Corporate and philanthropic models of hospital governance: a taxonomic evaluation.
OBJECTIVE
We assess the theoretical integrity and practical utility of the corporate-philanthropic governance typology frequently invoked in debates about the appropriate form of governance for nonprofit hospitals operating in increasingly competitive health care environments.


METHODS
Data were obtained from a 1985 national mailed survey of nonprofit hospitals conducted by the American Hospital Association (AHA) and the Hospital Research and Educational Trust (HRET).


METHODS
A sample 1,577 nonprofit community hospitals were selected for study. Representativeness was assessed by comparing the sample with the population of non-profit community hospitals on the dimensions of bed size, ownership type, urban-rural location, multihospital system membership, and census region.


METHODS
Measurement of governance types was based on hospital governance attributes conforming to those cited in the literature as distinguishing corporate from philanthropic models and classified into six central dimensions of governance: (1) size, (2) committee structure and activity, (3) board member selection, (4) board composition, (5) CEO power and influence, and (6) bylaws and activities.


RESULTS
Cluster analysis and ANCOVA indicated that hospital board forms adhered only partially to corporate and philanthropic governance models. Further, board forms varied systematically by specific organizational and environmental conditions. Boards exhibiting more corporate governance forms were more likely to be large, privately owned, urban, and operating in competitive markets than were hospitals showing more philanthropic governance forms.


CONCLUSIONS
Findings suggest that the corporate-philanthropic governance distinction must be seen as an ideal rather than an actual depiction of hospital governance forms. Implications for health care governance are discussed.
Weiner
B J
BJ
Department of Organizational Psychology, University of Michigan, Ann Arbor 48109-2909.
Alexander
J A
JA
D000704:Analysis of Variance; D016000:Cluster Analysis; D016002:Discriminant Analysis; D004465:Economic Competition / Q000145:classification / Q000706:statistics & numerical data; D006075:Governing Board / Q000458:organization & administration* / Q000706:statistics & numerical data; D006302:Health Services Research / Q000379:methods; D006761:Hospitals / Q000145:classification* / Q000706:statistics & numerical data; D007221:Industry / Q000706:statistics & numerical data; D017146:Models, Organizational; D009939:Organizations, Nonprofit / Q000706:statistics & numerical data; D015203:Reproducibility of Results; D014481:United States