Local hospital systems: forerunners of regional systems?
Over the past several decades, the hospital industry has been undergoing a major organizational change that has until now been little examined. Local hospital systems (LHSs) are combinations of two or more hospitals that are in the same company and located in or around the same metropolitan areas in this country. This article presents the first detailed examination of the 402 such systems that have been identified to date. LHSs offer great potential for achieving the cost, quality, and access benefits that are often attributable to regional systems. The degree to which LHSs have attained some basic structural features expected of regional systems are examined. Differences are compared within ownership categories. Issues and challenges facing leaders in the field, should they hope to achieve the potential of regional systems, are discussed.
Medical College of Virginia, Virginia Commonwealth University, Richmond.
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D002391:Catchment Area, Health / Q000191:economics / Q000706:statistics & numerical data; D003191:Comprehensive Health Care / Q000458:organization & administration*; D003659:Decision Making, Organizational; D006302:Health Services Research; D006754:Hospital Restructuring / Q000191:economics / Q000458:organization & administration; D006777:Hospitals, Proprietary / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D016519:Hospitals, Religious / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D006788:Hospitals, Voluntary / Q000191:economics / Q000458:organization & administration / Q000706:statistics & numerical data; D007373:Interinstitutional Relations; D017146:Models, Organizational; D009096:Multi-Institutional Systems / Q000191:economics / Q000458:organization & administration* / Q000706:statistics & numerical data / Q000639:trends; D009937:Organizational Objectives; D010067:Ownership / Q000706:statistics & numerical data*; D012040:Regional Health Planning / Q000191:economics / Q000458:organization & administration* / Q000639:trends; D012424:Rural Population; D014481:United States; D014505:Urban Population