016383/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/15629991/Sustainability_of_Collaborative_Capacity_in_Community_Health_Partnerships">Sustainability of Collaborative Capacity in Community Health Partnerships</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/DouglasConrad">Douglas Conrad</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/ShoshannaSofaer">Shoshanna Sofaer</a></span></div><div class="wp-workCard_item"><span>Medical Care Research and Review</span><span>, 2003</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Sustainability is a key requirement for partnership success and a major challenge for such organi...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Sustainability is a key requirement for partnership success and a major challenge for such organizations. Despite the critical importance of sustainability to the success of community health partnerships and the many threats to sustainability, there is little evidence that would provide partnerships with clear guidance on long-term viability. This article attempts to (1) develop a conceptual model of sustainability in community health partnerships and (2) identify potential determinants of sustainability using comparative qualitative data from four partnerships from the Community Care Network (CCN) Demonstration Program. Based on a grounded theory examination of qualitative data from 130S the CCN evaluation, the authors hypothesize that there are five primary attributes/activities of partnerships leading to consequential value and eventually to sustainability of collaborative capacity. They include outcomes-based advocacy, vision-focus balance, systems orientation, infrastructure development, and community linkages. The context in which the partnership operates provides the conditions for determining the appropriateness and relative impact of each of the factors related to creating consequential value in the partnership.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="a56bb3bdcef072bf0f8fe9ff5eb1e45c" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":43016383,"asset_id":15629991,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/43016383/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15629991"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15629991"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15629991; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15629991]").text(description); $(".js-view-count[data-work-id=15629991]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15629991; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15629991']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "a56bb3bdcef072bf0f8fe9ff5eb1e45c" } } $('.js-work-strip[data-work-id=15629991]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15629991,"title":"Sustainability of Collaborative Capacity in Community Health Partnerships","translated_title":"","metadata":{"grobid_abstract":"Sustainability is a key requirement for partnership success and a major challenge for such organizations. Despite the critical importance of sustainability to the success of community health partnerships and the many threats to sustainability, there is little evidence that would provide partnerships with clear guidance on long-term viability. This article attempts to (1) develop a conceptual model of sustainability in community health partnerships and (2) identify potential determinants of sustainability using comparative qualitative data from four partnerships from the Community Care Network (CCN) Demonstration Program. Based on a grounded theory examination of qualitative data from 130S the CCN evaluation, the authors hypothesize that there are five primary attributes/activities of partnerships leading to consequential value and eventually to sustainability of collaborative capacity. They include outcomes-based advocacy, vision-focus balance, systems orientation, infrastructure development, and community linkages. The context in which the partnership operates provides the conditions for determining the appropriateness and relative impact of each of the factors related to creating consequential value in the partnership.","publication_date":{"day":null,"month":null,"year":2003,"errors":{}},"publication_name":"Medical Care Research and Review","grobid_abstract_attachment_id":43016383},"translated_abstract":null,"internal_url":"https://www.academia.edu/15629991/Sustainability_of_Collaborative_Capacity_in_Community_Health_Partnerships","translated_internal_url":"","created_at":"2015-09-12T10:28:57.532-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762505,"work_id":15629991,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Sustainability of Collaborative Capacity in Community Health Partnerships"},{"id":5762527,"work_id":15629991,"tagging_user_id":34807327,"tagged_user_id":35004148,"co_author_invite_id":1274799,"email":"d***d@u.washington.edu","display_order":4194304,"name":"Douglas Conrad","title":"Sustainability of Collaborative Capacity in Community Health Partnerships"},{"id":5762538,"work_id":15629991,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274801,"email":"a***j@email.gwu.edu","display_order":6291456,"name":"Jeffrey Alexander","title":"Sustainability of Collaborative Capacity in Community Health Partnerships"},{"id":5762550,"work_id":15629991,"tagging_user_id":34807327,"tagged_user_id":34868761,"co_author_invite_id":1274802,"email":"s***r@baruch.cuny.edu","display_order":7340032,"name":"Shoshanna Sofaer","title":"Sustainability of Collaborative Capacity in Community Health Partnerships"},{"id":5762559,"work_id":15629991,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274805,"email":"w***r@email.unc.edu","display_order":7864320,"name":"Bryan Weiner","title":"Sustainability of Collaborative Capacity in Community Health Partnerships"},{"id":5762667,"work_id":15629991,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274837,"email":"r***n@aha.org","display_order":8126464,"name":"Romana Hasnain-wynia","title":"Sustainability of Collaborative Capacity in Community Health Partnerships"}],"downloadable_attachments":[{"id":43016383,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/43016383/thumbnails/1.jpg","file_name":"Sustainability_of_collaborative_capacity20160224-16595-168d0fe.pdf","download_url":"https://www.academia.edu/attachments/43016383/download_file","bulk_download_file_name":"Sustainability_of_Collaborative_Capacity.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/43016383/Sustainability_of_collaborative_capacity20160224-16595-168d0fe-libre.pdf?1456335629=\u0026response-content-disposition=attachment%3B+filename%3DSustainability_of_Collaborative_Capacity.pdf\u0026Expires=1743441980\u0026Signature=UY-A2j-k6XB7tULkYterdbX9ea-dFQnV4iItKDXc9wPzi14tR6hZVS1RZ3z1sIJ4oDXFHAVvfhp9eDUCXH1E0oT~CB7EfWJHAcYor2PvIHTT5P5W~BdHn~TNXLfHZB9jLMWuYq17pM0KKDROSrwAuBIecUIIrJtbOzgjwyKJIWR0FxfNRZ1zIDZWU1Q0f2u9pjalaSYLOcCYpawEwIr1LDncmQrZy0z93kqaBnRjp701iQ-1od3bZBP7QOw38uwx1jdL55w1Ioyl1gTCq24r3QcbsdPgXkKL-qG88UxjwC-fXclkWzOjgoqtNBSbhacB0qCyWs0EVOT6bqzOazJg1g__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Sustainability_of_Collaborative_Capacity_in_Community_Health_Partnerships","translated_slug":"","page_count":31,"language":"en","content_type":"Work","summary":"Sustainability is a key requirement for partnership success and a major challenge for such organizations. Despite the critical importance of sustainability to the success of community health partnerships and the many threats to sustainability, there is little evidence that would provide partnerships with clear guidance on long-term viability. This article attempts to (1) develop a conceptual model of sustainability in community health partnerships and (2) identify potential determinants of sustainability using comparative qualitative data from four partnerships from the Community Care Network (CCN) Demonstration Program. Based on a grounded theory examination of qualitative data from 130S the CCN evaluation, the authors hypothesize that there are five primary attributes/activities of partnerships leading to consequential value and eventually to sustainability of collaborative capacity. They include outcomes-based advocacy, vision-focus balance, systems orientation, infrastructure development, and community linkages. The context in which the partnership operates provides the conditions for determining the appropriateness and relative impact of each of the factors related to creating consequential value in the partnership.","owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[{"id":43016383,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/43016383/thumbnails/1.jpg","file_name":"Sustainability_of_collaborative_capacity20160224-16595-168d0fe.pdf","download_url":"https://www.academia.edu/attachments/43016383/download_file","bulk_download_file_name":"Sustainability_of_Collaborative_Capacity.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/43016383/Sustainability_of_collaborative_capacity20160224-16595-168d0fe-libre.pdf?1456335629=\u0026response-content-disposition=attachment%3B+filename%3DSustainability_of_Collaborative_Capacity.pdf\u0026Expires=1743441980\u0026Signature=UY-A2j-k6XB7tULkYterdbX9ea-dFQnV4iItKDXc9wPzi14tR6hZVS1RZ3z1sIJ4oDXFHAVvfhp9eDUCXH1E0oT~CB7EfWJHAcYor2PvIHTT5P5W~BdHn~TNXLfHZB9jLMWuYq17pM0KKDROSrwAuBIecUIIrJtbOzgjwyKJIWR0FxfNRZ1zIDZWU1Q0f2u9pjalaSYLOcCYpawEwIr1LDncmQrZy0z93kqaBnRjp701iQ-1od3bZBP7QOw38uwx1jdL55w1Ioyl1gTCq24r3QcbsdPgXkKL-qG88UxjwC-fXclkWzOjgoqtNBSbhacB0qCyWs0EVOT6bqzOazJg1g__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":202,"name":"Program Evaluation","url":"https://www.academia.edu/Documents/in/Program_Evaluation"},{"id":2919,"name":"Organizational Culture","url":"https://www.academia.edu/Documents/in/Organizational_Culture"},{"id":11435,"name":"Community Health","url":"https://www.academia.edu/Documents/in/Community_Health"},{"id":73149,"name":"Business and Management","url":"https://www.academia.edu/Documents/in/Business_and_Management"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":123411,"name":"Care","url":"https://www.academia.edu/Documents/in/Care"},{"id":219645,"name":"Medical Care","url":"https://www.academia.edu/Documents/in/Medical_Care"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":496530,"name":"Community Networks","url":"https://www.academia.edu/Documents/in/Community_Networks"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15629991-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15629989"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/15629989/Community_Care_Networks_Linking_Vision_to_Outcomes_for_Community_Health_Improvement"><img alt="Research paper thumbnail of Community Care Networks: Linking Vision to Outcomes for Community Health Improvement" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Community Care Networks: Linking Vision to Outcomes for Community Health Improvement</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/DouglasConrad">Douglas Conrad</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/ShoshannaSofaer">Shoshanna Sofaer</a></span></div><div class="wp-workCard_item"><span>Medical Care Research and Review</span><span>, 2003</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">This article examines the relationship between progress toward the Community Care Network (CCN) v...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">This article examines the relationship between progress toward the Community Care Network (CCN) vision and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;intermediate outcomes&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; of 25 community-based health partnerships (CCNs). Specific components of the CCN vision were community accountability, community health focus, creation of a seamless service continuum, and managing under limited resources. Four community outcome dimensions were evaluated: access, cost, health, and quality of service delivery integration. Overall progress toward the CCN vision was significantly positively related to average intermediate outcome score and most highly correlated with two dimensions: access and quality of service integration. Qualitative analysis suggests that CCN sites accomplished the most along two dimensions--access and health--noting that intermediate health outcomes generally were in health assessment and information rather than actual health status improvement. Keys to outcome achievement appear to be (1) clearly focused intervention; (2) explicit, ongoing outcome measurement; and (3) strong integration of separate intervention components.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15629989"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15629989"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15629989; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15629989]").text(description); $(".js-view-count[data-work-id=15629989]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15629989; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15629989']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=15629989]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15629989,"title":"Community Care Networks: Linking Vision to Outcomes for Community Health Improvement","translated_title":"","metadata":{"abstract":"This article examines the relationship between progress toward the Community Care Network (CCN) vision and \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;intermediate outcomes\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; of 25 community-based health partnerships (CCNs). Specific components of the CCN vision were community accountability, community health focus, creation of a seamless service continuum, and managing under limited resources. Four community outcome dimensions were evaluated: access, cost, health, and quality of service delivery integration. Overall progress toward the CCN vision was significantly positively related to average intermediate outcome score and most highly correlated with two dimensions: access and quality of service integration. Qualitative analysis suggests that CCN sites accomplished the most along two dimensions--access and health--noting that intermediate health outcomes generally were in health assessment and information rather than actual health status improvement. Keys to outcome achievement appear to be (1) clearly focused intervention; (2) explicit, ongoing outcome measurement; and (3) strong integration of separate intervention components.","publication_date":{"day":null,"month":null,"year":2003,"errors":{}},"publication_name":"Medical Care Research and Review"},"translated_abstract":"This article examines the relationship between progress toward the Community Care Network (CCN) vision and \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;intermediate outcomes\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; of 25 community-based health partnerships (CCNs). Specific components of the CCN vision were community accountability, community health focus, creation of a seamless service continuum, and managing under limited resources. Four community outcome dimensions were evaluated: access, cost, health, and quality of service delivery integration. Overall progress toward the CCN vision was significantly positively related to average intermediate outcome score and most highly correlated with two dimensions: access and quality of service integration. Qualitative analysis suggests that CCN sites accomplished the most along two dimensions--access and health--noting that intermediate health outcomes generally were in health assessment and information rather than actual health status improvement. Keys to outcome achievement appear to be (1) clearly focused intervention; (2) explicit, ongoing outcome measurement; and (3) strong integration of separate intervention components.","internal_url":"https://www.academia.edu/15629989/Community_Care_Networks_Linking_Vision_to_Outcomes_for_Community_Health_Improvement","translated_internal_url":"","created_at":"2015-09-12T10:28:57.352-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762503,"work_id":15629989,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Community Care Networks: Linking Vision to Outcomes for Community Health Improvement"},{"id":5762524,"work_id":15629989,"tagging_user_id":34807327,"tagged_user_id":35004148,"co_author_invite_id":1274799,"email":"d***d@u.washington.edu","display_order":4194304,"name":"Douglas Conrad","title":"Community Care Networks: Linking Vision to Outcomes for Community Health Improvement"},{"id":5762536,"work_id":15629989,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274801,"email":"a***j@email.gwu.edu","display_order":6291456,"name":"Jeffrey Alexander","title":"Community Care Networks: Linking Vision to Outcomes for Community Health Improvement"},{"id":5762548,"work_id":15629989,"tagging_user_id":34807327,"tagged_user_id":34868761,"co_author_invite_id":1274802,"email":"s***r@baruch.cuny.edu","display_order":7340032,"name":"Shoshanna Sofaer","title":"Community Care Networks: Linking Vision to Outcomes for Community Health Improvement"},{"id":5762665,"work_id":15629989,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274837,"email":"r***n@aha.org","display_order":7864320,"name":"Romana Hasnain-wynia","title":"Community Care Networks: Linking Vision to Outcomes for Community Health Improvement"}],"downloadable_attachments":[],"slug":"Community_Care_Networks_Linking_Vision_to_Outcomes_for_Community_Health_Improvement","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"This article examines the relationship between progress toward the Community Care Network (CCN) vision and \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;intermediate outcomes\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; of 25 community-based health partnerships (CCNs). Specific components of the CCN vision were community accountability, community health focus, creation of a seamless service continuum, and managing under limited resources. Four community outcome dimensions were evaluated: access, cost, health, and quality of service delivery integration. Overall progress toward the CCN vision was significantly positively related to average intermediate outcome score and most highly correlated with two dimensions: access and quality of service integration. Qualitative analysis suggests that CCN sites accomplished the most along two dimensions--access and health--noting that intermediate health outcomes generally were in health assessment and information rather than actual health status improvement. Keys to outcome achievement appear to be (1) clearly focused intervention; (2) explicit, ongoing outcome measurement; and (3) strong integration of separate intervention components.","owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[],"research_interests":[{"id":202,"name":"Program Evaluation","url":"https://www.academia.edu/Documents/in/Program_Evaluation"},{"id":3138,"name":"Community-Based Mental Health Services","url":"https://www.academia.edu/Documents/in/Community-Based_Mental_Health_Services"},{"id":11435,"name":"Community Health","url":"https://www.academia.edu/Documents/in/Community_Health"},{"id":73149,"name":"Business and Management","url":"https://www.academia.edu/Documents/in/Business_and_Management"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":123411,"name":"Care","url":"https://www.academia.edu/Documents/in/Care"},{"id":219645,"name":"Medical Care","url":"https://www.academia.edu/Documents/in/Medical_Care"},{"id":232534,"name":"Health Status","url":"https://www.academia.edu/Documents/in/Health_Status"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":496530,"name":"Community Networks","url":"https://www.academia.edu/Documents/in/Community_Networks"},{"id":784971,"name":"Community Care","url":"https://www.academia.edu/Documents/in/Community_Care"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15629989-figures'); } }); </script> </div><div class="profile--tab_content_container js-tab-pane tab-pane" data-section-id="3303104" id="papers"><div class="js-work-strip profile--work_container" data-work-id="17825796"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/17825796/Assessing_the_extent_of_integration_achieved_through_physician_hospital_arrangements"><img alt="Research paper thumbnail of Assessing the extent of integration achieved through physician-hospital arrangements" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Assessing the extent of integration achieved through physician-hospital arrangements</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://nku.academia.edu/LindaDynan">Linda Dynan</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Journal of healthcare management / American College of Healthcare Executives</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">In this article we examine management service organizations (MSOs), physician-hospital organizati...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">In this article we examine management service organizations (MSOs), physician-hospital organizations (PHOs), hospital-affiliated independent practice associations (IPAs), and hospital-sponsored &quot;group practices without walls&quot; (GPWWs) that allow physicians to retain their practices and link hospitals and health systems to physicians through contractual arrangements. Also examined were medical foundations (MFs), integrated salary models (ISMs), and integrated health organizations (IHOs) that own the physical assets of physician practices and contract with payors for physician and hospital services. The research provides several new insights for understanding the structure and process of physician-hospital integration. It was found that the extent of processual integration in physician-hospital organizational arrangements can be measured along six dimensions: administrative and practice management services; physician financial risk-sharing; joint ventures to create new servic...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825796"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825796"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825796; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825796]").text(description); $(".js-view-count[data-work-id=17825796]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825796; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825796']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=17825796]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825796,"title":"Assessing the extent of integration achieved through physician-hospital arrangements","translated_title":"","metadata":{"abstract":"In this article we examine management service organizations (MSOs), physician-hospital organizations (PHOs), hospital-affiliated independent practice associations (IPAs), and hospital-sponsored \u0026quot;group practices without walls\u0026quot; (GPWWs) that allow physicians to retain their practices and link hospitals and health systems to physicians through contractual arrangements. Also examined were medical foundations (MFs), integrated salary models (ISMs), and integrated health organizations (IHOs) that own the physical assets of physician practices and contract with payors for physician and hospital services. The research provides several new insights for understanding the structure and process of physician-hospital integration. It was found that the extent of processual integration in physician-hospital organizational arrangements can be measured along six dimensions: administrative and practice management services; physician financial risk-sharing; joint ventures to create new servic...","publication_name":"Journal of healthcare management / American College of Healthcare Executives"},"translated_abstract":"In this article we examine management service organizations (MSOs), physician-hospital organizations (PHOs), hospital-affiliated independent practice associations (IPAs), and hospital-sponsored \u0026quot;group practices without walls\u0026quot; (GPWWs) that allow physicians to retain their practices and link hospitals and health systems to physicians through contractual arrangements. Also examined were medical foundations (MFs), integrated salary models (ISMs), and integrated health organizations (IHOs) that own the physical assets of physician practices and contract with payors for physician and hospital services. The research provides several new insights for understanding the structure and process of physician-hospital integration. It was found that the extent of processual integration in physician-hospital organizational arrangements can be measured along six dimensions: administrative and practice management services; physician financial risk-sharing; joint ventures to create new servic...","internal_url":"https://www.academia.edu/17825796/Assessing_the_extent_of_integration_achieved_through_physician_hospital_arrangements","translated_internal_url":"","created_at":"2015-11-05T14:34:25.924-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745211,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863553,"work_id":17825796,"tagging_user_id":37745211,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Assessing the extent of integration achieved through physician-hospital arrangements"},{"id":8863556,"work_id":17825796,"tagging_user_id":37745211,"tagged_user_id":12614255,"co_author_invite_id":null,"email":"b***l@wharton.upenn.edu","affiliation":"University of Pennsylvania","display_order":4194304,"name":"lawton burns","title":"Assessing the extent of integration achieved through physician-hospital arrangements"},{"id":8863571,"work_id":17825796,"tagging_user_id":37745211,"tagged_user_id":null,"co_author_invite_id":349651,"email":"r***s@anu.edu.au","display_order":6291456,"name":"R. Burns","title":"Assessing the extent of integration achieved through physician-hospital arrangements"}],"downloadable_attachments":[],"slug":"Assessing_the_extent_of_integration_achieved_through_physician_hospital_arrangements","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"In this article we examine management service organizations (MSOs), physician-hospital organizations (PHOs), hospital-affiliated independent practice associations (IPAs), and hospital-sponsored \u0026quot;group practices without walls\u0026quot; (GPWWs) that allow physicians to retain their practices and link hospitals and health systems to physicians through contractual arrangements. Also examined were medical foundations (MFs), integrated salary models (ISMs), and integrated health organizations (IHOs) that own the physical assets of physician practices and contract with payors for physician and hospital services. The research provides several new insights for understanding the structure and process of physician-hospital integration. It was found that the extent of processual integration in physician-hospital organizational arrangements can be measured along six dimensions: administrative and practice management services; physician financial risk-sharing; joint ventures to create new servic...","owner":{"id":37745211,"first_name":"Linda","middle_initials":null,"last_name":"Dynan","page_name":"LindaDynan","domain_name":"nku","created_at":"2015-11-05T14:34:00.827-08:00","display_name":"Linda Dynan","url":"https://nku.academia.edu/LindaDynan"},"attachments":[],"research_interests":[{"id":16635,"name":"Health Services Research","url":"https://www.academia.edu/Documents/in/Health_Services_Research"},{"id":37745,"name":"Systems Integration","url":"https://www.academia.edu/Documents/in/Systems_Integration"},{"id":37925,"name":"Ownership","url":"https://www.academia.edu/Documents/in/Ownership"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":153168,"name":"Data Collection","url":"https://www.academia.edu/Documents/in/Data_Collection"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":2063677,"name":"Group practice","url":"https://www.academia.edu/Documents/in/Group_practice"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17825796-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17825797"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/17825797/Capitated_contracting_of_integrated_health_provider_organizations"><img alt="Research paper thumbnail of Capitated contracting of integrated health provider organizations" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Capitated contracting of integrated health provider organizations</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://nku.academia.edu/LindaDynan">Linda Dynan</a></span></div><div class="wp-workCard_item"><span>Inquiry : a journal of medical care organization, provision and financing</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">This paper examines global capitation of integrated health provider organizations that link physi...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">This paper examines global capitation of integrated health provider organizations that link physicians and hospitals, such as physician-hospital organizations and management service organizations. These organizations have proliferated in recent years, but their contracting activity has not been studied. We develop a conceptual model to understand the capitated contracting bargaining process. Exploratory multivariate analysis suggests that global capitation of these organizations is more common in markets with high health maintenance organization (HMO) market share, greater numbers of HMOs, and fewer physician group practices. Additionally, health provider organizations with more complex case mix, nonprofit status, more affiliated physicians, health system affiliations, and diversity in physician organizational arrangements are more likely to have global capitation. Finally, state regulation of provider contracting with self-insured employers appears to have spillover effects on heal...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825797"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825797"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825797; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825797]").text(description); $(".js-view-count[data-work-id=17825797]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825797; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825797']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=17825797]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825797,"title":"Capitated contracting of integrated health provider organizations","translated_title":"","metadata":{"abstract":"This paper examines global capitation of integrated health provider organizations that link physicians and hospitals, such as physician-hospital organizations and management service organizations. These organizations have proliferated in recent years, but their contracting activity has not been studied. We develop a conceptual model to understand the capitated contracting bargaining process. Exploratory multivariate analysis suggests that global capitation of these organizations is more common in markets with high health maintenance organization (HMO) market share, greater numbers of HMOs, and fewer physician group practices. Additionally, health provider organizations with more complex case mix, nonprofit status, more affiliated physicians, health system affiliations, and diversity in physician organizational arrangements are more likely to have global capitation. Finally, state regulation of provider contracting with self-insured employers appears to have spillover effects on heal...","publication_name":"Inquiry : a journal of medical care organization, provision and financing"},"translated_abstract":"This paper examines global capitation of integrated health provider organizations that link physicians and hospitals, such as physician-hospital organizations and management service organizations. These organizations have proliferated in recent years, but their contracting activity has not been studied. We develop a conceptual model to understand the capitated contracting bargaining process. Exploratory multivariate analysis suggests that global capitation of these organizations is more common in markets with high health maintenance organization (HMO) market share, greater numbers of HMOs, and fewer physician group practices. Additionally, health provider organizations with more complex case mix, nonprofit status, more affiliated physicians, health system affiliations, and diversity in physician organizational arrangements are more likely to have global capitation. Finally, state regulation of provider contracting with self-insured employers appears to have spillover effects on heal...","internal_url":"https://www.academia.edu/17825797/Capitated_contracting_of_integrated_health_provider_organizations","translated_internal_url":"","created_at":"2015-11-05T14:34:26.014-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745211,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863552,"work_id":17825797,"tagging_user_id":37745211,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Capitated contracting of integrated health provider organizations"},{"id":8863555,"work_id":17825797,"tagging_user_id":37745211,"tagged_user_id":12614255,"co_author_invite_id":null,"email":"b***l@wharton.upenn.edu","affiliation":"University of Pennsylvania","display_order":4194304,"name":"lawton burns","title":"Capitated contracting of integrated health provider organizations"}],"downloadable_attachments":[],"slug":"Capitated_contracting_of_integrated_health_provider_organizations","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"This paper examines global capitation of integrated health provider organizations that link physicians and hospitals, such as physician-hospital organizations and management service organizations. These organizations have proliferated in recent years, but their contracting activity has not been studied. We develop a conceptual model to understand the capitated contracting bargaining process. Exploratory multivariate analysis suggests that global capitation of these organizations is more common in markets with high health maintenance organization (HMO) market share, greater numbers of HMOs, and fewer physician group practices. Additionally, health provider organizations with more complex case mix, nonprofit status, more affiliated physicians, health system affiliations, and diversity in physician organizational arrangements are more likely to have global capitation. Finally, state regulation of provider contracting with self-insured employers appears to have spillover effects on heal...","owner":{"id":37745211,"first_name":"Linda","middle_initials":null,"last_name":"Dynan","page_name":"LindaDynan","domain_name":"nku","created_at":"2015-11-05T14:34:00.827-08:00","display_name":"Linda Dynan","url":"https://nku.academia.edu/LindaDynan"},"attachments":[],"research_interests":[{"id":41482,"name":"Multivariate Analysis","url":"https://www.academia.edu/Documents/in/Multivariate_Analysis"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":579119,"name":"Marketing of Health Services","url":"https://www.academia.edu/Documents/in/Marketing_of_Health_Services"},{"id":2063677,"name":"Group practice","url":"https://www.academia.edu/Documents/in/Group_practice"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17825797-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17825798"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/17825798/Impact_of_HMO_market_structure_on_physician_hospital_strategic_alliances"><img alt="Research paper thumbnail of Impact of HMO market structure on physician-hospital strategic alliances" class="work-thumbnail" src="https://attachments.academia-assets.com/41945415/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/17825798/Impact_of_HMO_market_structure_on_physician_hospital_strategic_alliances">Impact of HMO market structure on physician-hospital strategic alliances</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://nku.academia.edu/LindaDynan">Linda Dynan</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Health services research</span><span>, 2000</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">To assess the impact of HMO market structure on the formation of physician-hospital strategic all...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">To assess the impact of HMO market structure on the formation of physician-hospital strategic alliances from 1993 through 1995. The two trends, managed care and physician-hospital integration have been prominent in reshaping insurance and provider markets over the past decade. Pooled cross-sectional data from the InterStudy HMO Census and the Annual Survey conducted by the American Hospital Association (AHA) between 1993 and the end of 1995 to examine the effects of HMO penetration and HMO numbers in a market on the formation of hospital-sponsored alliances with physicians. Because prior research has found nonlinear effects of HMOs on a variety of dependent variables, we operationalized HMO market structure two ways: using a Taylor series expansion and cross-classifying quartile distributions of HMO penetration and numbers into 16 dummy indicators. Alliance formation was operationalized using the presence of any alliance model (IPA, PHO, MSO, and foundation) and the sum of the four ...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="fc11328134454f7c9197a5b9377257d2" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":41945415,"asset_id":17825798,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/41945415/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825798"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825798"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825798; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825798]").text(description); $(".js-view-count[data-work-id=17825798]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825798; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825798']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "fc11328134454f7c9197a5b9377257d2" } } $('.js-work-strip[data-work-id=17825798]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825798,"title":"Impact of HMO market structure on physician-hospital strategic alliances","translated_title":"","metadata":{"abstract":"To assess the impact of HMO market structure on the formation of physician-hospital strategic alliances from 1993 through 1995. The two trends, managed care and physician-hospital integration have been prominent in reshaping insurance and provider markets over the past decade. Pooled cross-sectional data from the InterStudy HMO Census and the Annual Survey conducted by the American Hospital Association (AHA) between 1993 and the end of 1995 to examine the effects of HMO penetration and HMO numbers in a market on the formation of hospital-sponsored alliances with physicians. Because prior research has found nonlinear effects of HMOs on a variety of dependent variables, we operationalized HMO market structure two ways: using a Taylor series expansion and cross-classifying quartile distributions of HMO penetration and numbers into 16 dummy indicators. Alliance formation was operationalized using the presence of any alliance model (IPA, PHO, MSO, and foundation) and the sum of the four ...","publication_date":{"day":null,"month":null,"year":2000,"errors":{}},"publication_name":"Health services research"},"translated_abstract":"To assess the impact of HMO market structure on the formation of physician-hospital strategic alliances from 1993 through 1995. The two trends, managed care and physician-hospital integration have been prominent in reshaping insurance and provider markets over the past decade. Pooled cross-sectional data from the InterStudy HMO Census and the Annual Survey conducted by the American Hospital Association (AHA) between 1993 and the end of 1995 to examine the effects of HMO penetration and HMO numbers in a market on the formation of hospital-sponsored alliances with physicians. Because prior research has found nonlinear effects of HMOs on a variety of dependent variables, we operationalized HMO market structure two ways: using a Taylor series expansion and cross-classifying quartile distributions of HMO penetration and numbers into 16 dummy indicators. Alliance formation was operationalized using the presence of any alliance model (IPA, PHO, MSO, and foundation) and the sum of the four ...","internal_url":"https://www.academia.edu/17825798/Impact_of_HMO_market_structure_on_physician_hospital_strategic_alliances","translated_internal_url":"","created_at":"2015-11-05T14:34:26.096-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745211,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863551,"work_id":17825798,"tagging_user_id":37745211,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Impact of HMO market structure on physician-hospital strategic alliances"},{"id":8863554,"work_id":17825798,"tagging_user_id":37745211,"tagged_user_id":12614255,"co_author_invite_id":null,"email":"b***l@wharton.upenn.edu","affiliation":"University of Pennsylvania","display_order":4194304,"name":"lawton burns","title":"Impact of HMO market structure on physician-hospital strategic alliances"}],"downloadable_attachments":[{"id":41945415,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/41945415/thumbnails/1.jpg","file_name":"Impact_of_HMO_Market_Structure_on_Physic20160203-30232-1o3c66w.pdf","download_url":"https://www.academia.edu/attachments/41945415/download_file","bulk_download_file_name":"Impact_of_HMO_market_structure_on_physic.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/41945415/Impact_of_HMO_Market_Structure_on_Physic20160203-30232-1o3c66w-libre.pdf?1454504939=\u0026response-content-disposition=attachment%3B+filename%3DImpact_of_HMO_market_structure_on_physic.pdf\u0026Expires=1743441979\u0026Signature=QF0B8FgbxNh9zu2aaJ5zSb-bIZ5vaA0-iM2j6nmTj75lRFJNLX9OgN4alJAa3cqdjeB1K~8~HpmlEA9whRQFoQj3qOauVwNfozBIqQ7vCG2pFCYGcaujW3yn0Ytx7lRmCZQG2sfXGWR6sPvoWbwsTtVUXzx7sNHQBbg3e7b4fnw-GT6ZJ7LcIxwiggjVhmPp4KW1MELmIauico2EOpGrVaKdDvB0Mi0wIySSmfZ-Us~9Ozqzi~sxuS64cOotvEqqHg9idtSbASciZTxs4Mc-bgDnePxBI2n65iHaUPLpcoyPW40LFWc01ERNZiOrx3nUEdGLlXlF6XXfs896zUKBNg__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Impact_of_HMO_market_structure_on_physician_hospital_strategic_alliances","translated_slug":"","page_count":32,"language":"en","content_type":"Work","summary":"To assess the impact of HMO market structure on the formation of physician-hospital strategic alliances from 1993 through 1995. The two trends, managed care and physician-hospital integration have been prominent in reshaping insurance and provider markets over the past decade. Pooled cross-sectional data from the InterStudy HMO Census and the Annual Survey conducted by the American Hospital Association (AHA) between 1993 and the end of 1995 to examine the effects of HMO penetration and HMO numbers in a market on the formation of hospital-sponsored alliances with physicians. Because prior research has found nonlinear effects of HMOs on a variety of dependent variables, we operationalized HMO market structure two ways: using a Taylor series expansion and cross-classifying quartile distributions of HMO penetration and numbers into 16 dummy indicators. Alliance formation was operationalized using the presence of any alliance model (IPA, PHO, MSO, and foundation) and the sum of the four ...","owner":{"id":37745211,"first_name":"Linda","middle_initials":null,"last_name":"Dynan","page_name":"LindaDynan","domain_name":"nku","created_at":"2015-11-05T14:34:00.827-08:00","display_name":"Linda Dynan","url":"https://nku.academia.edu/LindaDynan"},"attachments":[{"id":41945415,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/41945415/thumbnails/1.jpg","file_name":"Impact_of_HMO_Market_Structure_on_Physic20160203-30232-1o3c66w.pdf","download_url":"https://www.academia.edu/attachments/41945415/download_file","bulk_download_file_name":"Impact_of_HMO_market_structure_on_physic.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/41945415/Impact_of_HMO_Market_Structure_on_Physic20160203-30232-1o3c66w-libre.pdf?1454504939=\u0026response-content-disposition=attachment%3B+filename%3DImpact_of_HMO_market_structure_on_physic.pdf\u0026Expires=1743441979\u0026Signature=QF0B8FgbxNh9zu2aaJ5zSb-bIZ5vaA0-iM2j6nmTj75lRFJNLX9OgN4alJAa3cqdjeB1K~8~HpmlEA9whRQFoQj3qOauVwNfozBIqQ7vCG2pFCYGcaujW3yn0Ytx7lRmCZQG2sfXGWR6sPvoWbwsTtVUXzx7sNHQBbg3e7b4fnw-GT6ZJ7LcIxwiggjVhmPp4KW1MELmIauico2EOpGrVaKdDvB0Mi0wIySSmfZ-Us~9Ozqzi~sxuS64cOotvEqqHg9idtSbASciZTxs4Mc-bgDnePxBI2n65iHaUPLpcoyPW40LFWc01ERNZiOrx3nUEdGLlXlF6XXfs896zUKBNg__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":16635,"name":"Health Services Research","url":"https://www.academia.edu/Documents/in/Health_Services_Research"},{"id":28850,"name":"Linear models","url":"https://www.academia.edu/Documents/in/Linear_models"},{"id":83471,"name":"Health Services","url":"https://www.academia.edu/Documents/in/Health_Services"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":579119,"name":"Marketing of Health Services","url":"https://www.academia.edu/Documents/in/Marketing_of_Health_Services"},{"id":901876,"name":"Sensitivity and Specificity","url":"https://www.academia.edu/Documents/in/Sensitivity_and_Specificity"}],"urls":[{"id":6337474,"url":"https://www.researchgate.net/profile/Linda_Dynan/publication/12537578_Impact_of_HMO_Market_Structure_on_PhysicianHospital_Strategic_Alliances/links/0046351c2ef1c13ae3000000.pdf"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17825798-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17825704"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/17825704/Does_Loss_of_Safety_Net_Hospitals_in_a_Community_Disproportionately_Affect_Racial_and_Ethnic_Minority_Groups"><img alt="Research paper thumbnail of Does Loss of Safety Net Hospitals in a Community Disproportionately Affect Racial and Ethnic Minority Groups?" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Does Loss of Safety Net Hospitals in a Community Disproportionately Affect Racial and Ethnic Minority Groups?</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/HuiminHsieh">Hui-min Hsieh</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Research Objective: Safety net hospitals (SNHs) are thought to play a critical role in the U.S. h...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Research Objective: Safety net hospitals (SNHs) are thought to play a critical role in the U.S. health system by providing health care services for vulnerable populations. SNHs also frequently offer a variety of social and outreach services, which could potentially reduce disparities among ethnic and racial minority groups. This may be especially true for minority individuals living near an SNH because they will have ready access to these facilitating services. Our study examined whether closure or ownership conversions of nearby SNHs had a disproportionate effect on uninsured and Medicaid patients, especially for non-Hispanic black and Hispanic individuals. Study Design: Hospital discharge data for the states of Arizona, California, Florida, and Wisconsin were examined from the early 1990s to 2003. Our primary access measure was distance traveled by patients to hospitals for inpatient care. Both closure and for-profit conversion represent events that reduce safety net resources ava...</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825704"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825704"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825704; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825704]").text(description); $(".js-view-count[data-work-id=17825704]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825704; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825704']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=17825704]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825704,"title":"Does Loss of Safety Net Hospitals in a Community Disproportionately Affect Racial and Ethnic Minority Groups?","translated_title":"","metadata":{"abstract":"Research Objective: Safety net hospitals (SNHs) are thought to play a critical role in the U.S. health system by providing health care services for vulnerable populations. SNHs also frequently offer a variety of social and outreach services, which could potentially reduce disparities among ethnic and racial minority groups. This may be especially true for minority individuals living near an SNH because they will have ready access to these facilitating services. Our study examined whether closure or ownership conversions of nearby SNHs had a disproportionate effect on uninsured and Medicaid patients, especially for non-Hispanic black and Hispanic individuals. Study Design: Hospital discharge data for the states of Arizona, California, Florida, and Wisconsin were examined from the early 1990s to 2003. Our primary access measure was distance traveled by patients to hospitals for inpatient care. Both closure and for-profit conversion represent events that reduce safety net resources ava..."},"translated_abstract":"Research Objective: Safety net hospitals (SNHs) are thought to play a critical role in the U.S. health system by providing health care services for vulnerable populations. SNHs also frequently offer a variety of social and outreach services, which could potentially reduce disparities among ethnic and racial minority groups. This may be especially true for minority individuals living near an SNH because they will have ready access to these facilitating services. Our study examined whether closure or ownership conversions of nearby SNHs had a disproportionate effect on uninsured and Medicaid patients, especially for non-Hispanic black and Hispanic individuals. Study Design: Hospital discharge data for the states of Arizona, California, Florida, and Wisconsin were examined from the early 1990s to 2003. Our primary access measure was distance traveled by patients to hospitals for inpatient care. Both closure and for-profit conversion represent events that reduce safety net resources ava...","internal_url":"https://www.academia.edu/17825704/Does_Loss_of_Safety_Net_Hospitals_in_a_Community_Disproportionately_Affect_Racial_and_Ethnic_Minority_Groups","translated_internal_url":"","created_at":"2015-11-05T14:31:17.483-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745062,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863439,"work_id":17825704,"tagging_user_id":37745062,"tagged_user_id":null,"co_author_invite_id":2001862,"email":"l***y@rti.org","display_order":0,"name":"Lee Mobley","title":"Does Loss of Safety Net Hospitals in a Community Disproportionately Affect Racial and Ethnic Minority Groups?"},{"id":8863465,"work_id":17825704,"tagging_user_id":37745062,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":4194304,"name":"Gloria Bazzoli","title":"Does Loss of Safety Net Hospitals in a Community Disproportionately Affect Racial and Ethnic Minority Groups?"}],"downloadable_attachments":[],"slug":"Does_Loss_of_Safety_Net_Hospitals_in_a_Community_Disproportionately_Affect_Racial_and_Ethnic_Minority_Groups","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Research Objective: Safety net hospitals (SNHs) are thought to play a critical role in the U.S. health system by providing health care services for vulnerable populations. SNHs also frequently offer a variety of social and outreach services, which could potentially reduce disparities among ethnic and racial minority groups. This may be especially true for minority individuals living near an SNH because they will have ready access to these facilitating services. Our study examined whether closure or ownership conversions of nearby SNHs had a disproportionate effect on uninsured and Medicaid patients, especially for non-Hispanic black and Hispanic individuals. Study Design: Hospital discharge data for the states of Arizona, California, Florida, and Wisconsin were examined from the early 1990s to 2003. Our primary access measure was distance traveled by patients to hospitals for inpatient care. Both closure and for-profit conversion represent events that reduce safety net resources ava...","owner":{"id":37745062,"first_name":"Hui-min","middle_initials":null,"last_name":"Hsieh","page_name":"HuiminHsieh","domain_name":"independent","created_at":"2015-11-05T14:30:24.279-08:00","display_name":"Hui-min Hsieh","url":"https://independent.academia.edu/HuiminHsieh"},"attachments":[],"research_interests":[],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17825704-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17825693"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/17825693/Impacts_of_market_and_organizational_characteristics_on_hospital_efficiency_and_uncompensated_care"><img alt="Research paper thumbnail of Impacts of market and organizational characteristics on hospital efficiency and uncompensated care" class="work-thumbnail" src="https://attachments.academia-assets.com/39731105/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/17825693/Impacts_of_market_and_organizational_characteristics_on_hospital_efficiency_and_uncompensated_care">Impacts of market and organizational characteristics on hospital efficiency and uncompensated care</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/HuiminHsieh">Hui-min Hsieh</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Health Care Management Review</span><span>, 2010</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background: Hospitals have confronted a difficult financial environment given many factors, inclu...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background: Hospitals have confronted a difficult financial environment given many factors, including expansion of managed care, changes in public policy, growing market competition for certain services, and growth in the number of uninsured. Policy makers have expressed concern that hospitals may forgo providing care to the indigent as a means to reduce costs and become more efficient when faced with financial pressures. Purpose: This article examined the effects of environmental pressures on two dimensions of hospital performance: hospital efficiency and uncompensated care provision. Methodology/Approach: Longitudinal data for the Commonwealth of Virginia from 1998 to 2004 were analyzed. Data Envelopment Analysis and bivariate probit were used to examine the factors associated with efficiency and uncompensated care. Findings: The results indicated that a positive relationship between hospital efficiency and uncompensated care provision exists. That is, hospitals that are categorized as efficient are likely to provide more uncompensated care. We also found that hospitals tended to provide more uncompensated care when increased demand for these services occurred in a market. Increases in Medicare or Medicaid patient share reduced the provision of uncompensated care. In relation to hospital efficiency, the results indicated that HMO penetration and Medicaid patient share reduced hospital efficiency. Practice Implications: This study found that efficient hospitals tend to provide more uncompensated care over time. The findings also suggest that hospitals alter their efficiency and provision of uncompensated care in response to a number of environmental pressures, but it may depend on the type of pressures or uncertainties encountered.</span></div><div class="wp-workCard_item"><div class="carousel-container carousel-container--sm" id="profile-work-17825693-figures"><div class="prev-slide-container js-prev-button-container"><button aria-label="Previous" class="carousel-navigation-button js-profile-work-17825693-figures-prev"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">arrow_back_ios</span></button></div><div class="slides-container js-slides-container"><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/53618274/table-3-note-total-hospital-sample-from-to-in-this-study-msa"><img alt="Note. Total hospital sample from 1998 to 2004 in this study: N = 501. MSA = metropolitan statistical area. " class="figure-slide-image" src="https://figures.academia-assets.com/39731105/table_003.jpg" /></a></figure><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/53618283/table-4-note-lr-likelihood-ratio-chi-square-value-of-rho"><img alt="Note. ***p < .01; **p < .05; *p < .1. LR c? = Likelihood-ratio chi-square value of rho. " class="figure-slide-image" src="https://figures.academia-assets.com/39731105/table_004.jpg" /></a></figure><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/53618253/table-1-note-total-hospital-sample-from-to-in-this-study"><img alt="Note. Total hospital sample from 1998 to 2004 in this study: N = 501. " class="figure-slide-image" src="https://figures.academia-assets.com/39731105/table_001.jpg" /></a></figure><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/53618263/table-2-descriptive-statistics-of-dependent-variables"><img alt="Descriptive statistics of dependent variables, 1998-2004 Efficient is 1 if efficiency score is equal to 1. " class="figure-slide-image" src="https://figures.academia-assets.com/39731105/table_002.jpg" /></a></figure></div><div class="next-slide-container js-next-button-container"><button aria-label="Next" class="carousel-navigation-button js-profile-work-17825693-figures-next"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">arrow_forward_ios</span></button></div></div></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="3a5f59bf595d74e8426ad5632a94aa38" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":39731105,"asset_id":17825693,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/39731105/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825693"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825693"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825693; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825693]").text(description); $(".js-view-count[data-work-id=17825693]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825693; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825693']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "3a5f59bf595d74e8426ad5632a94aa38" } } $('.js-work-strip[data-work-id=17825693]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825693,"title":"Impacts of market and organizational characteristics on hospital efficiency and uncompensated care","translated_title":"","metadata":{"grobid_abstract":"Background: Hospitals have confronted a difficult financial environment given many factors, including expansion of managed care, changes in public policy, growing market competition for certain services, and growth in the number of uninsured. Policy makers have expressed concern that hospitals may forgo providing care to the indigent as a means to reduce costs and become more efficient when faced with financial pressures. Purpose: This article examined the effects of environmental pressures on two dimensions of hospital performance: hospital efficiency and uncompensated care provision. Methodology/Approach: Longitudinal data for the Commonwealth of Virginia from 1998 to 2004 were analyzed. Data Envelopment Analysis and bivariate probit were used to examine the factors associated with efficiency and uncompensated care. Findings: The results indicated that a positive relationship between hospital efficiency and uncompensated care provision exists. That is, hospitals that are categorized as efficient are likely to provide more uncompensated care. We also found that hospitals tended to provide more uncompensated care when increased demand for these services occurred in a market. Increases in Medicare or Medicaid patient share reduced the provision of uncompensated care. In relation to hospital efficiency, the results indicated that HMO penetration and Medicaid patient share reduced hospital efficiency. Practice Implications: This study found that efficient hospitals tend to provide more uncompensated care over time. The findings also suggest that hospitals alter their efficiency and provision of uncompensated care in response to a number of environmental pressures, but it may depend on the type of pressures or uncertainties encountered.","publication_date":{"day":null,"month":null,"year":2010,"errors":{}},"publication_name":"Health Care Management Review","grobid_abstract_attachment_id":39731105},"translated_abstract":null,"internal_url":"https://www.academia.edu/17825693/Impacts_of_market_and_organizational_characteristics_on_hospital_efficiency_and_uncompensated_care","translated_internal_url":"","created_at":"2015-11-05T14:31:16.096-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745062,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863464,"work_id":17825693,"tagging_user_id":37745062,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Impacts of market and organizational characteristics on hospital efficiency and uncompensated care"}],"downloadable_attachments":[{"id":39731105,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731105/thumbnails/1.jpg","file_name":"Impacts_of_market_and_organizational_cha20151105-31821-1lubqy6.pdf","download_url":"https://www.academia.edu/attachments/39731105/download_file","bulk_download_file_name":"Impacts_of_market_and_organizational_cha.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731105/Impacts_of_market_and_organizational_cha20151105-31821-1lubqy6-libre.pdf?1446762859=\u0026response-content-disposition=attachment%3B+filename%3DImpacts_of_market_and_organizational_cha.pdf\u0026Expires=1743441979\u0026Signature=VGC7thGMh54Abi2ecB3cuiuTWU3mRJV1~WSOYofQOiZAVstp~IuLTfRUM5zKfJGFrydwWW5gTAXqBHeDEvA1BHfzbgmfi9eW5MEvtxqdKgZ1-Pe7VP5EPt3v6xIB-FNDED8JyiaKKJPwRQNT5vCQnUcH1DiPDtYRie8Tq2M9oVi7giW6jDPkRFb8tfnbXuH99h-ur5IK3hgfAs-dnVdOiCUGy2RLN6h2sXg8FKvoIj2KwzSVd3Ymczpba8IrkIV5HHvSl-UqMUoXI-Xijb~8AhxrAQIAyGLxgMV7PN6khAC7Bc8QESG5li3XB9h2uGCnG5KBed8WX5zJS9StJVAriw__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Impacts_of_market_and_organizational_characteristics_on_hospital_efficiency_and_uncompensated_care","translated_slug":"","page_count":11,"language":"en","content_type":"Work","summary":"Background: Hospitals have confronted a difficult financial environment given many factors, including expansion of managed care, changes in public policy, growing market competition for certain services, and growth in the number of uninsured. Policy makers have expressed concern that hospitals may forgo providing care to the indigent as a means to reduce costs and become more efficient when faced with financial pressures. Purpose: This article examined the effects of environmental pressures on two dimensions of hospital performance: hospital efficiency and uncompensated care provision. Methodology/Approach: Longitudinal data for the Commonwealth of Virginia from 1998 to 2004 were analyzed. Data Envelopment Analysis and bivariate probit were used to examine the factors associated with efficiency and uncompensated care. Findings: The results indicated that a positive relationship between hospital efficiency and uncompensated care provision exists. That is, hospitals that are categorized as efficient are likely to provide more uncompensated care. We also found that hospitals tended to provide more uncompensated care when increased demand for these services occurred in a market. Increases in Medicare or Medicaid patient share reduced the provision of uncompensated care. In relation to hospital efficiency, the results indicated that HMO penetration and Medicaid patient share reduced hospital efficiency. Practice Implications: This study found that efficient hospitals tend to provide more uncompensated care over time. The findings also suggest that hospitals alter their efficiency and provision of uncompensated care in response to a number of environmental pressures, but it may depend on the type of pressures or uncertainties encountered.","owner":{"id":37745062,"first_name":"Hui-min","middle_initials":null,"last_name":"Hsieh","page_name":"HuiminHsieh","domain_name":"independent","created_at":"2015-11-05T14:30:24.279-08:00","display_name":"Hui-min Hsieh","url":"https://independent.academia.edu/HuiminHsieh"},"attachments":[{"id":39731105,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731105/thumbnails/1.jpg","file_name":"Impacts_of_market_and_organizational_cha20151105-31821-1lubqy6.pdf","download_url":"https://www.academia.edu/attachments/39731105/download_file","bulk_download_file_name":"Impacts_of_market_and_organizational_cha.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731105/Impacts_of_market_and_organizational_cha20151105-31821-1lubqy6-libre.pdf?1446762859=\u0026response-content-disposition=attachment%3B+filename%3DImpacts_of_market_and_organizational_cha.pdf\u0026Expires=1743441979\u0026Signature=VGC7thGMh54Abi2ecB3cuiuTWU3mRJV1~WSOYofQOiZAVstp~IuLTfRUM5zKfJGFrydwWW5gTAXqBHeDEvA1BHfzbgmfi9eW5MEvtxqdKgZ1-Pe7VP5EPt3v6xIB-FNDED8JyiaKKJPwRQNT5vCQnUcH1DiPDtYRie8Tq2M9oVi7giW6jDPkRFb8tfnbXuH99h-ur5IK3hgfAs-dnVdOiCUGy2RLN6h2sXg8FKvoIj2KwzSVd3Ymczpba8IrkIV5HHvSl-UqMUoXI-Xijb~8AhxrAQIAyGLxgMV7PN6khAC7Bc8QESG5li3XB9h2uGCnG5KBed8WX5zJS9StJVAriw__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":21559,"name":"Health Care Management","url":"https://www.academia.edu/Documents/in/Health_Care_Management"},{"id":73149,"name":"Business and Management","url":"https://www.academia.edu/Documents/in/Business_and_Management"},{"id":84107,"name":"Hospital administration","url":"https://www.academia.edu/Documents/in/Hospital_administration"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":218342,"name":"Medicare","url":"https://www.academia.edu/Documents/in/Medicare"},{"id":235072,"name":"Medicaid","url":"https://www.academia.edu/Documents/in/Medicaid"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (true) { Aedu.setUpFigureCarousel('profile-work-17825693-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17825696"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/17825696/Did_Budget_Cuts_in_Medicaid_Disproportionate_Share_Hospital_Payment_Affect_Hospital_Quality_of_Care"><img alt="Research paper thumbnail of Did Budget Cuts in Medicaid Disproportionate Share Hospital Payment Affect Hospital Quality of Care?" class="work-thumbnail" src="https://attachments.academia-assets.com/39731102/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/17825696/Did_Budget_Cuts_in_Medicaid_Disproportionate_Share_Hospital_Payment_Affect_Hospital_Quality_of_Care">Did Budget Cuts in Medicaid Disproportionate Share Hospital Payment Affect Hospital Quality of Care?</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/HuiminHsieh">Hui-min Hsieh</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Medical Care</span><span>, 2014</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background: Medicaid Disproportionate Share Hospital (DSH) payments are one of the major sources ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background: Medicaid Disproportionate Share Hospital (DSH) payments are one of the major sources of financial support for hospitals providing care to low-income patients. However, Medicaid DSH payments will be redirected from hospitals to subsidize individual health insurance purchase through US national health reform.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="0eec5a8bc49efd866a5ad8f25a9ea449" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":39731102,"asset_id":17825696,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/39731102/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825696"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825696"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825696; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825696]").text(description); $(".js-view-count[data-work-id=17825696]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825696; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825696']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "0eec5a8bc49efd866a5ad8f25a9ea449" } } $('.js-work-strip[data-work-id=17825696]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825696,"title":"Did Budget Cuts in Medicaid Disproportionate Share Hospital Payment Affect Hospital Quality of Care?","translated_title":"","metadata":{"ai_title_tag":"Impact of Medicaid DSH Cuts on Hospital Care","grobid_abstract":"Background: Medicaid Disproportionate Share Hospital (DSH) payments are one of the major sources of financial support for hospitals providing care to low-income patients. However, Medicaid DSH payments will be redirected from hospitals to subsidize individual health insurance purchase through US national health reform.","publication_date":{"day":null,"month":null,"year":2014,"errors":{}},"publication_name":"Medical Care","grobid_abstract_attachment_id":39731102},"translated_abstract":null,"internal_url":"https://www.academia.edu/17825696/Did_Budget_Cuts_in_Medicaid_Disproportionate_Share_Hospital_Payment_Affect_Hospital_Quality_of_Care","translated_internal_url":"","created_at":"2015-11-05T14:31:16.525-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745062,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863437,"work_id":17825696,"tagging_user_id":37745062,"tagged_user_id":null,"co_author_invite_id":1960824,"email":"h***n@unthsc.edu","display_order":0,"name":"Hsueh-fen Chen","title":"Did Budget Cuts in Medicaid Disproportionate Share Hospital Payment Affect Hospital Quality of Care?"},{"id":8863463,"work_id":17825696,"tagging_user_id":37745062,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":4194304,"name":"Gloria Bazzoli","title":"Did Budget Cuts in Medicaid Disproportionate Share Hospital Payment Affect Hospital Quality of Care?"}],"downloadable_attachments":[{"id":39731102,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731102/thumbnails/1.jpg","file_name":"Did_Budget_Cuts_in_Medicaid_Disproportio20151105-31826-iwy7np.pdf","download_url":"https://www.academia.edu/attachments/39731102/download_file","bulk_download_file_name":"Did_Budget_Cuts_in_Medicaid_Disproportio.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731102/Did_Budget_Cuts_in_Medicaid_Disproportio20151105-31826-iwy7np-libre.pdf?1446762858=\u0026response-content-disposition=attachment%3B+filename%3DDid_Budget_Cuts_in_Medicaid_Disproportio.pdf\u0026Expires=1743441979\u0026Signature=PzvLGtx37DhH06A0yup8KdUkrpmeWm2ZoGrp-Izx7Sma0rQH-GhJ-0-E~chuRSy8kicLwoYtrSXOhKFDjjFKgvEstN02SgeKNUqig8gTAVRoq~DGBTusZoWFWvNr2HolVEyOnAJai5UCoHj8I2cgynlp34NVYYmqQWBVbG01uKZfDPqihYJSJDiUQTynaiFXesxZHymUN~JHyYzVQnSWbaC8zuHRN4RBc6uIp-YpbyHgm7fINh-di~~SFcAUUMgolrMNqY86zvbDi3WF0IdK9yB7VFDhK8As9YUMY2wNSkLlmL0v6qOsrTr6mFmweSn1dOpN-4dCF8c8w2sdjBPuUw__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Did_Budget_Cuts_in_Medicaid_Disproportionate_Share_Hospital_Payment_Affect_Hospital_Quality_of_Care","translated_slug":"","page_count":7,"language":"en","content_type":"Work","summary":"Background: Medicaid Disproportionate Share Hospital (DSH) payments are one of the major sources of financial support for hospitals providing care to low-income patients. However, Medicaid DSH payments will be redirected from hospitals to subsidize individual health insurance purchase through US national health reform.","owner":{"id":37745062,"first_name":"Hui-min","middle_initials":null,"last_name":"Hsieh","page_name":"HuiminHsieh","domain_name":"independent","created_at":"2015-11-05T14:30:24.279-08:00","display_name":"Hui-min Hsieh","url":"https://independent.academia.edu/HuiminHsieh"},"attachments":[{"id":39731102,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731102/thumbnails/1.jpg","file_name":"Did_Budget_Cuts_in_Medicaid_Disproportio20151105-31826-iwy7np.pdf","download_url":"https://www.academia.edu/attachments/39731102/download_file","bulk_download_file_name":"Did_Budget_Cuts_in_Medicaid_Disproportio.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731102/Did_Budget_Cuts_in_Medicaid_Disproportio20151105-31826-iwy7np-libre.pdf?1446762858=\u0026response-content-disposition=attachment%3B+filename%3DDid_Budget_Cuts_in_Medicaid_Disproportio.pdf\u0026Expires=1743441979\u0026Signature=PzvLGtx37DhH06A0yup8KdUkrpmeWm2ZoGrp-Izx7Sma0rQH-GhJ-0-E~chuRSy8kicLwoYtrSXOhKFDjjFKgvEstN02SgeKNUqig8gTAVRoq~DGBTusZoWFWvNr2HolVEyOnAJai5UCoHj8I2cgynlp34NVYYmqQWBVbG01uKZfDPqihYJSJDiUQTynaiFXesxZHymUN~JHyYzVQnSWbaC8zuHRN4RBc6uIp-YpbyHgm7fINh-di~~SFcAUUMgolrMNqY86zvbDi3WF0IdK9yB7VFDhK8As9YUMY2wNSkLlmL0v6qOsrTr6mFmweSn1dOpN-4dCF8c8w2sdjBPuUw__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":8974,"name":"Quality of Mental Health Care","url":"https://www.academia.edu/Documents/in/Quality_of_Mental_Health_Care"},{"id":16635,"name":"Health Services Research","url":"https://www.academia.edu/Documents/in/Health_Services_Research"},{"id":27659,"name":"Applied Economics","url":"https://www.academia.edu/Documents/in/Applied_Economics"},{"id":37925,"name":"Ownership","url":"https://www.academia.edu/Documents/in/Ownership"},{"id":50113,"name":"California","url":"https://www.academia.edu/Documents/in/California"},{"id":84107,"name":"Hospital administration","url":"https://www.academia.edu/Documents/in/Hospital_administration"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":219645,"name":"Medical Care","url":"https://www.academia.edu/Documents/in/Medical_Care"},{"id":235072,"name":"Medicaid","url":"https://www.academia.edu/Documents/in/Medicaid"},{"id":386976,"name":"Budgets","url":"https://www.academia.edu/Documents/in/Budgets"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17825696-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17825694"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/17825694/The_Effects_of_Safety_Net_Hospital_Closures_and_Conversions_on_Patient_Travel_Distance_to_Hospital_Services"><img alt="Research paper thumbnail of The Effects of Safety Net Hospital Closures and Conversions on Patient Travel Distance to Hospital Services" class="work-thumbnail" src="https://attachments.academia-assets.com/39731101/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/17825694/The_Effects_of_Safety_Net_Hospital_Closures_and_Conversions_on_Patient_Travel_Distance_to_Hospital_Services">The Effects of Safety Net Hospital Closures and Conversions on Patient Travel Distance to Hospital Services</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/HuiminHsieh">Hui-min Hsieh</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Health Services Research</span><span>, 2012</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Objective-To examine the effects of safety net hospital (SNH) closure and for-profit conversion o...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Objective-To examine the effects of safety net hospital (SNH) closure and for-profit conversion on uninsured, Medicaid, and racial/ethnic minorities.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="3bbfc96fd32626bb2cf8b5c533797da0" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":39731101,"asset_id":17825694,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/39731101/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825694"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825694"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825694; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825694]").text(description); $(".js-view-count[data-work-id=17825694]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825694; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825694']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "3bbfc96fd32626bb2cf8b5c533797da0" } } $('.js-work-strip[data-work-id=17825694]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825694,"title":"The Effects of Safety Net Hospital Closures and Conversions on Patient Travel Distance to Hospital Services","translated_title":"","metadata":{"ai_title_tag":"Impact of Safety Net Hospital Closures on Patient Access","grobid_abstract":"Objective-To examine the effects of safety net hospital (SNH) closure and for-profit conversion on uninsured, Medicaid, and racial/ethnic minorities.","publication_date":{"day":null,"month":null,"year":2012,"errors":{}},"publication_name":"Health Services Research","grobid_abstract_attachment_id":39731101},"translated_abstract":null,"internal_url":"https://www.academia.edu/17825694/The_Effects_of_Safety_Net_Hospital_Closures_and_Conversions_on_Patient_Travel_Distance_to_Hospital_Services","translated_internal_url":"","created_at":"2015-11-05T14:31:16.198-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745062,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863438,"work_id":17825694,"tagging_user_id":37745062,"tagged_user_id":null,"co_author_invite_id":2001862,"email":"l***y@rti.org","display_order":0,"name":"Lee Mobley","title":"The Effects of Safety Net Hospital Closures and Conversions on Patient Travel Distance to Hospital Services"},{"id":8863462,"work_id":17825694,"tagging_user_id":37745062,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":4194304,"name":"Gloria Bazzoli","title":"The Effects of Safety Net Hospital Closures and Conversions on Patient Travel Distance to Hospital Services"}],"downloadable_attachments":[{"id":39731101,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731101/thumbnails/1.jpg","file_name":"The_Effects_of_Safety_Net_Hospital_Closu20151105-863-d9cbx8.pdf","download_url":"https://www.academia.edu/attachments/39731101/download_file","bulk_download_file_name":"The_Effects_of_Safety_Net_Hospital_Closu.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731101/The_Effects_of_Safety_Net_Hospital_Closu20151105-863-d9cbx8-libre.pdf?1446762861=\u0026response-content-disposition=attachment%3B+filename%3DThe_Effects_of_Safety_Net_Hospital_Closu.pdf\u0026Expires=1743441979\u0026Signature=f1bA4nkBuoZDThgruxZGzBR8Rk30HaIpGPOGRZMF8H1WVsy7RLAtYQnSoj~ymc~cmVcaBPJ7H-ubUaWxbYbijcmS1cfd0649GT11gYH159e6BSRJyTZY4eIawt9aC4IYv8ZfiaZPezGj2SSNvzwle3GfXzVPzrgTM3OU1CZ-DSofDWsdnPygpbqeH9ZUy4~8~JepL2Vz~pAJ8aVlGzxC74I00mrYngX4A0TBnMkPsw2Xu5-i6FhaFnpAFKypNXvMcehQ~D~UVVJjLz~xUhELcJl901P94HsXBjXNZP7H0fKeaXeI5BklBEbDnir~R0aU-2m6z24daorh1Z5JpuNhTQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"The_Effects_of_Safety_Net_Hospital_Closures_and_Conversions_on_Patient_Travel_Distance_to_Hospital_Services","translated_slug":"","page_count":20,"language":"en","content_type":"Work","summary":"Objective-To examine the effects of safety net hospital (SNH) closure and for-profit conversion on uninsured, Medicaid, and racial/ethnic minorities.","owner":{"id":37745062,"first_name":"Hui-min","middle_initials":null,"last_name":"Hsieh","page_name":"HuiminHsieh","domain_name":"independent","created_at":"2015-11-05T14:30:24.279-08:00","display_name":"Hui-min Hsieh","url":"https://independent.academia.edu/HuiminHsieh"},"attachments":[{"id":39731101,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731101/thumbnails/1.jpg","file_name":"The_Effects_of_Safety_Net_Hospital_Closu20151105-863-d9cbx8.pdf","download_url":"https://www.academia.edu/attachments/39731101/download_file","bulk_download_file_name":"The_Effects_of_Safety_Net_Hospital_Closu.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731101/The_Effects_of_Safety_Net_Hospital_Closu20151105-863-d9cbx8-libre.pdf?1446762861=\u0026response-content-disposition=attachment%3B+filename%3DThe_Effects_of_Safety_Net_Hospital_Closu.pdf\u0026Expires=1743441979\u0026Signature=f1bA4nkBuoZDThgruxZGzBR8Rk30HaIpGPOGRZMF8H1WVsy7RLAtYQnSoj~ymc~cmVcaBPJ7H-ubUaWxbYbijcmS1cfd0649GT11gYH159e6BSRJyTZY4eIawt9aC4IYv8ZfiaZPezGj2SSNvzwle3GfXzVPzrgTM3OU1CZ-DSofDWsdnPygpbqeH9ZUy4~8~JepL2Vz~pAJ8aVlGzxC74I00mrYngX4A0TBnMkPsw2Xu5-i6FhaFnpAFKypNXvMcehQ~D~UVVJjLz~xUhELcJl901P94HsXBjXNZP7H0fKeaXeI5BklBEbDnir~R0aU-2m6z24daorh1Z5JpuNhTQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":37772,"name":"Hospitals","url":"https://www.academia.edu/Documents/in/Hospitals"},{"id":41482,"name":"Multivariate Analysis","url":"https://www.academia.edu/Documents/in/Multivariate_Analysis"},{"id":83471,"name":"Health Services","url":"https://www.academia.edu/Documents/in/Health_Services"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":235072,"name":"Medicaid","url":"https://www.academia.edu/Documents/in/Medicaid"},{"id":289271,"name":"Aged","url":"https://www.academia.edu/Documents/in/Aged"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17825694-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17825692"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/17825692/Hospital_Financial_Conditions_and_the_Provision_of_Unprofitable_Services"><img alt="Research paper thumbnail of Hospital Financial Conditions and the Provision of Unprofitable Services" class="work-thumbnail" src="https://attachments.academia-assets.com/39731140/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/17825692/Hospital_Financial_Conditions_and_the_Provision_of_Unprofitable_Services">Hospital Financial Conditions and the Provision of Unprofitable Services</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/HuiminHsieh">Hui-min Hsieh</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Atlantic Economic Journal</span><span>, 2009</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Increases in hospital financial pressure resulting from public and private payment policy may sub...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Increases in hospital financial pressure resulting from public and private payment policy may substantially reduce a hospital's ability to provide certain services that are not well compensated or are frequently used by the uninsured. The objective of this study is to examine the impact of hospital financial condition on the provision of these unprofitable services for the insured and uninsured. Economic theory provides the conceptual underpinnings for the analysis, and a longitudinal empirical analysis is conducted for an eight-year study period. The results indicate that not-for-profit hospitals with strong financial performance provide more unprofitable services for the insured and uninsured than do not-for-profit hospitals with weaker condition. Forprofit hospital provision of these services is not influenced by their financial condition and instead may reflect actions to meet community expectations or to offer a sufficiently broad service array to maintain the business of insured patients.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="d344c1f5ccda6f475247b1b05430f32e" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":39731140,"asset_id":17825692,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/39731140/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17825692"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17825692"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17825692; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17825692]").text(description); $(".js-view-count[data-work-id=17825692]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17825692; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17825692']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "d344c1f5ccda6f475247b1b05430f32e" } } $('.js-work-strip[data-work-id=17825692]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17825692,"title":"Hospital Financial Conditions and the Provision of Unprofitable Services","translated_title":"","metadata":{"grobid_abstract":"Increases in hospital financial pressure resulting from public and private payment policy may substantially reduce a hospital's ability to provide certain services that are not well compensated or are frequently used by the uninsured. The objective of this study is to examine the impact of hospital financial condition on the provision of these unprofitable services for the insured and uninsured. Economic theory provides the conceptual underpinnings for the analysis, and a longitudinal empirical analysis is conducted for an eight-year study period. The results indicate that not-for-profit hospitals with strong financial performance provide more unprofitable services for the insured and uninsured than do not-for-profit hospitals with weaker condition. Forprofit hospital provision of these services is not influenced by their financial condition and instead may reflect actions to meet community expectations or to offer a sufficiently broad service array to maintain the business of insured patients.","publication_date":{"day":null,"month":null,"year":2009,"errors":{}},"publication_name":"Atlantic Economic Journal","grobid_abstract_attachment_id":39731140},"translated_abstract":null,"internal_url":"https://www.academia.edu/17825692/Hospital_Financial_Conditions_and_the_Provision_of_Unprofitable_Services","translated_internal_url":"","created_at":"2015-11-05T14:31:15.991-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37745062,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8863436,"work_id":17825692,"tagging_user_id":37745062,"tagged_user_id":null,"co_author_invite_id":1960824,"email":"h***n@unthsc.edu","display_order":0,"name":"Hsueh-fen Chen","title":"Hospital Financial Conditions and the Provision of Unprofitable Services"},{"id":8863461,"work_id":17825692,"tagging_user_id":37745062,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":4194304,"name":"Gloria Bazzoli","title":"Hospital Financial Conditions and the Provision of Unprofitable Services"}],"downloadable_attachments":[{"id":39731140,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731140/thumbnails/1.jpg","file_name":"Hospital_Financial_Conditions_and_the_Pr20151105-20592-1a5zih8.pdf","download_url":"https://www.academia.edu/attachments/39731140/download_file","bulk_download_file_name":"Hospital_Financial_Conditions_and_the_Pr.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731140/Hospital_Financial_Conditions_and_the_Pr20151105-20592-1a5zih8-libre.pdf?1446764887=\u0026response-content-disposition=attachment%3B+filename%3DHospital_Financial_Conditions_and_the_Pr.pdf\u0026Expires=1743441979\u0026Signature=LZJ8KCn7tudMEuRudW3xOkvkzp9i8mIMvZ3AedPRY1dKoLJe104FzT39K6lrSTIB8iTQHg4FN9ezA0xVR6JzVjXeRjQAioUalpdTXPvoM4nMwhslVrHzr86~sJOxMl71p6rodtSmIir7tPxNvY5eoD7nDLe9dvU1raM1gNMH7E-jczft9YzpVMASteRFDAo6t8C3gbhEdTMUzVqtxrLbOlvIy1TGKXCul11c5y98c6~vRsr1QTO9~yy8yNxrXv6qONjMPedrrJOliWCKYSIaVdOU5bu~viLY9lwDgR5Uo4VtVr7uJWtF0meVevFqe6luT9FI8Pj8TpqnvlFhVjplqQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Hospital_Financial_Conditions_and_the_Provision_of_Unprofitable_Services","translated_slug":"","page_count":19,"language":"en","content_type":"Work","summary":"Increases in hospital financial pressure resulting from public and private payment policy may substantially reduce a hospital's ability to provide certain services that are not well compensated or are frequently used by the uninsured. The objective of this study is to examine the impact of hospital financial condition on the provision of these unprofitable services for the insured and uninsured. Economic theory provides the conceptual underpinnings for the analysis, and a longitudinal empirical analysis is conducted for an eight-year study period. The results indicate that not-for-profit hospitals with strong financial performance provide more unprofitable services for the insured and uninsured than do not-for-profit hospitals with weaker condition. Forprofit hospital provision of these services is not influenced by their financial condition and instead may reflect actions to meet community expectations or to offer a sufficiently broad service array to maintain the business of insured patients.","owner":{"id":37745062,"first_name":"Hui-min","middle_initials":null,"last_name":"Hsieh","page_name":"HuiminHsieh","domain_name":"independent","created_at":"2015-11-05T14:30:24.279-08:00","display_name":"Hui-min Hsieh","url":"https://independent.academia.edu/HuiminHsieh"},"attachments":[{"id":39731140,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/39731140/thumbnails/1.jpg","file_name":"Hospital_Financial_Conditions_and_the_Pr20151105-20592-1a5zih8.pdf","download_url":"https://www.academia.edu/attachments/39731140/download_file","bulk_download_file_name":"Hospital_Financial_Conditions_and_the_Pr.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/39731140/Hospital_Financial_Conditions_and_the_Pr20151105-20592-1a5zih8-libre.pdf?1446764887=\u0026response-content-disposition=attachment%3B+filename%3DHospital_Financial_Conditions_and_the_Pr.pdf\u0026Expires=1743441979\u0026Signature=LZJ8KCn7tudMEuRudW3xOkvkzp9i8mIMvZ3AedPRY1dKoLJe104FzT39K6lrSTIB8iTQHg4FN9ezA0xVR6JzVjXeRjQAioUalpdTXPvoM4nMwhslVrHzr86~sJOxMl71p6rodtSmIir7tPxNvY5eoD7nDLe9dvU1raM1gNMH7E-jczft9YzpVMASteRFDAo6t8C3gbhEdTMUzVqtxrLbOlvIy1TGKXCul11c5y98c6~vRsr1QTO9~yy8yNxrXv6qONjMPedrrJOliWCKYSIaVdOU5bu~viLY9lwDgR5Uo4VtVr7uJWtF0meVevFqe6luT9FI8Pj8TpqnvlFhVjplqQ__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":724,"name":"Economics","url":"https://www.academia.edu/Documents/in/Economics"},{"id":6208,"name":"Economic Theory","url":"https://www.academia.edu/Documents/in/Economic_Theory"},{"id":184586,"name":"Financial Performance","url":"https://www.academia.edu/Documents/in/Financial_Performance"},{"id":395436,"name":"Not for profit","url":"https://www.academia.edu/Documents/in/Not_for_profit"},{"id":993329,"name":"Empirical Analysis","url":"https://www.academia.edu/Documents/in/Empirical_Analysis"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17825692-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17815064"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/17815064/The_effect_of_changing_state_health_policy_on_hospital_uncompensated_care"><img alt="Research paper thumbnail of The effect of changing state health policy on hospital uncompensated care" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">The effect of changing state health policy on hospital uncompensated care</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenZuckerman">Stephen Zuckerman</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Inquiry : a journal of medical care organization, provision and financing</span><span>, 2000</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">This paper examines the effect of changing state policy, such as Medicaid eligibility, payment ge...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">This paper examines the effect of changing state policy, such as Medicaid eligibility, payment generosity, and HMO enrollment on provision of hospital uncompensated care. Using national data from the American Hospital Association for the period 1990 through 1995, we find that not-for-profit and public hospitals&#39; uncompensated care levels respond positively to Medicaid payment generosity, although the magnitude of the effect is small. Not-for-profit hospitals respond negatively to Medicaid HMO penetration. Public and for-profit hospitals respond negatively to increases in Medicaid eligibility. Results suggest that public insurance payment generosity is an effective but inefficient policy instrument for influencing uncompensated care among not-for-profit hospitals. Further, in localities with high HMO penetration or high penetration of for-profit hospitals, it may be necessary to establish explicit payments for care of the uninsured.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17815064"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17815064"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17815064; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17815064]").text(description); $(".js-view-count[data-work-id=17815064]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17815064; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17815064']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=17815064]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17815064,"title":"The effect of changing state health policy on hospital uncompensated care","translated_title":"","metadata":{"abstract":"This paper examines the effect of changing state policy, such as Medicaid eligibility, payment generosity, and HMO enrollment on provision of hospital uncompensated care. Using national data from the American Hospital Association for the period 1990 through 1995, we find that not-for-profit and public hospitals\u0026#39; uncompensated care levels respond positively to Medicaid payment generosity, although the magnitude of the effect is small. Not-for-profit hospitals respond negatively to Medicaid HMO penetration. Public and for-profit hospitals respond negatively to increases in Medicaid eligibility. Results suggest that public insurance payment generosity is an effective but inefficient policy instrument for influencing uncompensated care among not-for-profit hospitals. Further, in localities with high HMO penetration or high penetration of for-profit hospitals, it may be necessary to establish explicit payments for care of the uninsured.","publication_date":{"day":null,"month":null,"year":2000,"errors":{}},"publication_name":"Inquiry : a journal of medical care organization, provision and financing"},"translated_abstract":"This paper examines the effect of changing state policy, such as Medicaid eligibility, payment generosity, and HMO enrollment on provision of hospital uncompensated care. Using national data from the American Hospital Association for the period 1990 through 1995, we find that not-for-profit and public hospitals\u0026#39; uncompensated care levels respond positively to Medicaid payment generosity, although the magnitude of the effect is small. Not-for-profit hospitals respond negatively to Medicaid HMO penetration. Public and for-profit hospitals respond negatively to increases in Medicaid eligibility. Results suggest that public insurance payment generosity is an effective but inefficient policy instrument for influencing uncompensated care among not-for-profit hospitals. Further, in localities with high HMO penetration or high penetration of for-profit hospitals, it may be necessary to establish explicit payments for care of the uninsured.","internal_url":"https://www.academia.edu/17815064/The_effect_of_changing_state_health_policy_on_hospital_uncompensated_care","translated_internal_url":"","created_at":"2015-11-05T12:18:24.960-08:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":37738526,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":8842721,"work_id":17815064,"tagging_user_id":37738526,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"The effect of changing state health policy on hospital uncompensated care"},{"id":8842723,"work_id":17815064,"tagging_user_id":37738526,"tagged_user_id":null,"co_author_invite_id":1996647,"email":"a***f@ahrq.hhs.gov","display_order":4194304,"name":"A. Davidoff","title":"The effect of changing state health policy on hospital uncompensated care"},{"id":8842725,"work_id":17815064,"tagging_user_id":37738526,"tagged_user_id":null,"co_author_invite_id":1960815,"email":"a***s@gmail.com","display_order":6291456,"name":"A. Losasso","title":"The effect of changing state health policy on hospital uncompensated care"}],"downloadable_attachments":[],"slug":"The_effect_of_changing_state_health_policy_on_hospital_uncompensated_care","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"This paper examines the effect of changing state policy, such as Medicaid eligibility, payment generosity, and HMO enrollment on provision of hospital uncompensated care. Using national data from the American Hospital Association for the period 1990 through 1995, we find that not-for-profit and public hospitals\u0026#39; uncompensated care levels respond positively to Medicaid payment generosity, although the magnitude of the effect is small. Not-for-profit hospitals respond negatively to Medicaid HMO penetration. Public and for-profit hospitals respond negatively to increases in Medicaid eligibility. Results suggest that public insurance payment generosity is an effective but inefficient policy instrument for influencing uncompensated care among not-for-profit hospitals. Further, in localities with high HMO penetration or high penetration of for-profit hospitals, it may be necessary to establish explicit payments for care of the uninsured.","owner":{"id":37738526,"first_name":"Stephen","middle_initials":null,"last_name":"Zuckerman","page_name":"StephenZuckerman","domain_name":"independent","created_at":"2015-11-05T12:17:57.305-08:00","display_name":"Stephen Zuckerman","url":"https://independent.academia.edu/StephenZuckerman"},"attachments":[],"research_interests":[{"id":16635,"name":"Health Services Research","url":"https://www.academia.edu/Documents/in/Health_Services_Research"},{"id":17969,"name":"Health Policy","url":"https://www.academia.edu/Documents/in/Health_Policy"},{"id":37925,"name":"Ownership","url":"https://www.academia.edu/Documents/in/Ownership"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":235072,"name":"Medicaid","url":"https://www.academia.edu/Documents/in/Medicaid"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":458190,"name":"Organizational Innovation","url":"https://www.academia.edu/Documents/in/Organizational_Innovation"},{"id":579119,"name":"Marketing of Health Services","url":"https://www.academia.edu/Documents/in/Marketing_of_Health_Services"},{"id":849052,"name":"Public Art Hospitals","url":"https://www.academia.edu/Documents/in/Public_Art_Hospitals"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17815064-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17008511"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/17008511/Variations_in_Inpatient_Mortality_Among_Hospitals_in_Different_System_Types_1995_to_2000"><img alt="Research paper thumbnail of Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/DavidHarless">David Harless</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/AskarChukmaitov">Askar Chukmaitov</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Medical Care</span><span>, 2009</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Relatively few studies focused on the impact of system formation and hospital merger on quality, ...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Relatively few studies focused on the impact of system formation and hospital merger on quality, and these studies reported typically little or no quality effect. To study associations among 5 main types of health systems--centralized, centralized physician/insurance, moderately centralized, decentralized, and independent--and inpatient mortality from acute myocardial infarction (AMI), congestive heart failure, stroke, and pneumonia. Panel data (1995-2000) were assembled from 11 states and multiple sources: Agency for Healthcare Research and Quality State Inpatient Database, American Hospital Association Annual Surveys, Area Resource File, HMO InterStudy, and the Centers for Medicare and Medicaid Services. We applied a panel study design with fixed effects models using information on variation within hospitals. We found that centralized health systems are associated with lower AMI, congestive heart failure, and pneumonia mortality. Independent hospital systems had better AMI quality outcomes than centralized physician/insurance and moderately centralized health systems. We found no difference in inpatient mortality among system types for the stroke outcome. Thus, for certain types of clinical service lines and patients, hospital system type matters. Research that focuses only on system membership may mask the impact of system type on the quality of care.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17008511"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17008511"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17008511; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17008511]").text(description); $(".js-view-count[data-work-id=17008511]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17008511; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17008511']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=17008511]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17008511,"title":"Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000","translated_title":"","metadata":{"abstract":"Relatively few studies focused on the impact of system formation and hospital merger on quality, and these studies reported typically little or no quality effect. To study associations among 5 main types of health systems--centralized, centralized physician/insurance, moderately centralized, decentralized, and independent--and inpatient mortality from acute myocardial infarction (AMI), congestive heart failure, stroke, and pneumonia. Panel data (1995-2000) were assembled from 11 states and multiple sources: Agency for Healthcare Research and Quality State Inpatient Database, American Hospital Association Annual Surveys, Area Resource File, HMO InterStudy, and the Centers for Medicare and Medicaid Services. We applied a panel study design with fixed effects models using information on variation within hospitals. We found that centralized health systems are associated with lower AMI, congestive heart failure, and pneumonia mortality. Independent hospital systems had better AMI quality outcomes than centralized physician/insurance and moderately centralized health systems. We found no difference in inpatient mortality among system types for the stroke outcome. Thus, for certain types of clinical service lines and patients, hospital system type matters. Research that focuses only on system membership may mask the impact of system type on the quality of care.","publication_date":{"day":null,"month":null,"year":2009,"errors":{}},"publication_name":"Medical Care"},"translated_abstract":"Relatively few studies focused on the impact of system formation and hospital merger on quality, and these studies reported typically little or no quality effect. To study associations among 5 main types of health systems--centralized, centralized physician/insurance, moderately centralized, decentralized, and independent--and inpatient mortality from acute myocardial infarction (AMI), congestive heart failure, stroke, and pneumonia. Panel data (1995-2000) were assembled from 11 states and multiple sources: Agency for Healthcare Research and Quality State Inpatient Database, American Hospital Association Annual Surveys, Area Resource File, HMO InterStudy, and the Centers for Medicare and Medicaid Services. We applied a panel study design with fixed effects models using information on variation within hospitals. We found that centralized health systems are associated with lower AMI, congestive heart failure, and pneumonia mortality. Independent hospital systems had better AMI quality outcomes than centralized physician/insurance and moderately centralized health systems. We found no difference in inpatient mortality among system types for the stroke outcome. Thus, for certain types of clinical service lines and patients, hospital system type matters. Research that focuses only on system membership may mask the impact of system type on the quality of care.","internal_url":"https://www.academia.edu/17008511/Variations_in_Inpatient_Mortality_Among_Hospitals_in_Different_System_Types_1995_to_2000","translated_internal_url":"","created_at":"2015-10-19T13:32:49.657-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":36547483,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":7563932,"work_id":17008511,"tagging_user_id":36547483,"tagged_user_id":36698468,"co_author_invite_id":1690080,"email":"a***v@vcu.edu","display_order":0,"name":"Askar Chukmaitov","title":"Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000"},{"id":7563935,"work_id":17008511,"tagging_user_id":36547483,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":4194304,"name":"Gloria Bazzoli","title":"Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000"},{"id":7563955,"work_id":17008511,"tagging_user_id":36547483,"tagged_user_id":null,"co_author_invite_id":1690087,"email":"k***s@vcu.edu","display_order":6291456,"name":"K. Devers","title":"Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000"},{"id":7563959,"work_id":17008511,"tagging_user_id":36547483,"tagged_user_id":null,"co_author_invite_id":1690091,"email":"r***y@hsc.vcu.edu","display_order":7340032,"name":"Robert Hurley","title":"Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000"},{"id":7563960,"work_id":17008511,"tagging_user_id":36547483,"tagged_user_id":null,"co_author_invite_id":1690092,"email":"m***o@pku.edu.cn","display_order":7864320,"name":"Mei Zhao","title":"Variations in Inpatient Mortality Among Hospitals in Different System Types, 1995 to 2000"}],"downloadable_attachments":[],"slug":"Variations_in_Inpatient_Mortality_Among_Hospitals_in_Different_System_Types_1995_to_2000","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Relatively few studies focused on the impact of system formation and hospital merger on quality, and these studies reported typically little or no quality effect. To study associations among 5 main types of health systems--centralized, centralized physician/insurance, moderately centralized, decentralized, and independent--and inpatient mortality from acute myocardial infarction (AMI), congestive heart failure, stroke, and pneumonia. Panel data (1995-2000) were assembled from 11 states and multiple sources: Agency for Healthcare Research and Quality State Inpatient Database, American Hospital Association Annual Surveys, Area Resource File, HMO InterStudy, and the Centers for Medicare and Medicaid Services. We applied a panel study design with fixed effects models using information on variation within hospitals. We found that centralized health systems are associated with lower AMI, congestive heart failure, and pneumonia mortality. Independent hospital systems had better AMI quality outcomes than centralized physician/insurance and moderately centralized health systems. We found no difference in inpatient mortality among system types for the stroke outcome. Thus, for certain types of clinical service lines and patients, hospital system type matters. Research that focuses only on system membership may mask the impact of system type on the quality of care.","owner":{"id":36547483,"first_name":"David","middle_initials":null,"last_name":"Harless","page_name":"DavidHarless","domain_name":"vcu","created_at":"2015-10-19T13:28:04.248-07:00","display_name":"David Harless","url":"https://vcu.academia.edu/DavidHarless"},"attachments":[],"research_interests":[{"id":8974,"name":"Quality of Mental Health Care","url":"https://www.academia.edu/Documents/in/Quality_of_Mental_Health_Care"},{"id":27659,"name":"Applied Economics","url":"https://www.academia.edu/Documents/in/Applied_Economics"},{"id":49633,"name":"Heart Failure","url":"https://www.academia.edu/Documents/in/Heart_Failure"},{"id":61234,"name":"Stroke","url":"https://www.academia.edu/Documents/in/Stroke"},{"id":84107,"name":"Hospital administration","url":"https://www.academia.edu/Documents/in/Hospital_administration"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":111112,"name":"Pneumonia","url":"https://www.academia.edu/Documents/in/Pneumonia"},{"id":219645,"name":"Medical Care","url":"https://www.academia.edu/Documents/in/Medical_Care"},{"id":378016,"name":"Myocardial Infarction","url":"https://www.academia.edu/Documents/in/Myocardial_Infarction"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":901284,"name":"Hospital Mortality","url":"https://www.academia.edu/Documents/in/Hospital_Mortality"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17008511-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17008490"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/17008490/Delivery_system_characteristics_and_their_association_with_quality_and_costs_of_care"><img alt="Research paper thumbnail of Delivery system characteristics and their association with quality and costs of care" class="work-thumbnail" src="https://attachments.academia-assets.com/42360150/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/17008490/Delivery_system_characteristics_and_their_association_with_quality_and_costs_of_care">Delivery system characteristics and their association with quality and costs of care</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/DavidHarless">David Harless</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/AskarChukmaitov">Askar Chukmaitov</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Health Care Management Review</span><span>, 2014</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Background Implementation of accountable care organizations (ACOs) is currently underway, but the...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Background Implementation of accountable care organizations (ACOs) is currently underway, but there is limited empirical evidence on the merits of the ACO model. Purpose The aim was to study the associations between delivery system characteristics and ACO competencies, including centralization strategies to manage organizations, hospital integration with physicians and outpatient facilities, health information technology, infrastructure to monitor community health and report quality, and risk-adjusted 30-day all-cause mortality and case-mixed-adjusted inpatient costs for the Medicare population. Methodology Panel data (2006Y2009) were assembled from Florida and multiple sources: inpatient hospital discharge, vital statistics, the American Hospital Association, the Healthcare Information and Management Systems Society, and other databases. We applied a panel study design, controlling for hospital and market characteristics. Principal Findings Hospitals that were in centralized health systems or became more centralized over the study period had significantly larger reductions in mortality compared with hospitals that remained freestanding. Surprisingly, tightly integrated hospitalYphysician arrangements were associated with increased mortality; as such, hospitals may wish to proceed cautiously when developing specific types of alignment with local physician organizations. We observed no statistically significant differences in the growth rate of costs across hospitals in any of the health systems studied relative to freestanding hospitals. Although we observed quality improvement in some organizational types, these outcome improvements were not coupled with the additional desired objective of lower cost growth. This implies that additional changes not present during our study period, potentially changes in provider payment approaches, are essential for achieving the ACO objectives of higher quality of care at lower costs. Practice Implications Provider organizations implementing ACOs should consider centralizing service delivery as a viable strategy to improve quality of care, although the strategy did not result in lower cost growth.</span></div><div class="wp-workCard_item"><div class="carousel-container carousel-container--sm" id="profile-work-17008490-figures"><div class="prev-slide-container js-prev-button-container"><button aria-label="Previous" class="carousel-navigation-button js-profile-work-17008490-figures-prev"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">arrow_back_ios</span></button></div><div class="slides-container js-slides-container"><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/33828443/figure-1-percentage-changes-in-mortality-and-cost"><img alt="percentage changes in mortality and cost* " class="figure-slide-image" src="https://figures.academia-assets.com/42360150/figure_001.jpg" /></a></figure><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/33828453/table-1-note-aco-accouncare-organization-hit-health"><img alt="Note. ACO = accountable care organization; HIT = health information technology; EHR = electronic health records. Accountable care organization thought-leaders have sug- gested that integrated delivery systems may serve as effective platforms for ACO development (Devers & Berenson, 2009; Fisher & Shortell, 2010; Fisher et al., 2012; McClellan et al., 2010). However, not all health systems are alike, with some having highly centralized and integrated structures while others are decentralized (Bazzoli Bazzoli, Shortell, Dubbs, Chan, & Kralovec, 1999). Survey research by Alexander, Lee, and Bazzoli (2003) found that governance attributes of centralized health systems (CHSs) were characterized by higher levels of administrative intensity, higher levels of decision-making authority concentrated at the system level, and more board representation of affiliate members when compared with decentralized systems. Centralized decision making and representative governance may allow for more effective management of task interdependence and more coordinated communication across system participants than would arise in decentralized systems. Early evidence from ACO pilots suggested that committed executive leadership and strong governance are major facilitators of ACO for- mation by promoting development of shared aims, resource prioritization, and coordinated response to transformational challenges (Larson et al., 2012). Case studies of ACO pilots showed that hospital systems were engaged in a broad array of care management and care coordination services (Larson etal., 2012). Chukmaitov et al. (2009) found that hospitals in CHSs had lower inpatient mortalities in comparison with hospitals in other system types. As such, more CHSs, due to high levels of administrative capacity and decision- making authority at the system level, may be more effective in coordinating and diffusing disease management protocols across their members. Other mechanisms, such as alignment of economic and noneconomic incentives, adoption of evidence-based medicine, and decisions to develop centers for clinical excellence that improve processes of care deliv- ery, may stem from centralized governance and leadership of hospital-led health systems. As such, more centralized structures may be conducive to achieving ACO goals, and we therefore hypothesize: " class="figure-slide-image" src="https://figures.academia-assets.com/42360150/table_001.jpg" /></a></figure><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/33828463/table-2-note-data-are-presented-as-sd-fh-freestanding"><img alt="Note. Data are presented as M (SD). FH = freestanding hospital; IHS = independent hospital system; DHS = decentralized health system; MCHS moderately centralized health system; CHPIHS = centralized health and physician—insurance system; POA = physician—-organization arrangemer HIT = health information technology; HMO = health management organization; HHI, herfindah|-hirschman index. lote. Data are presented as M (SD). FH = freestanding hospital; IHS = independent hospital system; DHS = decentralized health system; MCHS 1oderately centralized health system; CHPIHS = centralized health and physician—insurance system; POA = physician—-organization arrangemen IT = health information technology; HMO = health management organization; HHI, herfindahl-hirschman index. Column summarizes the results of test of the null hypothesis of equality of means across the five categories of system type for each variable. p <.05. " class="figure-slide-image" src="https://figures.academia-assets.com/42360150/table_002.jpg" /></a></figure><figure class="figure-slide-container"><a href="https://www.academia.edu/figures/33828475/table-4-note-ihs-independent-hospital-system-dhs"><img alt="Note. IHS = independent hospital system; DHS = decentralized health system; MCHS = moderately centralized health system; CHPIHS = centralized health and physician—insurance system; POA = physician-hospital arrangement; HIT = health information technology; HMO = health management organization; HHI, herfindahl-hirschman index. *Consistent with the definitions in Table 4, the binary variables for system status (IHS, DHS, MCHS, and CHPIHS) indicate system status o hospitals that had the same system status in 2009 as in 2006. Similarly, the binary variables more and less indicate whether hospitals ar more or less centralized in 2009 versus 2006. " class="figure-slide-image" src="https://figures.academia-assets.com/42360150/table_003.jpg" /></a></figure></div><div class="next-slide-container js-next-button-container"><button aria-label="Next" class="carousel-navigation-button js-profile-work-17008490-figures-next"><span class="material-symbols-outlined" style="font-size: 24px" translate="no">arrow_forward_ios</span></button></div></div></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="ebc372fc0b4978075e33fc5c22fa586c" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":42360150,"asset_id":17008490,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/42360150/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17008490"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17008490"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17008490; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17008490]").text(description); $(".js-view-count[data-work-id=17008490]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17008490; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17008490']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "ebc372fc0b4978075e33fc5c22fa586c" } } $('.js-work-strip[data-work-id=17008490]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17008490,"title":"Delivery system characteristics and their association with quality and costs of care","translated_title":"","metadata":{"grobid_abstract":"Background Implementation of accountable care organizations (ACOs) is currently underway, but there is limited empirical evidence on the merits of the ACO model. Purpose The aim was to study the associations between delivery system characteristics and ACO competencies, including centralization strategies to manage organizations, hospital integration with physicians and outpatient facilities, health information technology, infrastructure to monitor community health and report quality, and risk-adjusted 30-day all-cause mortality and case-mixed-adjusted inpatient costs for the Medicare population. Methodology Panel data (2006Y2009) were assembled from Florida and multiple sources: inpatient hospital discharge, vital statistics, the American Hospital Association, the Healthcare Information and Management Systems Society, and other databases. We applied a panel study design, controlling for hospital and market characteristics. Principal Findings Hospitals that were in centralized health systems or became more centralized over the study period had significantly larger reductions in mortality compared with hospitals that remained freestanding. Surprisingly, tightly integrated hospitalYphysician arrangements were associated with increased mortality; as such, hospitals may wish to proceed cautiously when developing specific types of alignment with local physician organizations. We observed no statistically significant differences in the growth rate of costs across hospitals in any of the health systems studied relative to freestanding hospitals. Although we observed quality improvement in some organizational types, these outcome improvements were not coupled with the additional desired objective of lower cost growth. This implies that additional changes not present during our study period, potentially changes in provider payment approaches, are essential for achieving the ACO objectives of higher quality of care at lower costs. Practice Implications Provider organizations implementing ACOs should consider centralizing service delivery as a viable strategy to improve quality of care, although the strategy did not result in lower cost growth.","publication_date":{"day":null,"month":null,"year":2014,"errors":{}},"publication_name":"Health Care Management Review","grobid_abstract_attachment_id":42360150},"translated_abstract":null,"internal_url":"https://www.academia.edu/17008490/Delivery_system_characteristics_and_their_association_with_quality_and_costs_of_care","translated_internal_url":"","created_at":"2015-10-19T13:32:47.243-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":36547483,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":7563929,"work_id":17008490,"tagging_user_id":36547483,"tagged_user_id":36698468,"co_author_invite_id":1690080,"email":"a***v@vcu.edu","display_order":0,"name":"Askar Chukmaitov","title":"Delivery system characteristics and their association with quality and costs of care"},{"id":7563933,"work_id":17008490,"tagging_user_id":36547483,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":4194304,"name":"Gloria Bazzoli","title":"Delivery system characteristics and their association with quality and costs of care"},{"id":7563937,"work_id":17008490,"tagging_user_id":36547483,"tagged_user_id":25092276,"co_author_invite_id":null,"email":"h***a@med.fsu.edu","affiliation":"Florida State University","display_order":6291456,"name":"Henry Carretta","title":"Delivery system characteristics and their association with quality and costs of care"},{"id":7563939,"work_id":17008490,"tagging_user_id":36547483,"tagged_user_id":null,"co_author_invite_id":1690081,"email":"s***u@vcu.edu","display_order":7340032,"name":"Umaporn Siangphoe","title":"Delivery system characteristics and their association with quality and costs of care"}],"downloadable_attachments":[{"id":42360150,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/42360150/thumbnails/1.jpg","file_name":"Delivery_system_characteristics_and_thei20160207-17867-1d9t3bd.pdf","download_url":"https://www.academia.edu/attachments/42360150/download_file","bulk_download_file_name":"Delivery_system_characteristics_and_thei.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/42360150/Delivery_system_characteristics_and_thei20160207-17867-1d9t3bd-libre.pdf?1454912263=\u0026response-content-disposition=attachment%3B+filename%3DDelivery_system_characteristics_and_thei.pdf\u0026Expires=1743441980\u0026Signature=gNn~ouovJUI~Zzz3Jgd5wBSpHAM6t7PxBY0w9vK3T2figKZhHlu9zpfcnZLg3sSR2abdNZ4bjTmH2a1QqIczl1qJGxqWzWKZoiSaRjpVWWcgBtahaZGAfV-QnndTgwvUvXNuD5tq0vS1aZXJ8x6Ip9CJ0qhCAo-8qqahU4jRQYsR0HykUBBL1H~5TxHFn5zIETo97XZKZc-2AllLVlq8dZ3IO6TnxdxWh4NJXnH6wMfXWvEQeJIb1w4GfSjQ62w7jAOTT7u5gNBkU19K3JHcEil~mzv~M8UCfPwjcqsgtHpY3byVzo~JtFrQedkzgKVe0ndnmQq4tTI4q7OGBFrtcw__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Delivery_system_characteristics_and_their_association_with_quality_and_costs_of_care","translated_slug":"","page_count":12,"language":"en","content_type":"Work","summary":"Background Implementation of accountable care organizations (ACOs) is currently underway, but there is limited empirical evidence on the merits of the ACO model. Purpose The aim was to study the associations between delivery system characteristics and ACO competencies, including centralization strategies to manage organizations, hospital integration with physicians and outpatient facilities, health information technology, infrastructure to monitor community health and report quality, and risk-adjusted 30-day all-cause mortality and case-mixed-adjusted inpatient costs for the Medicare population. Methodology Panel data (2006Y2009) were assembled from Florida and multiple sources: inpatient hospital discharge, vital statistics, the American Hospital Association, the Healthcare Information and Management Systems Society, and other databases. We applied a panel study design, controlling for hospital and market characteristics. Principal Findings Hospitals that were in centralized health systems or became more centralized over the study period had significantly larger reductions in mortality compared with hospitals that remained freestanding. Surprisingly, tightly integrated hospitalYphysician arrangements were associated with increased mortality; as such, hospitals may wish to proceed cautiously when developing specific types of alignment with local physician organizations. We observed no statistically significant differences in the growth rate of costs across hospitals in any of the health systems studied relative to freestanding hospitals. Although we observed quality improvement in some organizational types, these outcome improvements were not coupled with the additional desired objective of lower cost growth. This implies that additional changes not present during our study period, potentially changes in provider payment approaches, are essential for achieving the ACO objectives of higher quality of care at lower costs. Practice Implications Provider organizations implementing ACOs should consider centralizing service delivery as a viable strategy to improve quality of care, although the strategy did not result in lower cost growth.","owner":{"id":36547483,"first_name":"David","middle_initials":null,"last_name":"Harless","page_name":"DavidHarless","domain_name":"vcu","created_at":"2015-10-19T13:28:04.248-07:00","display_name":"David Harless","url":"https://vcu.academia.edu/DavidHarless"},"attachments":[{"id":42360150,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/42360150/thumbnails/1.jpg","file_name":"Delivery_system_characteristics_and_thei20160207-17867-1d9t3bd.pdf","download_url":"https://www.academia.edu/attachments/42360150/download_file","bulk_download_file_name":"Delivery_system_characteristics_and_thei.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/42360150/Delivery_system_characteristics_and_thei20160207-17867-1d9t3bd-libre.pdf?1454912263=\u0026response-content-disposition=attachment%3B+filename%3DDelivery_system_characteristics_and_thei.pdf\u0026Expires=1743441980\u0026Signature=gNn~ouovJUI~Zzz3Jgd5wBSpHAM6t7PxBY0w9vK3T2figKZhHlu9zpfcnZLg3sSR2abdNZ4bjTmH2a1QqIczl1qJGxqWzWKZoiSaRjpVWWcgBtahaZGAfV-QnndTgwvUvXNuD5tq0vS1aZXJ8x6Ip9CJ0qhCAo-8qqahU4jRQYsR0HykUBBL1H~5TxHFn5zIETo97XZKZc-2AllLVlq8dZ3IO6TnxdxWh4NJXnH6wMfXWvEQeJIb1w4GfSjQ62w7jAOTT7u5gNBkU19K3JHcEil~mzv~M8UCfPwjcqsgtHpY3byVzo~JtFrQedkzgKVe0ndnmQq4tTI4q7OGBFrtcw__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":8974,"name":"Quality of Mental Health Care","url":"https://www.academia.edu/Documents/in/Quality_of_Mental_Health_Care"},{"id":21559,"name":"Health Care Management","url":"https://www.academia.edu/Documents/in/Health_Care_Management"},{"id":24377,"name":"Mortality","url":"https://www.academia.edu/Documents/in/Mortality"},{"id":73149,"name":"Business and Management","url":"https://www.academia.edu/Documents/in/Business_and_Management"},{"id":96680,"name":"Hospital costs","url":"https://www.academia.edu/Documents/in/Hospital_costs"},{"id":110287,"name":"Florida","url":"https://www.academia.edu/Documents/in/Florida"},{"id":405849,"name":"Accountable Care Organizations","url":"https://www.academia.edu/Documents/in/Accountable_Care_Organizations"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":906536,"name":"Health Care Costs","url":"https://www.academia.edu/Documents/in/Health_Care_Costs"}],"urls":[{"id":6552479,"url":"https://www.researchgate.net/profile/Henry_Carretta/publication/260378205_Delivery_system_characteristics_and_their_association_with_quality_and_costs_of_care_Implications_for_accountable_care_organizations/links/54259c730cf26120b7acc547.pdf"}]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (true) { Aedu.setUpFigureCarousel('profile-work-17008490-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="17008499"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/17008499/Is_Quality_of_Cardiac_Hospital_Care_a_Public_or_Private_Good"><img alt="Research paper thumbnail of Is Quality of Cardiac Hospital Care a Public or Private Good?" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Is Quality of Cardiac Hospital Care a Public or Private Good?</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/DavidHarless">David Harless</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>Medical Care</span><span>, 2010</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">There are many studies examining the effects of financial pressure from different payment sources...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">There are many studies examining the effects of financial pressure from different payment sources on hospital quality of care, but most have assumed that quality of care is a public good in that payment changes from one payer will affect all hospital patients rather than just those directly associated with the payer. Although quality of hospital care can be either a public or private good, few studies have tested which of these scenarios are more likely to hold. To examine whether the change in the magnitude of in-hospital mortality for Medicare and managed care patients is different based on financial pressure resulting from the Balanced Budget Act and growing managed care market penetration; and to examine what role hospital competition may play in affecting these changes. The unit of analysis for the study was the hospital. Multiple data sources were used including the Agency for Healthcare Research and Quality State Inpatient Databases, American Hospital Association Annual Surveys, Area Resource File, and health maintenance organization data from InterStudy. A difference-in-difference-in-difference model was applied for a 2-period panel design. In general, Balanced Budget Act financial pressure and managed care market share did not magnify the difference in in-hospital mortality rates between Medicare and managed care patients. The results suggest that quality of cardiac care in the hospital setting is more likely to be a public good; however, more investigation using other quality indicators and the role of hospital competition under different payment systems is recommended.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="17008499"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="17008499"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 17008499; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=17008499]").text(description); $(".js-view-count[data-work-id=17008499]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 17008499; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='17008499']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=17008499]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":17008499,"title":"Is Quality of Cardiac Hospital Care a Public or Private Good?","translated_title":"","metadata":{"abstract":"There are many studies examining the effects of financial pressure from different payment sources on hospital quality of care, but most have assumed that quality of care is a public good in that payment changes from one payer will affect all hospital patients rather than just those directly associated with the payer. Although quality of hospital care can be either a public or private good, few studies have tested which of these scenarios are more likely to hold. To examine whether the change in the magnitude of in-hospital mortality for Medicare and managed care patients is different based on financial pressure resulting from the Balanced Budget Act and growing managed care market penetration; and to examine what role hospital competition may play in affecting these changes. The unit of analysis for the study was the hospital. Multiple data sources were used including the Agency for Healthcare Research and Quality State Inpatient Databases, American Hospital Association Annual Surveys, Area Resource File, and health maintenance organization data from InterStudy. A difference-in-difference-in-difference model was applied for a 2-period panel design. In general, Balanced Budget Act financial pressure and managed care market share did not magnify the difference in in-hospital mortality rates between Medicare and managed care patients. The results suggest that quality of cardiac care in the hospital setting is more likely to be a public good; however, more investigation using other quality indicators and the role of hospital competition under different payment systems is recommended.","publication_date":{"day":null,"month":null,"year":2010,"errors":{}},"publication_name":"Medical Care"},"translated_abstract":"There are many studies examining the effects of financial pressure from different payment sources on hospital quality of care, but most have assumed that quality of care is a public good in that payment changes from one payer will affect all hospital patients rather than just those directly associated with the payer. Although quality of hospital care can be either a public or private good, few studies have tested which of these scenarios are more likely to hold. To examine whether the change in the magnitude of in-hospital mortality for Medicare and managed care patients is different based on financial pressure resulting from the Balanced Budget Act and growing managed care market penetration; and to examine what role hospital competition may play in affecting these changes. The unit of analysis for the study was the hospital. Multiple data sources were used including the Agency for Healthcare Research and Quality State Inpatient Databases, American Hospital Association Annual Surveys, Area Resource File, and health maintenance organization data from InterStudy. A difference-in-difference-in-difference model was applied for a 2-period panel design. In general, Balanced Budget Act financial pressure and managed care market share did not magnify the difference in in-hospital mortality rates between Medicare and managed care patients. The results suggest that quality of cardiac care in the hospital setting is more likely to be a public good; however, more investigation using other quality indicators and the role of hospital competition under different payment systems is recommended.","internal_url":"https://www.academia.edu/17008499/Is_Quality_of_Cardiac_Hospital_Care_a_Public_or_Private_Good","translated_internal_url":"","created_at":"2015-10-19T13:32:48.204-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":36547483,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":7563934,"work_id":17008499,"tagging_user_id":36547483,"tagged_user_id":33441845,"co_author_invite_id":null,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Is Quality of Cardiac Hospital Care a Public or Private Good?"},{"id":7563953,"work_id":17008499,"tagging_user_id":36547483,"tagged_user_id":null,"co_author_invite_id":1626301,"email":"j***t@vcu.edu","display_order":4194304,"name":"Jan Clement","title":"Is Quality of Cardiac Hospital Care a Public or Private Good?"}],"downloadable_attachments":[],"slug":"Is_Quality_of_Cardiac_Hospital_Care_a_Public_or_Private_Good","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"There are many studies examining the effects of financial pressure from different payment sources on hospital quality of care, but most have assumed that quality of care is a public good in that payment changes from one payer will affect all hospital patients rather than just those directly associated with the payer. Although quality of hospital care can be either a public or private good, few studies have tested which of these scenarios are more likely to hold. To examine whether the change in the magnitude of in-hospital mortality for Medicare and managed care patients is different based on financial pressure resulting from the Balanced Budget Act and growing managed care market penetration; and to examine what role hospital competition may play in affecting these changes. The unit of analysis for the study was the hospital. Multiple data sources were used including the Agency for Healthcare Research and Quality State Inpatient Databases, American Hospital Association Annual Surveys, Area Resource File, and health maintenance organization data from InterStudy. A difference-in-difference-in-difference model was applied for a 2-period panel design. In general, Balanced Budget Act financial pressure and managed care market share did not magnify the difference in in-hospital mortality rates between Medicare and managed care patients. The results suggest that quality of cardiac care in the hospital setting is more likely to be a public good; however, more investigation using other quality indicators and the role of hospital competition under different payment systems is recommended.","owner":{"id":36547483,"first_name":"David","middle_initials":null,"last_name":"Harless","page_name":"DavidHarless","domain_name":"vcu","created_at":"2015-10-19T13:28:04.248-07:00","display_name":"David Harless","url":"https://vcu.academia.edu/DavidHarless"},"attachments":[],"research_interests":[{"id":27659,"name":"Applied Economics","url":"https://www.academia.edu/Documents/in/Applied_Economics"},{"id":96680,"name":"Hospital costs","url":"https://www.academia.edu/Documents/in/Hospital_costs"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":218342,"name":"Medicare","url":"https://www.academia.edu/Documents/in/Medicare"},{"id":219645,"name":"Medical Care","url":"https://www.academia.edu/Documents/in/Medical_Care"},{"id":378016,"name":"Myocardial Infarction","url":"https://www.academia.edu/Documents/in/Myocardial_Infarction"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":849052,"name":"Public Art Hospitals","url":"https://www.academia.edu/Documents/in/Public_Art_Hospitals"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-17008499-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15629969"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/15629969/Rejoinder_to_Taxonomy_of_Health_Networks_and_Systems_A_Reassessment"><img alt="Research paper thumbnail of Rejoinder to Taxonomy of Health Networks and Systems: A Reassessment" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Rejoinder to Taxonomy of Health Networks and Systems: A Reassessment</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a></span></div><div class="wp-workCard_item"><span>Health Services Research</span><span>, 2006</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15629969"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15629969"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15629969; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15629969]").text(description); $(".js-view-count[data-work-id=15629969]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15629969; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15629969']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=15629969]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15629969,"title":"Rejoinder to Taxonomy of Health Networks and Systems: A Reassessment","translated_title":"","metadata":{"publication_date":{"day":null,"month":null,"year":2006,"errors":{}},"publication_name":"Health Services Research"},"translated_abstract":null,"internal_url":"https://www.academia.edu/15629969/Rejoinder_to_Taxonomy_of_Health_Networks_and_Systems_A_Reassessment","translated_internal_url":"","created_at":"2015-09-12T10:28:54.778-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762509,"work_id":15629969,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Rejoinder to Taxonomy of Health Networks and Systems: A Reassessment"}],"downloadable_attachments":[],"slug":"Rejoinder_to_Taxonomy_of_Health_Networks_and_Systems_A_Reassessment","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":null,"owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[],"research_interests":[{"id":83471,"name":"Health Services","url":"https://www.academia.edu/Documents/in/Health_Services"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":257181,"name":"Hospital Information Systems","url":"https://www.academia.edu/Documents/in/Hospital_Information_Systems"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":936874,"name":"Bias (Epidemiology)","url":"https://www.academia.edu/Documents/in/Bias_Epidemiology_"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15629969-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15630012"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/15630012/A_SOCIAL_CAPITAL_INDEX_FOR_COMMUNITY_PARTNERSHIPS"><img alt="Research paper thumbnail of A SOCIAL CAPITAL INDEX FOR COMMUNITY PARTNERSHIPS" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">A SOCIAL CAPITAL INDEX FOR COMMUNITY PARTNERSHIPS</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a></span></div><div class="wp-workCard_item"><span>The International Quarterly of Community Health Education</span><span>, 2001</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15630012"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15630012"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15630012; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15630012]").text(description); $(".js-view-count[data-work-id=15630012]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15630012; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15630012']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=15630012]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15630012,"title":"A SOCIAL CAPITAL INDEX FOR COMMUNITY PARTNERSHIPS","translated_title":"","metadata":{"publication_date":{"day":null,"month":null,"year":2001,"errors":{}},"publication_name":"The International Quarterly of Community Health Education"},"translated_abstract":null,"internal_url":"https://www.academia.edu/15630012/A_SOCIAL_CAPITAL_INDEX_FOR_COMMUNITY_PARTNERSHIPS","translated_internal_url":"","created_at":"2015-09-12T10:28:59.560-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762510,"work_id":15630012,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"A SOCIAL CAPITAL INDEX FOR COMMUNITY PARTNERSHIPS"},{"id":5762670,"work_id":15630012,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274837,"email":"r***n@aha.org","display_order":4194304,"name":"Romana Hasnain-wynia","title":"A SOCIAL CAPITAL INDEX FOR COMMUNITY PARTNERSHIPS"}],"downloadable_attachments":[],"slug":"A_SOCIAL_CAPITAL_INDEX_FOR_COMMUNITY_PARTNERSHIPS","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":null,"owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[],"research_interests":[{"id":5745,"name":"Social Capital","url":"https://www.academia.edu/Documents/in/Social_Capital"},{"id":749302,"name":"Indexation","url":"https://www.academia.edu/Documents/in/Indexation"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15630012-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15629966"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/15629966/Reexamining_Organizational_Configurations_An_Update_Validation_and_Expansion_of_the_Taxonomy_of_Health_Networks_and_Systems"><img alt="Research paper thumbnail of Reexamining Organizational Configurations: An Update, Validation, and Expansion of the Taxonomy of Health Networks and Systems" class="work-thumbnail" src="https://attachments.academia-assets.com/43016398/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/15629966/Reexamining_Organizational_Configurations_An_Update_Validation_and_Expansion_of_the_Taxonomy_of_Health_Networks_and_Systems">Reexamining Organizational Configurations: An Update, Validation, and Expansion of the Taxonomy of Health Networks and Systems</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a> and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a></span></div><div class="wp-workCard_item"><span>Health Services Research</span><span>, 2004</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Objectives. To (a) assess how the original cluster categories of hospital-led health networks and...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Objectives. To (a) assess how the original cluster categories of hospital-led health networks and systems have changed over time; (b) identify any new patterns of cluster configurations; and (c) demonstrate how additional data can be used to refine and enhance the taxonomy measures. Data Sources. 1994 and 1998 American Hospital Association (AHA) Annual Survey of Hospitals. Study Design. As in the original taxonomy, separate cluster solutions are identified for health networks and health systems by applying three strategic/structural dimensions (differentiation, integration, and centralization) to three components of the health service/product continuum (hospital services, physician arrangements, and providerbased insurance activities). Data Extraction Methods. Factor, cluster, and discriminant analyses are used to analyze the 1998 data. Descriptive and comparative methods are used to analyze the updated 1998 taxonomy relative to the original 1994 version. Principal Findings. The 1998 cluster categories are similar to the original taxonomy, however, they reveal some new organizational configurations. For the health networks, centralization of product/service lines is occurring more selectively than in the past. For the health systems, participation has grown in and dispersed across a more diverse set of decentralized organizational forms. For both networks and systems, the definition of centralization has changed over time.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="f75576ac1d8ac83eba402c3f6a14abd9" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":43016398,"asset_id":15629966,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/43016398/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15629966"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15629966"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15629966; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15629966]").text(description); $(".js-view-count[data-work-id=15629966]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15629966; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15629966']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "f75576ac1d8ac83eba402c3f6a14abd9" } } $('.js-work-strip[data-work-id=15629966]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15629966,"title":"Reexamining Organizational Configurations: An Update, Validation, and Expansion of the Taxonomy of Health Networks and Systems","translated_title":"","metadata":{"grobid_abstract":"Objectives. To (a) assess how the original cluster categories of hospital-led health networks and systems have changed over time; (b) identify any new patterns of cluster configurations; and (c) demonstrate how additional data can be used to refine and enhance the taxonomy measures. Data Sources. 1994 and 1998 American Hospital Association (AHA) Annual Survey of Hospitals. Study Design. As in the original taxonomy, separate cluster solutions are identified for health networks and health systems by applying three strategic/structural dimensions (differentiation, integration, and centralization) to three components of the health service/product continuum (hospital services, physician arrangements, and providerbased insurance activities). Data Extraction Methods. Factor, cluster, and discriminant analyses are used to analyze the 1998 data. Descriptive and comparative methods are used to analyze the updated 1998 taxonomy relative to the original 1994 version. Principal Findings. The 1998 cluster categories are similar to the original taxonomy, however, they reveal some new organizational configurations. For the health networks, centralization of product/service lines is occurring more selectively than in the past. For the health systems, participation has grown in and dispersed across a more diverse set of decentralized organizational forms. For both networks and systems, the definition of centralization has changed over time.","publication_date":{"day":null,"month":null,"year":2004,"errors":{}},"publication_name":"Health Services Research","grobid_abstract_attachment_id":43016398},"translated_abstract":null,"internal_url":"https://www.academia.edu/15629966/Reexamining_Organizational_Configurations_An_Update_Validation_and_Expansion_of_the_Taxonomy_of_Health_Networks_and_Systems","translated_internal_url":"","created_at":"2015-09-12T10:28:54.532-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762508,"work_id":15629966,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Reexamining Organizational Configurations: An Update, Validation, and Expansion of the Taxonomy of Health Networks and Systems"}],"downloadable_attachments":[{"id":43016398,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/43016398/thumbnails/1.jpg","file_name":"Reexamining_Organizational_Configuration20160224-15736-5ids5v.pdf","download_url":"https://www.academia.edu/attachments/43016398/download_file","bulk_download_file_name":"Reexamining_Organizational_Configuration.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/43016398/Reexamining_Organizational_Configuration20160224-15736-5ids5v-libre.pdf?1456335625=\u0026response-content-disposition=attachment%3B+filename%3DReexamining_Organizational_Configuration.pdf\u0026Expires=1743441980\u0026Signature=CXzsfaLlyRCxzMi2HIaV3tfEdIUXyrMidlThVTvqbVe6XeUhx5qkelk4SjDqXW3wzp31gSbhsD2F0acyWNKZShONU5GEgp0-eCVw3qgXSbxg0wT0rE44GwqFsiCXDdwaBS2ltB5tdb5shrSQs3Z2lEUpHKe5vt6tCACKzSi1sVQZFa~KhS4shaAQIzS1e4syaEkYQ7V~kjpShTEL0o7ItfcQk3LM9UWA8x3Kof7zlrabanmnPQ8ldB78EViefeD2sdtlTyqUX2b8sM59RmZqXfA0InLNSW-HZ0Nf1ZNZVIAyQ-UB0Y7Jdtbai616jo63LbXlkBNEo6Notb6oxBGPrg__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Reexamining_Organizational_Configurations_An_Update_Validation_and_Expansion_of_the_Taxonomy_of_Health_Networks_and_Systems","translated_slug":"","page_count":14,"language":"en","content_type":"Work","summary":"Objectives. To (a) assess how the original cluster categories of hospital-led health networks and systems have changed over time; (b) identify any new patterns of cluster configurations; and (c) demonstrate how additional data can be used to refine and enhance the taxonomy measures. Data Sources. 1994 and 1998 American Hospital Association (AHA) Annual Survey of Hospitals. Study Design. As in the original taxonomy, separate cluster solutions are identified for health networks and health systems by applying three strategic/structural dimensions (differentiation, integration, and centralization) to three components of the health service/product continuum (hospital services, physician arrangements, and providerbased insurance activities). Data Extraction Methods. Factor, cluster, and discriminant analyses are used to analyze the 1998 data. Descriptive and comparative methods are used to analyze the updated 1998 taxonomy relative to the original 1994 version. Principal Findings. The 1998 cluster categories are similar to the original taxonomy, however, they reveal some new organizational configurations. For the health networks, centralization of product/service lines is occurring more selectively than in the past. For the health systems, participation has grown in and dispersed across a more diverse set of decentralized organizational forms. For both networks and systems, the definition of centralization has changed over time.","owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[{"id":43016398,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/43016398/thumbnails/1.jpg","file_name":"Reexamining_Organizational_Configuration20160224-15736-5ids5v.pdf","download_url":"https://www.academia.edu/attachments/43016398/download_file","bulk_download_file_name":"Reexamining_Organizational_Configuration.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/43016398/Reexamining_Organizational_Configuration20160224-15736-5ids5v-libre.pdf?1456335625=\u0026response-content-disposition=attachment%3B+filename%3DReexamining_Organizational_Configuration.pdf\u0026Expires=1743441980\u0026Signature=CXzsfaLlyRCxzMi2HIaV3tfEdIUXyrMidlThVTvqbVe6XeUhx5qkelk4SjDqXW3wzp31gSbhsD2F0acyWNKZShONU5GEgp0-eCVw3qgXSbxg0wT0rE44GwqFsiCXDdwaBS2ltB5tdb5shrSQs3Z2lEUpHKe5vt6tCACKzSi1sVQZFa~KhS4shaAQIzS1e4syaEkYQ7V~kjpShTEL0o7ItfcQk3LM9UWA8x3Kof7zlrabanmnPQ8ldB78EViefeD2sdtlTyqUX2b8sM59RmZqXfA0InLNSW-HZ0Nf1ZNZVIAyQ-UB0Y7Jdtbai616jo63LbXlkBNEo6Notb6oxBGPrg__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":7076,"name":"Taxonomy","url":"https://www.academia.edu/Documents/in/Taxonomy"},{"id":16635,"name":"Health Services Research","url":"https://www.academia.edu/Documents/in/Health_Services_Research"},{"id":83471,"name":"Health Services","url":"https://www.academia.edu/Documents/in/Health_Services"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":131237,"name":"Cluster Analysis","url":"https://www.academia.edu/Documents/in/Cluster_Analysis"},{"id":231637,"name":"Organizational Policy","url":"https://www.academia.edu/Documents/in/Organizational_Policy"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":496530,"name":"Community Networks","url":"https://www.academia.edu/Documents/in/Community_Networks"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15629966-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15629975"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/15629975/Evaluating_Partnerships_for_Community_Health_Improvement_Tracking_the_Footprints"><img alt="Research paper thumbnail of Evaluating Partnerships for Community Health Improvement: Tracking the Footprints" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Evaluating Partnerships for Community Health Improvement: Tracking the Footprints</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/DouglasConrad">Douglas Conrad</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/ShoshannaSofaer">Shoshanna Sofaer</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/AnnZukoski">Ann Zukoski</a></span></div><div class="wp-workCard_item"><span>Journal of Health Politics, Policy and Law</span><span>, 2002</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Private-public partnerships are increasingly seen as an important mechanism for improving communi...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Private-public partnerships are increasingly seen as an important mechanism for improving community health. Despite their popularity, traditional evaluations of these efforts have produced negative or mixed results. This is often attributed to weak interventions or an insufficient period of time to observe an impact. This study examines two additional possibilities--the need for a well-articulated shared vision and the governance and management capabilities of the partnership itself. We conducted a midstream process evaluation of twenty-five community partnerships associated with the Community Care Network (CCN) Demonstration Program. We examined how the roles of a common shared vision, strong governance, and effective management influence a partnership&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s ability to achieve its objectives. The findings, based on both qualitative and quantitative analyses, underscore the importance of membership organizations&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceived benefits and costs of participation and management capabilities to the partnership&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s progress toward a vision. Based on the qualitative data, six key governance and management characteristics are identified that separate the top performing partnerships from the lowest performing ones. We explore the implications of this research for future evaluations of public-private community health partnerships.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15629975"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15629975"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15629975; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15629975]").text(description); $(".js-view-count[data-work-id=15629975]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15629975; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15629975']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=15629975]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15629975,"title":"Evaluating Partnerships for Community Health Improvement: Tracking the Footprints","translated_title":"","metadata":{"abstract":"Private-public partnerships are increasingly seen as an important mechanism for improving community health. Despite their popularity, traditional evaluations of these efforts have produced negative or mixed results. This is often attributed to weak interventions or an insufficient period of time to observe an impact. This study examines two additional possibilities--the need for a well-articulated shared vision and the governance and management capabilities of the partnership itself. We conducted a midstream process evaluation of twenty-five community partnerships associated with the Community Care Network (CCN) Demonstration Program. We examined how the roles of a common shared vision, strong governance, and effective management influence a partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s ability to achieve its objectives. The findings, based on both qualitative and quantitative analyses, underscore the importance of membership organizations\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceived benefits and costs of participation and management capabilities to the partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s progress toward a vision. Based on the qualitative data, six key governance and management characteristics are identified that separate the top performing partnerships from the lowest performing ones. We explore the implications of this research for future evaluations of public-private community health partnerships.","publication_date":{"day":null,"month":null,"year":2002,"errors":{}},"publication_name":"Journal of Health Politics, Policy and Law"},"translated_abstract":"Private-public partnerships are increasingly seen as an important mechanism for improving community health. Despite their popularity, traditional evaluations of these efforts have produced negative or mixed results. This is often attributed to weak interventions or an insufficient period of time to observe an impact. This study examines two additional possibilities--the need for a well-articulated shared vision and the governance and management capabilities of the partnership itself. We conducted a midstream process evaluation of twenty-five community partnerships associated with the Community Care Network (CCN) Demonstration Program. We examined how the roles of a common shared vision, strong governance, and effective management influence a partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s ability to achieve its objectives. The findings, based on both qualitative and quantitative analyses, underscore the importance of membership organizations\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceived benefits and costs of participation and management capabilities to the partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s progress toward a vision. Based on the qualitative data, six key governance and management characteristics are identified that separate the top performing partnerships from the lowest performing ones. We explore the implications of this research for future evaluations of public-private community health partnerships.","internal_url":"https://www.academia.edu/15629975/Evaluating_Partnerships_for_Community_Health_Improvement_Tracking_the_Footprints","translated_internal_url":"","created_at":"2015-09-12T10:28:55.494-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762507,"work_id":15629975,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Evaluating Partnerships for Community Health Improvement: Tracking the Footprints"},{"id":5762529,"work_id":15629975,"tagging_user_id":34807327,"tagged_user_id":35004148,"co_author_invite_id":1274799,"email":"d***d@u.washington.edu","display_order":4194304,"name":"Douglas Conrad","title":"Evaluating Partnerships for Community Health Improvement: Tracking the Footprints"},{"id":5762543,"work_id":15629975,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274801,"email":"a***j@email.gwu.edu","display_order":6291456,"name":"Jeffrey Alexander","title":"Evaluating Partnerships for Community Health Improvement: Tracking the Footprints"},{"id":5762552,"work_id":15629975,"tagging_user_id":34807327,"tagged_user_id":34868761,"co_author_invite_id":1274802,"email":"s***r@baruch.cuny.edu","display_order":7340032,"name":"Shoshanna Sofaer","title":"Evaluating Partnerships for Community Health Improvement: Tracking the Footprints"},{"id":5762556,"work_id":15629975,"tagging_user_id":34807327,"tagged_user_id":37738388,"co_author_invite_id":1274803,"email":"a***i@rainbowresearch.org","display_order":7864320,"name":"Ann Zukoski","title":"Evaluating Partnerships for Community Health Improvement: Tracking the Footprints"},{"id":5762669,"work_id":15629975,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274837,"email":"r***n@aha.org","display_order":8126464,"name":"Romana Hasnain-wynia","title":"Evaluating Partnerships for Community Health Improvement: Tracking the Footprints"}],"downloadable_attachments":[],"slug":"Evaluating_Partnerships_for_Community_Health_Improvement_Tracking_the_Footprints","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Private-public partnerships are increasingly seen as an important mechanism for improving community health. Despite their popularity, traditional evaluations of these efforts have produced negative or mixed results. This is often attributed to weak interventions or an insufficient period of time to observe an impact. This study examines two additional possibilities--the need for a well-articulated shared vision and the governance and management capabilities of the partnership itself. We conducted a midstream process evaluation of twenty-five community partnerships associated with the Community Care Network (CCN) Demonstration Program. We examined how the roles of a common shared vision, strong governance, and effective management influence a partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s ability to achieve its objectives. The findings, based on both qualitative and quantitative analyses, underscore the importance of membership organizations\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceived benefits and costs of participation and management capabilities to the partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s progress toward a vision. Based on the qualitative data, six key governance and management characteristics are identified that separate the top performing partnerships from the lowest performing ones. We explore the implications of this research for future evaluations of public-private community health partnerships.","owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[],"research_interests":[{"id":202,"name":"Program Evaluation","url":"https://www.academia.edu/Documents/in/Program_Evaluation"},{"id":534,"name":"Law","url":"https://www.academia.edu/Documents/in/Law"},{"id":981,"name":"Health Promotion","url":"https://www.academia.edu/Documents/in/Health_Promotion"},{"id":2969,"name":"Leadership","url":"https://www.academia.edu/Documents/in/Leadership"},{"id":11435,"name":"Community Health","url":"https://www.academia.edu/Documents/in/Community_Health"},{"id":14406,"name":"Health","url":"https://www.academia.edu/Documents/in/Health"},{"id":16457,"name":"Public sector","url":"https://www.academia.edu/Documents/in/Public_sector"},{"id":40023,"name":"Social Responsibility","url":"https://www.academia.edu/Documents/in/Social_Responsibility"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":232534,"name":"Health Status","url":"https://www.academia.edu/Documents/in/Health_Status"},{"id":380315,"name":"Public Administration and Policy","url":"https://www.academia.edu/Documents/in/Public_Administration_and_Policy"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":466484,"name":"Private Sector","url":"https://www.academia.edu/Documents/in/Private_Sector"},{"id":496530,"name":"Community Networks","url":"https://www.academia.edu/Documents/in/Community_Networks"},{"id":945595,"name":"Pilot Projects","url":"https://www.academia.edu/Documents/in/Pilot_Projects"},{"id":1034177,"name":"Continuity of Patient Care","url":"https://www.academia.edu/Documents/in/Continuity_of_Patient_Care"},{"id":1141653,"name":"Community Health Planning","url":"https://www.academia.edu/Documents/in/Community_Health_Planning"},{"id":1153482,"name":"Cooperative Behavior","url":"https://www.academia.edu/Documents/in/Cooperative_Behavior"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15629975-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15629988"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/15629988/Collaborative_Initiatives_Where_the_Rubber_Meets_the_Road_in_Community_Partnerships"><img alt="Research paper thumbnail of Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/DouglasConrad">Douglas Conrad</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/ShoshannaSofaer">Shoshanna Sofaer</a></span></div><div class="wp-workCard_item"><span>Medical Care Research and Review</span><span>, 2003</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Amajor challenge facing a community partnership is the implementation of its collaborative initia...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Amajor challenge facing a community partnership is the implementation of its collaborative initiatives. This article examines the progress Community Care Networks (CCNs) made in implementing their initiatives and factors that helped or hindered their progress. Study findings suggest that partnership progress is affected by external market and regulatory factors beyond the control of the partnership, the availability of local community resources to support efforts, the scope and intensity of tasks associated with an initiative, expansion of the partnership to include new members, and the balance of work between partners and paid partnership staff. Implications of study findings for community partnerships include (1) recognizing and anticipating dependency on others, (2) acknowledging that the tasks that lie ahead will be more complicated than imagined, (3) maintaining focus on priorities, and (4) learning to be adaptive and creative, given a constantly changing environment.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15629988"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15629988"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15629988; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15629988]").text(description); $(".js-view-count[data-work-id=15629988]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15629988; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15629988']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=15629988]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15629988,"title":"Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships","translated_title":"","metadata":{"abstract":"Amajor challenge facing a community partnership is the implementation of its collaborative initiatives. This article examines the progress Community Care Networks (CCNs) made in implementing their initiatives and factors that helped or hindered their progress. Study findings suggest that partnership progress is affected by external market and regulatory factors beyond the control of the partnership, the availability of local community resources to support efforts, the scope and intensity of tasks associated with an initiative, expansion of the partnership to include new members, and the balance of work between partners and paid partnership staff. Implications of study findings for community partnerships include (1) recognizing and anticipating dependency on others, (2) acknowledging that the tasks that lie ahead will be more complicated than imagined, (3) maintaining focus on priorities, and (4) learning to be adaptive and creative, given a constantly changing environment.","publication_date":{"day":null,"month":null,"year":2003,"errors":{}},"publication_name":"Medical Care Research and Review"},"translated_abstract":"Amajor challenge facing a community partnership is the implementation of its collaborative initiatives. This article examines the progress Community Care Networks (CCNs) made in implementing their initiatives and factors that helped or hindered their progress. Study findings suggest that partnership progress is affected by external market and regulatory factors beyond the control of the partnership, the availability of local community resources to support efforts, the scope and intensity of tasks associated with an initiative, expansion of the partnership to include new members, and the balance of work between partners and paid partnership staff. Implications of study findings for community partnerships include (1) recognizing and anticipating dependency on others, (2) acknowledging that the tasks that lie ahead will be more complicated than imagined, (3) maintaining focus on priorities, and (4) learning to be adaptive and creative, given a constantly changing environment.","internal_url":"https://www.academia.edu/15629988/Collaborative_Initiatives_Where_the_Rubber_Meets_the_Road_in_Community_Partnerships","translated_internal_url":"","created_at":"2015-09-12T10:28:57.267-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762506,"work_id":15629988,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships"},{"id":5762528,"work_id":15629988,"tagging_user_id":34807327,"tagged_user_id":35004148,"co_author_invite_id":1274799,"email":"d***d@u.washington.edu","display_order":4194304,"name":"Douglas Conrad","title":"Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships"},{"id":5762539,"work_id":15629988,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274801,"email":"a***j@email.gwu.edu","display_order":6291456,"name":"Jeffrey Alexander","title":"Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships"},{"id":5762551,"work_id":15629988,"tagging_user_id":34807327,"tagged_user_id":34868761,"co_author_invite_id":1274802,"email":"s***r@baruch.cuny.edu","display_order":7340032,"name":"Shoshanna Sofaer","title":"Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships"},{"id":5762555,"work_id":15629988,"tagging_user_id":34807327,"tagged_user_id":37738388,"co_author_invite_id":1274803,"email":"a***i@rainbowresearch.org","display_order":7864320,"name":"Ann Zukoski","title":"Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships"},{"id":5762668,"work_id":15629988,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274837,"email":"r***n@aha.org","display_order":8126464,"name":"Romana Hasnain-wynia","title":"Collaborative Initiatives: Where the Rubber Meets the Road in Community Partnerships"}],"downloadable_attachments":[],"slug":"Collaborative_Initiatives_Where_the_Rubber_Meets_the_Road_in_Community_Partnerships","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Amajor challenge facing a community partnership is the implementation of its collaborative initiatives. This article examines the progress Community Care Networks (CCNs) made in implementing their initiatives and factors that helped or hindered their progress. Study findings suggest that partnership progress is affected by external market and regulatory factors beyond the control of the partnership, the availability of local community resources to support efforts, the scope and intensity of tasks associated with an initiative, expansion of the partnership to include new members, and the balance of work between partners and paid partnership staff. Implications of study findings for community partnerships include (1) recognizing and anticipating dependency on others, (2) acknowledging that the tasks that lie ahead will be more complicated than imagined, (3) maintaining focus on priorities, and (4) learning to be adaptive and creative, given a constantly changing environment.","owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[],"research_interests":[{"id":202,"name":"Program Evaluation","url":"https://www.academia.edu/Documents/in/Program_Evaluation"},{"id":3138,"name":"Community-Based Mental Health Services","url":"https://www.academia.edu/Documents/in/Community-Based_Mental_Health_Services"},{"id":73149,"name":"Business and Management","url":"https://www.academia.edu/Documents/in/Business_and_Management"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":123411,"name":"Care","url":"https://www.academia.edu/Documents/in/Care"},{"id":219645,"name":"Medical Care","url":"https://www.academia.edu/Documents/in/Medical_Care"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":496530,"name":"Community Networks","url":"https://www.academia.edu/Documents/in/Community_Networks"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15629988-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15629986"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/15629986/Members_Perceptions_of_Community_Care_Network_Partnerships_Effectiveness"><img alt="Research paper thumbnail of Members’ Perceptions of Community Care Network Partnerships’ Effectiveness" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Members’ Perceptions of Community Care Network Partnerships’ Effectiveness</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/DouglasConrad">Douglas Conrad</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/ShoshannaSofaer">Shoshanna Sofaer</a></span></div><div class="wp-workCard_item"><span>Medical Care Research and Review</span><span>, 2003</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Investment in voluntary partnerships raises important questions: Should we invest in collaboratio...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Investment in voluntary partnerships raises important questions: Should we invest in collaboration in moving toward the goals of health system redesign? What makes collaborative groups effective? Given the voluntary nature of these partnerships, membership perceptions of their experiences and the partnership&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s effectiveness should be important predictors of success. This article provides a preliminary analyses of perceived effectiveness of participants&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions of their own partnership, particularly focusing on leadership, conflict management, decision-making dynamics, and the breadth and depth of partnership membership. Members&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions that the partnership membership was &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;sufficiently broad to accomplish objectives&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; had a negative and highly significant relationship to perceived effectiveness. Members&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions about leadership being ethical was positively related to perceived effectiveness while perceptions that the leadership was not effective a keeping the group focused was negatively related to perceived effectiveness.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15629986"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15629986"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15629986; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15629986]").text(description); $(".js-view-count[data-work-id=15629986]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15629986; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15629986']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=15629986]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15629986,"title":"Members’ Perceptions of Community Care Network Partnerships’ Effectiveness","translated_title":"","metadata":{"abstract":"Investment in voluntary partnerships raises important questions: Should we invest in collaboration in moving toward the goals of health system redesign? What makes collaborative groups effective? Given the voluntary nature of these partnerships, membership perceptions of their experiences and the partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s effectiveness should be important predictors of success. This article provides a preliminary analyses of perceived effectiveness of participants\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions of their own partnership, particularly focusing on leadership, conflict management, decision-making dynamics, and the breadth and depth of partnership membership. Members\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions that the partnership membership was \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;sufficiently broad to accomplish objectives\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; had a negative and highly significant relationship to perceived effectiveness. Members\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions about leadership being ethical was positively related to perceived effectiveness while perceptions that the leadership was not effective a keeping the group focused was negatively related to perceived effectiveness.","publication_date":{"day":null,"month":null,"year":2003,"errors":{}},"publication_name":"Medical Care Research and Review"},"translated_abstract":"Investment in voluntary partnerships raises important questions: Should we invest in collaboration in moving toward the goals of health system redesign? What makes collaborative groups effective? Given the voluntary nature of these partnerships, membership perceptions of their experiences and the partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s effectiveness should be important predictors of success. This article provides a preliminary analyses of perceived effectiveness of participants\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions of their own partnership, particularly focusing on leadership, conflict management, decision-making dynamics, and the breadth and depth of partnership membership. Members\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions that the partnership membership was \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;sufficiently broad to accomplish objectives\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; had a negative and highly significant relationship to perceived effectiveness. Members\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions about leadership being ethical was positively related to perceived effectiveness while perceptions that the leadership was not effective a keeping the group focused was negatively related to perceived effectiveness.","internal_url":"https://www.academia.edu/15629986/Members_Perceptions_of_Community_Care_Network_Partnerships_Effectiveness","translated_internal_url":"","created_at":"2015-09-12T10:28:57.083-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762504,"work_id":15629986,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Members’ Perceptions of Community Care Network Partnerships’ Effectiveness"},{"id":5762526,"work_id":15629986,"tagging_user_id":34807327,"tagged_user_id":35004148,"co_author_invite_id":1274799,"email":"d***d@u.washington.edu","display_order":4194304,"name":"Douglas Conrad","title":"Members’ Perceptions of Community Care Network Partnerships’ Effectiveness"},{"id":5762537,"work_id":15629986,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274801,"email":"a***j@email.gwu.edu","display_order":6291456,"name":"Jeffrey Alexander","title":"Members’ Perceptions of Community Care Network Partnerships’ Effectiveness"},{"id":5762549,"work_id":15629986,"tagging_user_id":34807327,"tagged_user_id":34868761,"co_author_invite_id":1274802,"email":"s***r@baruch.cuny.edu","display_order":7340032,"name":"Shoshanna Sofaer","title":"Members’ Perceptions of Community Care Network Partnerships’ Effectiveness"},{"id":5762554,"work_id":15629986,"tagging_user_id":34807327,"tagged_user_id":37738388,"co_author_invite_id":1274803,"email":"a***i@rainbowresearch.org","display_order":7864320,"name":"Ann Zukoski","title":"Members’ Perceptions of Community Care Network Partnerships’ Effectiveness"},{"id":5762666,"work_id":15629986,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274837,"email":"r***n@aha.org","display_order":8126464,"name":"Romana Hasnain-wynia","title":"Members’ Perceptions of Community Care Network Partnerships’ Effectiveness"}],"downloadable_attachments":[],"slug":"Members_Perceptions_of_Community_Care_Network_Partnerships_Effectiveness","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"Investment in voluntary partnerships raises important questions: Should we invest in collaboration in moving toward the goals of health system redesign? What makes collaborative groups effective? Given the voluntary nature of these partnerships, membership perceptions of their experiences and the partnership\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s effectiveness should be important predictors of success. This article provides a preliminary analyses of perceived effectiveness of participants\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions of their own partnership, particularly focusing on leadership, conflict management, decision-making dynamics, and the breadth and depth of partnership membership. Members\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions that the partnership membership was \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;sufficiently broad to accomplish objectives\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; had a negative and highly significant relationship to perceived effectiveness. Members\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39; perceptions about leadership being ethical was positively related to perceived effectiveness while perceptions that the leadership was not effective a keeping the group focused was negatively related to perceived effectiveness.","owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[],"research_interests":[{"id":202,"name":"Program Evaluation","url":"https://www.academia.edu/Documents/in/Program_Evaluation"},{"id":73149,"name":"Business and Management","url":"https://www.academia.edu/Documents/in/Business_and_Management"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":219645,"name":"Medical Care","url":"https://www.academia.edu/Documents/in/Medical_Care"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":496530,"name":"Community Networks","url":"https://www.academia.edu/Documents/in/Community_Networks"},{"id":784971,"name":"Community Care","url":"https://www.academia.edu/Documents/in/Community_Care"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15629986-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15629991"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" href="https://www.academia.edu/15629991/Sustainability_of_Collaborative_Capacity_in_Community_Health_Partnerships"><img alt="Research paper thumbnail of Sustainability of Collaborative Capacity in Community Health Partnerships" class="work-thumbnail" src="https://attachments.academia-assets.com/43016383/thumbnails/1.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title"><a class="js-work-strip-work-link text-gray-darker" data-click-track="profile-work-strip-title" href="https://www.academia.edu/15629991/Sustainability_of_Collaborative_Capacity_in_Community_Health_Partnerships">Sustainability of Collaborative Capacity in Community Health Partnerships</a></div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/DouglasConrad">Douglas Conrad</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/ShoshannaSofaer">Shoshanna Sofaer</a></span></div><div class="wp-workCard_item"><span>Medical Care Research and Review</span><span>, 2003</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">Sustainability is a key requirement for partnership success and a major challenge for such organi...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">Sustainability is a key requirement for partnership success and a major challenge for such organizations. Despite the critical importance of sustainability to the success of community health partnerships and the many threats to sustainability, there is little evidence that would provide partnerships with clear guidance on long-term viability. This article attempts to (1) develop a conceptual model of sustainability in community health partnerships and (2) identify potential determinants of sustainability using comparative qualitative data from four partnerships from the Community Care Network (CCN) Demonstration Program. Based on a grounded theory examination of qualitative data from 130S the CCN evaluation, the authors hypothesize that there are five primary attributes/activities of partnerships leading to consequential value and eventually to sustainability of collaborative capacity. They include outcomes-based advocacy, vision-focus balance, systems orientation, infrastructure development, and community linkages. The context in which the partnership operates provides the conditions for determining the appropriateness and relative impact of each of the factors related to creating consequential value in the partnership.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><a id="a56bb3bdcef072bf0f8fe9ff5eb1e45c" class="wp-workCard--action" rel="nofollow" data-click-track="profile-work-strip-download" data-download="{"attachment_id":43016383,"asset_id":15629991,"asset_type":"Work","button_location":"profile"}" href="https://www.academia.edu/attachments/43016383/download_file?s=profile"><span><i class="fa fa-arrow-down"></i></span><span>Download</span></a><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15629991"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15629991"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15629991; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15629991]").text(description); $(".js-view-count[data-work-id=15629991]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15629991; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15629991']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (true){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "a56bb3bdcef072bf0f8fe9ff5eb1e45c" } } $('.js-work-strip[data-work-id=15629991]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15629991,"title":"Sustainability of Collaborative Capacity in Community Health Partnerships","translated_title":"","metadata":{"grobid_abstract":"Sustainability is a key requirement for partnership success and a major challenge for such organizations. Despite the critical importance of sustainability to the success of community health partnerships and the many threats to sustainability, there is little evidence that would provide partnerships with clear guidance on long-term viability. This article attempts to (1) develop a conceptual model of sustainability in community health partnerships and (2) identify potential determinants of sustainability using comparative qualitative data from four partnerships from the Community Care Network (CCN) Demonstration Program. Based on a grounded theory examination of qualitative data from 130S the CCN evaluation, the authors hypothesize that there are five primary attributes/activities of partnerships leading to consequential value and eventually to sustainability of collaborative capacity. They include outcomes-based advocacy, vision-focus balance, systems orientation, infrastructure development, and community linkages. The context in which the partnership operates provides the conditions for determining the appropriateness and relative impact of each of the factors related to creating consequential value in the partnership.","publication_date":{"day":null,"month":null,"year":2003,"errors":{}},"publication_name":"Medical Care Research and Review","grobid_abstract_attachment_id":43016383},"translated_abstract":null,"internal_url":"https://www.academia.edu/15629991/Sustainability_of_Collaborative_Capacity_in_Community_Health_Partnerships","translated_internal_url":"","created_at":"2015-09-12T10:28:57.532-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762505,"work_id":15629991,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Sustainability of Collaborative Capacity in Community Health Partnerships"},{"id":5762527,"work_id":15629991,"tagging_user_id":34807327,"tagged_user_id":35004148,"co_author_invite_id":1274799,"email":"d***d@u.washington.edu","display_order":4194304,"name":"Douglas Conrad","title":"Sustainability of Collaborative Capacity in Community Health Partnerships"},{"id":5762538,"work_id":15629991,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274801,"email":"a***j@email.gwu.edu","display_order":6291456,"name":"Jeffrey Alexander","title":"Sustainability of Collaborative Capacity in Community Health Partnerships"},{"id":5762550,"work_id":15629991,"tagging_user_id":34807327,"tagged_user_id":34868761,"co_author_invite_id":1274802,"email":"s***r@baruch.cuny.edu","display_order":7340032,"name":"Shoshanna Sofaer","title":"Sustainability of Collaborative Capacity in Community Health Partnerships"},{"id":5762559,"work_id":15629991,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274805,"email":"w***r@email.unc.edu","display_order":7864320,"name":"Bryan Weiner","title":"Sustainability of Collaborative Capacity in Community Health Partnerships"},{"id":5762667,"work_id":15629991,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274837,"email":"r***n@aha.org","display_order":8126464,"name":"Romana Hasnain-wynia","title":"Sustainability of Collaborative Capacity in Community Health Partnerships"}],"downloadable_attachments":[{"id":43016383,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/43016383/thumbnails/1.jpg","file_name":"Sustainability_of_collaborative_capacity20160224-16595-168d0fe.pdf","download_url":"https://www.academia.edu/attachments/43016383/download_file","bulk_download_file_name":"Sustainability_of_Collaborative_Capacity.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/43016383/Sustainability_of_collaborative_capacity20160224-16595-168d0fe-libre.pdf?1456335629=\u0026response-content-disposition=attachment%3B+filename%3DSustainability_of_Collaborative_Capacity.pdf\u0026Expires=1743441980\u0026Signature=UY-A2j-k6XB7tULkYterdbX9ea-dFQnV4iItKDXc9wPzi14tR6hZVS1RZ3z1sIJ4oDXFHAVvfhp9eDUCXH1E0oT~CB7EfWJHAcYor2PvIHTT5P5W~BdHn~TNXLfHZB9jLMWuYq17pM0KKDROSrwAuBIecUIIrJtbOzgjwyKJIWR0FxfNRZ1zIDZWU1Q0f2u9pjalaSYLOcCYpawEwIr1LDncmQrZy0z93kqaBnRjp701iQ-1od3bZBP7QOw38uwx1jdL55w1Ioyl1gTCq24r3QcbsdPgXkKL-qG88UxjwC-fXclkWzOjgoqtNBSbhacB0qCyWs0EVOT6bqzOazJg1g__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"slug":"Sustainability_of_Collaborative_Capacity_in_Community_Health_Partnerships","translated_slug":"","page_count":31,"language":"en","content_type":"Work","summary":"Sustainability is a key requirement for partnership success and a major challenge for such organizations. Despite the critical importance of sustainability to the success of community health partnerships and the many threats to sustainability, there is little evidence that would provide partnerships with clear guidance on long-term viability. This article attempts to (1) develop a conceptual model of sustainability in community health partnerships and (2) identify potential determinants of sustainability using comparative qualitative data from four partnerships from the Community Care Network (CCN) Demonstration Program. Based on a grounded theory examination of qualitative data from 130S the CCN evaluation, the authors hypothesize that there are five primary attributes/activities of partnerships leading to consequential value and eventually to sustainability of collaborative capacity. They include outcomes-based advocacy, vision-focus balance, systems orientation, infrastructure development, and community linkages. The context in which the partnership operates provides the conditions for determining the appropriateness and relative impact of each of the factors related to creating consequential value in the partnership.","owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[{"id":43016383,"title":"","file_type":"pdf","scribd_thumbnail_url":"https://attachments.academia-assets.com/43016383/thumbnails/1.jpg","file_name":"Sustainability_of_collaborative_capacity20160224-16595-168d0fe.pdf","download_url":"https://www.academia.edu/attachments/43016383/download_file","bulk_download_file_name":"Sustainability_of_Collaborative_Capacity.pdf","bulk_download_url":"https://d1wqtxts1xzle7.cloudfront.net/43016383/Sustainability_of_collaborative_capacity20160224-16595-168d0fe-libre.pdf?1456335629=\u0026response-content-disposition=attachment%3B+filename%3DSustainability_of_Collaborative_Capacity.pdf\u0026Expires=1743441980\u0026Signature=UY-A2j-k6XB7tULkYterdbX9ea-dFQnV4iItKDXc9wPzi14tR6hZVS1RZ3z1sIJ4oDXFHAVvfhp9eDUCXH1E0oT~CB7EfWJHAcYor2PvIHTT5P5W~BdHn~TNXLfHZB9jLMWuYq17pM0KKDROSrwAuBIecUIIrJtbOzgjwyKJIWR0FxfNRZ1zIDZWU1Q0f2u9pjalaSYLOcCYpawEwIr1LDncmQrZy0z93kqaBnRjp701iQ-1od3bZBP7QOw38uwx1jdL55w1Ioyl1gTCq24r3QcbsdPgXkKL-qG88UxjwC-fXclkWzOjgoqtNBSbhacB0qCyWs0EVOT6bqzOazJg1g__\u0026Key-Pair-Id=APKAJLOHF5GGSLRBV4ZA"}],"research_interests":[{"id":202,"name":"Program Evaluation","url":"https://www.academia.edu/Documents/in/Program_Evaluation"},{"id":2919,"name":"Organizational Culture","url":"https://www.academia.edu/Documents/in/Organizational_Culture"},{"id":11435,"name":"Community Health","url":"https://www.academia.edu/Documents/in/Community_Health"},{"id":73149,"name":"Business and Management","url":"https://www.academia.edu/Documents/in/Business_and_Management"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":123411,"name":"Care","url":"https://www.academia.edu/Documents/in/Care"},{"id":219645,"name":"Medical Care","url":"https://www.academia.edu/Documents/in/Medical_Care"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":496530,"name":"Community Networks","url":"https://www.academia.edu/Documents/in/Community_Networks"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15629991-figures'); } }); </script> <div class="js-work-strip profile--work_container" data-work-id="15629989"><div class="profile--work_thumbnail hidden-xs"><a class="js-work-strip-work-link" data-click-track="profile-work-strip-thumbnail" rel="nofollow" href="https://www.academia.edu/15629989/Community_Care_Networks_Linking_Vision_to_Outcomes_for_Community_Health_Improvement"><img alt="Research paper thumbnail of Community Care Networks: Linking Vision to Outcomes for Community Health Improvement" class="work-thumbnail" src="https://a.academia-assets.com/images/blank-paper.jpg" /></a></div><div class="wp-workCard wp-workCard_itemContainer"><div class="wp-workCard_item wp-workCard--title">Community Care Networks: Linking Vision to Outcomes for Community Health Improvement</div><div class="wp-workCard_item wp-workCard--coauthors"><span>by </span><span><a class="" data-click-track="profile-work-strip-authors" href="https://vcu.academia.edu/GloriaBazzoli">Gloria Bazzoli</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/StephenShortell">Stephen Shortell</a>, <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/DouglasConrad">Douglas Conrad</a>, and <a class="" data-click-track="profile-work-strip-authors" href="https://independent.academia.edu/ShoshannaSofaer">Shoshanna Sofaer</a></span></div><div class="wp-workCard_item"><span>Medical Care Research and Review</span><span>, 2003</span></div><div class="wp-workCard_item"><span class="js-work-more-abstract-truncated">This article examines the relationship between progress toward the Community Care Network (CCN) v...</span><a class="js-work-more-abstract" data-broccoli-component="work_strip.more_abstract" data-click-track="profile-work-strip-more-abstract" href="javascript:;"><span> more </span><span><i class="fa fa-caret-down"></i></span></a><span class="js-work-more-abstract-untruncated hidden">This article examines the relationship between progress toward the Community Care Network (CCN) vision and &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;intermediate outcomes&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; of 25 community-based health partnerships (CCNs). Specific components of the CCN vision were community accountability, community health focus, creation of a seamless service continuum, and managing under limited resources. Four community outcome dimensions were evaluated: access, cost, health, and quality of service delivery integration. Overall progress toward the CCN vision was significantly positively related to average intermediate outcome score and most highly correlated with two dimensions: access and quality of service integration. Qualitative analysis suggests that CCN sites accomplished the most along two dimensions--access and health--noting that intermediate health outcomes generally were in health assessment and information rather than actual health status improvement. Keys to outcome achievement appear to be (1) clearly focused intervention; (2) explicit, ongoing outcome measurement; and (3) strong integration of separate intervention components.</span></div><div class="wp-workCard_item wp-workCard--actions"><span class="work-strip-bookmark-button-container"></span><span class="wp-workCard--action visible-if-viewed-by-owner inline-block" style="display: none;"><span class="js-profile-work-strip-edit-button-wrapper profile-work-strip-edit-button-wrapper" data-work-id="15629989"><a class="js-profile-work-strip-edit-button" tabindex="0"><span><i class="fa fa-pencil"></i></span><span>Edit</span></a></span></span></div><div class="wp-workCard_item wp-workCard--stats"><span><span><span class="js-view-count view-count u-mr2x" data-work-id="15629989"><i class="fa fa-spinner fa-spin"></i></span><script>$(function () { var workId = 15629989; window.Academia.workViewCountsFetcher.queue(workId, function (count) { var description = window.$h.commaizeInt(count) + " " + window.$h.pluralize(count, 'View'); $(".js-view-count[data-work-id=15629989]").text(description); $(".js-view-count[data-work-id=15629989]").attr('title', description).tooltip(); }); });</script></span></span><span><span class="percentile-widget hidden"><span class="u-mr2x work-percentile"></span></span><script>$(function () { var workId = 15629989; window.Academia.workPercentilesFetcher.queue(workId, function (percentileText) { var container = $(".js-work-strip[data-work-id='15629989']"); container.find('.work-percentile').text(percentileText.charAt(0).toUpperCase() + percentileText.slice(1)); container.find('.percentile-widget').show(); container.find('.percentile-widget').removeClass('hidden'); }); });</script></span></div><div id="work-strip-premium-row-container"></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/work_edit-ad038b8c047c1a8d4fa01b402d530ff93c45fee2137a149a4a5398bc8ad67560.js"], function() { // from javascript_helper.rb var dispatcherData = {} if (false){ window.WowProfile.dispatcher = window.WowProfile.dispatcher || _.clone(Backbone.Events); dispatcherData = { dispatcher: window.WowProfile.dispatcher, downloadLinkId: "-1" } } $('.js-work-strip[data-work-id=15629989]').each(function() { if (!$(this).data('initialized')) { new WowProfile.WorkStripView({ el: this, workJSON: {"id":15629989,"title":"Community Care Networks: Linking Vision to Outcomes for Community Health Improvement","translated_title":"","metadata":{"abstract":"This article examines the relationship between progress toward the Community Care Network (CCN) vision and \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;intermediate outcomes\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; of 25 community-based health partnerships (CCNs). Specific components of the CCN vision were community accountability, community health focus, creation of a seamless service continuum, and managing under limited resources. Four community outcome dimensions were evaluated: access, cost, health, and quality of service delivery integration. Overall progress toward the CCN vision was significantly positively related to average intermediate outcome score and most highly correlated with two dimensions: access and quality of service integration. Qualitative analysis suggests that CCN sites accomplished the most along two dimensions--access and health--noting that intermediate health outcomes generally were in health assessment and information rather than actual health status improvement. Keys to outcome achievement appear to be (1) clearly focused intervention; (2) explicit, ongoing outcome measurement; and (3) strong integration of separate intervention components.","publication_date":{"day":null,"month":null,"year":2003,"errors":{}},"publication_name":"Medical Care Research and Review"},"translated_abstract":"This article examines the relationship between progress toward the Community Care Network (CCN) vision and \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;intermediate outcomes\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; of 25 community-based health partnerships (CCNs). Specific components of the CCN vision were community accountability, community health focus, creation of a seamless service continuum, and managing under limited resources. Four community outcome dimensions were evaluated: access, cost, health, and quality of service delivery integration. Overall progress toward the CCN vision was significantly positively related to average intermediate outcome score and most highly correlated with two dimensions: access and quality of service integration. Qualitative analysis suggests that CCN sites accomplished the most along two dimensions--access and health--noting that intermediate health outcomes generally were in health assessment and information rather than actual health status improvement. Keys to outcome achievement appear to be (1) clearly focused intervention; (2) explicit, ongoing outcome measurement; and (3) strong integration of separate intervention components.","internal_url":"https://www.academia.edu/15629989/Community_Care_Networks_Linking_Vision_to_Outcomes_for_Community_Health_Improvement","translated_internal_url":"","created_at":"2015-09-12T10:28:57.352-07:00","preview_url":null,"current_user_can_edit":null,"current_user_is_owner":null,"owner_id":34807327,"coauthors_can_edit":true,"document_type":"paper","co_author_tags":[{"id":5762503,"work_id":15629989,"tagging_user_id":34807327,"tagged_user_id":33441845,"co_author_invite_id":1274795,"email":"g***i@vcu.edu","affiliation":"Virginia Commonwealth University","display_order":0,"name":"Gloria Bazzoli","title":"Community Care Networks: Linking Vision to Outcomes for Community Health Improvement"},{"id":5762524,"work_id":15629989,"tagging_user_id":34807327,"tagged_user_id":35004148,"co_author_invite_id":1274799,"email":"d***d@u.washington.edu","display_order":4194304,"name":"Douglas Conrad","title":"Community Care Networks: Linking Vision to Outcomes for Community Health Improvement"},{"id":5762536,"work_id":15629989,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274801,"email":"a***j@email.gwu.edu","display_order":6291456,"name":"Jeffrey Alexander","title":"Community Care Networks: Linking Vision to Outcomes for Community Health Improvement"},{"id":5762548,"work_id":15629989,"tagging_user_id":34807327,"tagged_user_id":34868761,"co_author_invite_id":1274802,"email":"s***r@baruch.cuny.edu","display_order":7340032,"name":"Shoshanna Sofaer","title":"Community Care Networks: Linking Vision to Outcomes for Community Health Improvement"},{"id":5762665,"work_id":15629989,"tagging_user_id":34807327,"tagged_user_id":null,"co_author_invite_id":1274837,"email":"r***n@aha.org","display_order":7864320,"name":"Romana Hasnain-wynia","title":"Community Care Networks: Linking Vision to Outcomes for Community Health Improvement"}],"downloadable_attachments":[],"slug":"Community_Care_Networks_Linking_Vision_to_Outcomes_for_Community_Health_Improvement","translated_slug":"","page_count":null,"language":"en","content_type":"Work","summary":"This article examines the relationship between progress toward the Community Care Network (CCN) vision and \u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot;intermediate outcomes\u0026amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;quot; of 25 community-based health partnerships (CCNs). Specific components of the CCN vision were community accountability, community health focus, creation of a seamless service continuum, and managing under limited resources. Four community outcome dimensions were evaluated: access, cost, health, and quality of service delivery integration. Overall progress toward the CCN vision was significantly positively related to average intermediate outcome score and most highly correlated with two dimensions: access and quality of service integration. Qualitative analysis suggests that CCN sites accomplished the most along two dimensions--access and health--noting that intermediate health outcomes generally were in health assessment and information rather than actual health status improvement. Keys to outcome achievement appear to be (1) clearly focused intervention; (2) explicit, ongoing outcome measurement; and (3) strong integration of separate intervention components.","owner":{"id":34807327,"first_name":"Stephen","middle_initials":null,"last_name":"Shortell","page_name":"StephenShortell","domain_name":"independent","created_at":"2015-09-12T10:27:27.783-07:00","display_name":"Stephen Shortell","url":"https://independent.academia.edu/StephenShortell"},"attachments":[],"research_interests":[{"id":202,"name":"Program Evaluation","url":"https://www.academia.edu/Documents/in/Program_Evaluation"},{"id":3138,"name":"Community-Based Mental Health Services","url":"https://www.academia.edu/Documents/in/Community-Based_Mental_Health_Services"},{"id":11435,"name":"Community Health","url":"https://www.academia.edu/Documents/in/Community_Health"},{"id":73149,"name":"Business and Management","url":"https://www.academia.edu/Documents/in/Business_and_Management"},{"id":98134,"name":"United States","url":"https://www.academia.edu/Documents/in/United_States"},{"id":123411,"name":"Care","url":"https://www.academia.edu/Documents/in/Care"},{"id":219645,"name":"Medical Care","url":"https://www.academia.edu/Documents/in/Medical_Care"},{"id":232534,"name":"Health Status","url":"https://www.academia.edu/Documents/in/Health_Status"},{"id":410370,"name":"Public health systems and services research","url":"https://www.academia.edu/Documents/in/Public_health_systems_and_services_research-1"},{"id":496530,"name":"Community Networks","url":"https://www.academia.edu/Documents/in/Community_Networks"},{"id":784971,"name":"Community Care","url":"https://www.academia.edu/Documents/in/Community_Care"}],"urls":[]}, dispatcherData: dispatcherData }); $(this).data('initialized', true); } }); $a.trackClickSource(".js-work-strip-work-link", "profile_work_strip") if (false) { Aedu.setUpFigureCarousel('profile-work-15629989-figures'); } }); </script> </div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js","https://a.academia-assets.com/assets/google_contacts-0dfb882d836b94dbcb4a2d123d6933fc9533eda5be911641f20b4eb428429600.js"], function() { // from javascript_helper.rb $('.js-google-connect-button').click(function(e) { e.preventDefault(); GoogleContacts.authorize_and_show_contacts(); Aedu.Dismissibles.recordClickthrough("WowProfileImportContactsPrompt"); }); $('.js-update-biography-button').click(function(e) { e.preventDefault(); Aedu.Dismissibles.recordClickthrough("UpdateUserBiographyPrompt"); $.ajax({ url: $r.api_v0_profiles_update_about_path({ subdomain_param: 'api', about: "", }), type: 'PUT', success: function(response) { location.reload(); } }); }); $('.js-work-creator-button').click(function (e) { e.preventDefault(); window.location = $r.upload_funnel_document_path({ source: encodeURIComponent(""), }); }); $('.js-video-upload-button').click(function (e) { e.preventDefault(); window.location = $r.upload_funnel_video_path({ source: encodeURIComponent(""), }); }); $('.js-do-this-later-button').click(function() { $(this).closest('.js-profile-nag-panel').remove(); Aedu.Dismissibles.recordDismissal("WowProfileImportContactsPrompt"); }); $('.js-update-biography-do-this-later-button').click(function(){ $(this).closest('.js-profile-nag-panel').remove(); Aedu.Dismissibles.recordDismissal("UpdateUserBiographyPrompt"); }); $('.wow-profile-mentions-upsell--close').click(function(){ $('.wow-profile-mentions-upsell--panel').hide(); Aedu.Dismissibles.recordDismissal("WowProfileMentionsUpsell"); }); $('.wow-profile-mentions-upsell--button').click(function(){ Aedu.Dismissibles.recordClickthrough("WowProfileMentionsUpsell"); }); new WowProfile.SocialRedesignUserWorks({ initialWorksOffset: 20, allWorksOffset: 20, maxSections: 1 }) }); </script> </div></div></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/wow_profile_edit-5ea339ee107c863779f560dd7275595239fed73f1a13d279d2b599a28c0ecd33.js","https://a.academia-assets.com/assets/add_coauthor-22174b608f9cb871d03443cafa7feac496fb50d7df2d66a53f5ee3c04ba67f53.js","https://a.academia-assets.com/assets/tab-dcac0130902f0cc2d8cb403714dd47454f11fc6fb0e99ae6a0827b06613abc20.js","https://a.academia-assets.com/assets/wow_profile-a9bf3a2bc8c89fa2a77156577594264ee8a0f214d74241bc0fcd3f69f8d107ac.js"], function() { // from javascript_helper.rb window.ae = window.ae || {}; window.ae.WowProfile = window.ae.WowProfile || {}; if(Aedu.User.current && Aedu.User.current.id === $viewedUser.id) { window.ae.WowProfile.current_user_edit = {}; new WowProfileEdit.EditUploadView({ el: '.js-edit-upload-button-wrapper', model: window.$current_user, }); new AddCoauthor.AddCoauthorsController(); } var userInfoView = new WowProfile.SocialRedesignUserInfo({ recaptcha_key: "6LdxlRMTAAAAADnu_zyLhLg0YF9uACwz78shpjJB" }); WowProfile.router = new WowProfile.Router({ userInfoView: userInfoView }); Backbone.history.start({ pushState: true, root: "/" + $viewedUser.page_name }); new WowProfile.UserWorksNav() }); </script> </div> <div class="bootstrap login"><div class="modal fade login-modal" id="login-modal"><div class="login-modal-dialog modal-dialog"><div class="modal-content"><div class="modal-header"><button class="close close" data-dismiss="modal" type="button"><span aria-hidden="true">×</span><span class="sr-only">Close</span></button><h4 class="modal-title text-center"><strong>Log In</strong></h4></div><div class="modal-body"><div class="row"><div class="col-xs-10 col-xs-offset-1"><button class="btn btn-fb btn-lg btn-block btn-v-center-content" id="login-facebook-oauth-button"><svg style="float: left; width: 19px; line-height: 1em; margin-right: .3em;" aria-hidden="true" focusable="false" data-prefix="fab" data-icon="facebook-square" class="svg-inline--fa fa-facebook-square fa-w-14" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 448 512"><path fill="currentColor" d="M400 32H48A48 48 0 0 0 0 80v352a48 48 0 0 0 48 48h137.25V327.69h-63V256h63v-54.64c0-62.15 37-96.48 93.67-96.48 27.14 0 55.52 4.84 55.52 4.84v61h-31.27c-30.81 0-40.42 19.12-40.42 38.73V256h68.78l-11 71.69h-57.78V480H400a48 48 0 0 0 48-48V80a48 48 0 0 0-48-48z"></path></svg><small><strong>Log in</strong> with <strong>Facebook</strong></small></button><br /><button class="btn btn-google btn-lg btn-block btn-v-center-content" id="login-google-oauth-button"><svg style="float: left; width: 22px; line-height: 1em; margin-right: .3em;" aria-hidden="true" focusable="false" data-prefix="fab" data-icon="google-plus" class="svg-inline--fa fa-google-plus fa-w-16" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512"><path fill="currentColor" d="M256,8C119.1,8,8,119.1,8,256S119.1,504,256,504,504,392.9,504,256,392.9,8,256,8ZM185.3,380a124,124,0,0,1,0-248c31.3,0,60.1,11,83,32.3l-33.6,32.6c-13.2-12.9-31.3-19.1-49.4-19.1-42.9,0-77.2,35.5-77.2,78.1S142.3,334,185.3,334c32.6,0,64.9-19.1,70.1-53.3H185.3V238.1H302.2a109.2,109.2,0,0,1,1.9,20.7c0,70.8-47.5,121.2-118.8,121.2ZM415.5,273.8v35.5H380V273.8H344.5V238.3H380V202.8h35.5v35.5h35.2v35.5Z"></path></svg><small><strong>Log in</strong> with <strong>Google</strong></small></button><br /><style type="text/css">.sign-in-with-apple-button { width: 100%; height: 52px; border-radius: 3px; border: 1px solid black; cursor: pointer; } .sign-in-with-apple-button > div { margin: 0 auto; / This centers the Apple-rendered button horizontally }</style><script src="https://appleid.cdn-apple.com/appleauth/static/jsapi/appleid/1/en_US/appleid.auth.js" type="text/javascript"></script><div class="sign-in-with-apple-button" data-border="false" data-color="white" id="appleid-signin"><span   ="Sign Up with Apple" class="u-fs11"></span></div><script>AppleID.auth.init({ clientId: 'edu.academia.applesignon', scope: 'name email', redirectURI: 'https://www.academia.edu/sessions', state: "154871a5d841b613faff0dc49644ab3513a769392caffe238fab6d78874fdcd6", });</script><script>// Hacky way of checking if on fast loswp if (window.loswp == null) { (function() { const Google = window?.Aedu?.Auth?.OauthButton?.Login?.Google; const Facebook = window?.Aedu?.Auth?.OauthButton?.Login?.Facebook; if (Google) { new Google({ el: '#login-google-oauth-button', rememberMeCheckboxId: 'remember_me', track: null }); } if (Facebook) { new Facebook({ el: '#login-facebook-oauth-button', rememberMeCheckboxId: 'remember_me', track: null }); } })(); }</script></div></div></div><div class="modal-body"><div class="row"><div class="col-xs-10 col-xs-offset-1"><div class="hr-heading login-hr-heading"><span class="hr-heading-text">or</span></div></div></div></div><div class="modal-body"><div class="row"><div class="col-xs-10 col-xs-offset-1"><form class="js-login-form" action="https://www.academia.edu/sessions" accept-charset="UTF-8" method="post"><input type="hidden" name="authenticity_token" value="nCdMROguTKLYr55QyYjDxTrXrivVGCQriC_R6i7uTp1uNelLW2wvoFI4na-xdf0OMCAwaiFygL-cSrvg_KVwrA" autocomplete="off" /><div class="form-group"><label class="control-label" for="login-modal-email-input" style="font-size: 14px;">Email</label><input class="form-control" id="login-modal-email-input" name="login" type="email" /></div><div class="form-group"><label class="control-label" for="login-modal-password-input" style="font-size: 14px;">Password</label><input class="form-control" id="login-modal-password-input" name="password" type="password" /></div><input type="hidden" name="post_login_redirect_url" id="post_login_redirect_url" value="https://vcu.academia.edu/GloriaBazzoli" autocomplete="off" /><div class="checkbox"><label><input type="checkbox" name="remember_me" id="remember_me" value="1" checked="checked" /><small style="font-size: 12px; margin-top: 2px; display: inline-block;">Remember me on this computer</small></label></div><br><input type="submit" name="commit" value="Log In" class="btn btn-primary btn-block btn-lg js-login-submit" data-disable-with="Log In" /></br></form><script>typeof window?.Aedu?.recaptchaManagedForm === 'function' && window.Aedu.recaptchaManagedForm( document.querySelector('.js-login-form'), document.querySelector('.js-login-submit') );</script><small style="font-size: 12px;"><br />or <a data-target="#login-modal-reset-password-container" data-toggle="collapse" href="javascript:void(0)">reset password</a></small><div class="collapse" id="login-modal-reset-password-container"><br /><div class="well margin-0x"><form class="js-password-reset-form" action="https://www.academia.edu/reset_password" accept-charset="UTF-8" method="post"><input type="hidden" name="authenticity_token" value="P6aAmYfnwZQhxMgaPU2SQktCbYyK0QumCFtSN93ukKDNtCWWNKWilqtTy-VFsKyJQbXzzX67rzIcPjg9D6WukQ" autocomplete="off" /><p>Enter the email address you signed up with and we'll email you a reset link.</p><div class="form-group"><input class="form-control" name="email" type="email" /></div><script src="https://recaptcha.net/recaptcha/api.js" async defer></script> <script> var invisibleRecaptchaSubmit = function () { var closestForm = function (ele) { var curEle = ele.parentNode; while (curEle.nodeName !== 'FORM' && curEle.nodeName !== 'BODY'){ curEle = curEle.parentNode; } return curEle.nodeName === 'FORM' ? curEle : null }; var eles = document.getElementsByClassName('g-recaptcha'); if (eles.length > 0) { var form = closestForm(eles[0]); if (form) { form.submit(); } } }; </script> <input type="submit" data-sitekey="6Lf3KHUUAAAAACggoMpmGJdQDtiyrjVlvGJ6BbAj" data-callback="invisibleRecaptchaSubmit" class="g-recaptcha btn btn-primary btn-block" value="Email me a link" value=""/> </form></div></div><script> require.config({ waitSeconds: 90 })(["https://a.academia-assets.com/assets/collapse-45805421cf446ca5adf7aaa1935b08a3a8d1d9a6cc5d91a62a2a3a00b20b3e6a.js"], function() { // from javascript_helper.rb $("#login-modal-reset-password-container").on("shown.bs.collapse", function() { $(this).find("input[type=email]").focus(); }); }); </script> </div></div></div><div class="modal-footer"><div class="text-center"><small style="font-size: 12px;">Need an account? <a rel="nofollow" href="https://www.academia.edu/signup">Click here to sign up</a></small></div></div></div></div></div></div><script>// If we are on subdomain or non-bootstrapped page, redirect to login page instead of showing modal (function(){ if (typeof $ === 'undefined') return; var host = window.location.hostname; if ((host === $domain || host === "www."+$domain) && (typeof $().modal === 'function')) { $("#nav_log_in").click(function(e) { // Don't follow the link and open the modal e.preventDefault(); $("#login-modal").on('shown.bs.modal', function() { $(this).find("#login-modal-email-input").focus() }).modal('show'); }); } })()</script> <div class="bootstrap" id="footer"><div class="footer-content clearfix text-center padding-top-7x" style="width:100%;"><ul class="footer-links-secondary footer-links-wide list-inline margin-bottom-1x"><li><a href="https://www.academia.edu/about">About</a></li><li><a href="https://www.academia.edu/press">Press</a></li><li><a href="https://www.academia.edu/documents">Papers</a></li><li><a href="https://www.academia.edu/topics">Topics</a></li><li><a href="https://www.academia.edu/journals">Academia.edu Journals</a></li><li><a rel="nofollow" href="https://www.academia.edu/hiring"><svg style="width: 13px; height: 13px;" aria-hidden="true" focusable="false" data-prefix="fas" data-icon="briefcase" class="svg-inline--fa fa-briefcase fa-w-16" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512"><path fill="currentColor" d="M320 336c0 8.84-7.16 16-16 16h-96c-8.84 0-16-7.16-16-16v-48H0v144c0 25.6 22.4 48 48 48h416c25.6 0 48-22.4 48-48V288H320v48zm144-208h-80V80c0-25.6-22.4-48-48-48H176c-25.6 0-48 22.4-48 48v48H48c-25.6 0-48 22.4-48 48v80h512v-80c0-25.6-22.4-48-48-48zm-144 0H192V96h128v32z"></path></svg> <strong>We're Hiring!</strong></a></li><li><a rel="nofollow" href="https://support.academia.edu/hc/en-us"><svg style="width: 12px; height: 12px;" aria-hidden="true" focusable="false" data-prefix="fas" data-icon="question-circle" class="svg-inline--fa fa-question-circle fa-w-16" role="img" xmlns="http://www.w3.org/2000/svg" viewBox="0 0 512 512"><path fill="currentColor" d="M504 256c0 136.997-111.043 248-248 248S8 392.997 8 256C8 119.083 119.043 8 256 8s248 111.083 248 248zM262.655 90c-54.497 0-89.255 22.957-116.549 63.758-3.536 5.286-2.353 12.415 2.715 16.258l34.699 26.31c5.205 3.947 12.621 3.008 16.665-2.122 17.864-22.658 30.113-35.797 57.303-35.797 20.429 0 45.698 13.148 45.698 32.958 0 14.976-12.363 22.667-32.534 33.976C247.128 238.528 216 254.941 216 296v4c0 6.627 5.373 12 12 12h56c6.627 0 12-5.373 12-12v-1.333c0-28.462 83.186-29.647 83.186-106.667 0-58.002-60.165-102-116.531-102zM256 338c-25.365 0-46 20.635-46 46 0 25.364 20.635 46 46 46s46-20.636 46-46c0-25.365-20.635-46-46-46z"></path></svg> <strong>Help Center</strong></a></li></ul><ul class="footer-links-tertiary list-inline margin-bottom-1x"><li class="small">Find new research papers in:</li><li class="small"><a href="https://www.academia.edu/Documents/in/Physics">Physics</a></li><li class="small"><a href="https://www.academia.edu/Documents/in/Chemistry">Chemistry</a></li><li class="small"><a href="https://www.academia.edu/Documents/in/Biology">Biology</a></li><li class="small"><a href="https://www.academia.edu/Documents/in/Health_Sciences">Health Sciences</a></li><li class="small"><a href="https://www.academia.edu/Documents/in/Ecology">Ecology</a></li><li class="small"><a href="https://www.academia.edu/Documents/in/Earth_Sciences">Earth Sciences</a></li><li class="small"><a href="https://www.academia.edu/Documents/in/Cognitive_Science">Cognitive Science</a></li><li class="small"><a href="https://www.academia.edu/Documents/in/Mathematics">Mathematics</a></li><li class="small"><a href="https://www.academia.edu/Documents/in/Computer_Science">Computer Science</a></li></ul></div></div><div class="DesignSystem" id="credit" style="width:100%;"><ul class="u-pl0x footer-links-legal list-inline"><li><a rel="nofollow" href="https://www.academia.edu/terms">Terms</a></li><li><a rel="nofollow" href="https://www.academia.edu/privacy">Privacy</a></li><li><a rel="nofollow" href="https://www.academia.edu/copyright">Copyright</a></li><li>Academia ©2025</li></ul></div><script> //<![CDATA[ window.detect_gmtoffset = true; window.Academia && window.Academia.set_gmtoffset && Academia.set_gmtoffset('/gmtoffset'); //]]> </script> <div id='overlay_background'></div> <div id='bootstrap-modal-container' class='bootstrap'></div> <div id='ds-modal-container' class='bootstrap DesignSystem'></div> <div id='full-screen-modal'></div> </div> </body> </html>