Organizational and administrative factors influencing the adoption of consortia programs by rural hospitals.
This study was designed to assess the effects of various hospital and environmental characteristics on the involvement of rural hospitals in forming and governing consortia and adopting consortia programs. The study focused on the 127 hospitals that are members of the nine rural consortia developed by grants from the Robert Wood Johnson Foundation during 1989 under its Hospital-Based Rural Hospital Consortia Program. Hospital involvement in the formation and governance of the consortia was found to be far less than expected for these grass-roots organizations. Only 38 percent of the administrators said that their hospitals were involved in developing the consortia, and 44 percent said that they played a role in determining the program menu. Governing board and medical staff involvement was even more limited. Program adoption rates were found to be related to both the types of programs offered by the consortia and the characteristics of the hospitals. In general, greater involvement of physicians and governing board members in hospital decisions was found to enhance program adoption rates, but the influence varied by type of involvement in the hospital and program content.
Institute for Health Services Research, School of Public Health, University of Minnesota, Minneapolis 55455.
J E
JE
Kralewski
I S
IS
Moscovice
J A
JA
Johnson
J B
JB
Christianson
B
B
Chan
D016542:Chief Executive Officers, Hospital / Q000706:statistics & numerical data; D003659:Decision Making, Organizational; D006075:Governing Board / Q000706:statistics & numerical data; D006302:Health Services Research; D006755:Hospital Shared Services / Q000706:statistics & numerical data*; D006780:Hospitals, Rural / Q000458:organization & administration* / Q000706:statistics & numerical data; D008505:Medical Staff, Hospital / Q000706:statistics & numerical data; D015999:Multivariate Analysis; D009935:Organizational Affiliation / Q000706:statistics & numerical data*; D015279:Organizational Culture; D016730:Program Development / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014481:United States