Integrated healthcare networks' performance: a growth curve modeling approach.
This study examines the effects of integration on the performance ratings of the top 100 integrated healthcare networks (IHNs) in the United States. A strategic-contingency theory is used to identify the relationship of IHNs' performance to their structural and operational characteristics and integration strategies. To create a database for the panel study, the top 100 IHNs selected by the SMG Marketing Group in 1998 were followed up in 1999 and 2000. The data were merged with the Dorenfest data on information system integration. A growth curve model was developed and validated by the Mplus statistical program. Factors influencing the top 100 IHNs' performance in 1998 and their subsequent rankings in the consecutive years were analyzed. IHNs' initial performance scores were positively influenced by network size, number of affiliated physicians and profit margin, and were negatively associated with average length of stay and technical efficiency. The continuing high performance, judged by maintaining higher performance scores, tended to be enhanced by the use of more managerial or executive decision-support systems. Future studies should include time-varying operational indicators to serve as predictors of network performance.
Department of Health Administration, Virginia Commonwealth University, 1008 East Clay Street, PO Box 980203, Richmond, VA 23298-0203, USA. twan@hsc.vcu.edu
Thomas T H
TT
Wan
Bill B L
BB
Wang
D019090:Case Management; D003266:Continuity of Patient Care; D003660:Decision Support Systems, Management; D019033:Delivery of Health Care, Integrated / Q000145:classification* / Q000458:organization & administration* / Q000706:statistics & numerical data; D019468:Disease Management; D017598:Efficiency, Organizational / Q000706:statistics & numerical data*; D006302:Health Services Research; D006801:Humans; D007902:Length of Stay; D016014:Linear Models; D015233:Models, Statistical; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D018511:Systems Integration; D014481:United States