Abstract

American hospitals have made serious efforts to implement and expand their health information technology capabilities and to integrate different specialized care or high-tech services in order to maximize the efficiency and quality of care. In providing a variety of HIT-related services, these hospitals expanded their national reputation in line with integrated care goals. As a result, hospitals are encouraged to establish effective communication channels to facilitate patient-physician sharing of the patient care experience, to enhance effective pain management, and to transform patient-centered care modalities to solidify the adequacy of patient care processes. By analyzing national data sets publicly available, this investigation explored the relationship of acute-care hospitals' performance to the contextual, organizational and patient characteristics, using a cross-sectional study design. This study developed and evaluated the quality and efficiency of hospitals with respects to the structural complexity, process adequacy, efficiency, and quality of care. The structure-process-outcome theory in quality of care developed by Donabedian (1980), is adopted for this investigation. Statistical methods such as confirmatory factor analysis (CFA) and covariance structure model are employed. The population surveyed by the American Hospital Association (AHA) are acute care hospitals throughout the United States, including more than 3000 acute care hospitals of all types of ownership. The data provided by HIMSS Analytics and AHA are available for 2015 and the data provided CMS quality indicators are available for 2016. The key finding of this research is that process adequacy mediates the relationship between hospital structure and performance variables. The efficiency variable played an important role in shaping quality. The location and hospital teaching status have a moderate impact in determining hospital performance by affecting the structure and process of hospitals.

Notes

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Graduation Date

2019

Semester

Spring

Advisor

Wan, Thomas

Degree

Doctor of Philosophy (Ph.D.)

College

College of Community Innovation and Education

Degree Program

Public Affairs; Health Services Management and Research

Format

application/pdf

Identifier

CFE0007888

URL

http://purl.fcla.edu/fcla/etd/CFE0007888

Language

English

Release Date

November 2019

Length of Campus-only Access

None

Access Status

Doctoral Dissertation (Open Access)

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