title: A cost-constrained model of strategic service quality emphasis in nursing homes.
abstract: This study employed structural equation modeling to test the relationship between three aspects of the environmental context of nursing homes; Medicaid dependence, ownership status, and market demand, and two basic strategic orientations: low cost and differentiation based on service quality emphasis. Hypotheses were proposed and tested against data collected from a sample of nursing homes operating in a single state. Because of the overwhelming importance of cost control in the nursing home industry, a cost constrained strategy perspective was supported. Specifically, while the three contextual variables had no direct effect on service quality emphasis, the entire model was supported when cost control orientation was introduced as a mediating variable.
authors.affiliation: College of Business and Economics, University of Kentucky, Lexington 40506, USA.
authors.forename: M A
authors.initials: MA
authors.lastname: Davis
authors.forename: K G
authors.initials: KG
authors.lastname: Provan
mesh_terms: D003363:Cost Control; D006301:Health Services Needs and Demand; D006302:Health Services Research / Q000379:methods; D008484:Medicaid / Q000706:statistics & numerical data; D017059:Models, Econometric; D009735:Nursing Homes / Q000191:economics / Q000592:standards* / Q000706:statistics & numerical data; D010067:Ownership; D011787:Quality of Health Care / Q000191:economics* / Q000706:statistics & numerical data; D014481:United States