title: Integration and the performance of healthcare networks: do integration strategies enhance efficiency, profitability, and image?
abstract: OBJECTIVE
  This study examines the integration effects on efficiency and financial viability of the top 100 integrated healthcare networks (IHNs) in the United States.
  
  
  BACKGROUND
  A contingency-strategic theory is used to identify the relationship of IHNs' performance to their structural and operational characteristics and integration strategies.
  
  
  METHODS
  The lists of the top 100 IHNs ranked in two years, 1998 and 1999, by the SMG Marketing Group were merged to create a database for the study. Multiple indicators were used to examine the relationship between IHNs' characteristics and their performance in efficiency and financial viability. A path analytical model was developed and validated by the Mplus statistical program. Factors influencing the top 100 IHNs' images, represented by attaining ranking among the top 100 in two consecutive years, were analysed.
  
  
  CONCLUSIONS
  No positive associations were found between integration and network performance in efficiency or profits. Longitudinal data are needed to investigate the effect of integration on healthcare networks' financial performance.
authors.affiliation: Department of Health Administration, Virginia Commonwealth University, Richmond, VA 23298, USA.
authors.forename: T T
authors.initials: TT
authors.lastname: Wan
authors.forename: A
authors.initials: A
authors.lastname: Ma
authors.forename: B Y
authors.initials: BY
authors.lastname: Lin