title: A study of the effects of innovative and efficient practices on the performance of hospice care organizations.
abstract: BACKGROUND
  Due to changes in social norms, funding initiatives, and other environmental factors, the business of hospice care has significantly evolved over the past 40 years. There has been an influx of for-profit firms, increased consolidation, and significant funding changes. We have witnessed a growth in utilization rates, an increase in insurance coverage, and improved governmental funding. Hospice care organizations have responded to these pressures by pursuing more efficient and innovative business practices.
  
  
  OBJECTIVE
  Drawing upon institutional theory, this study seeks to address whether quality of care provided to hospice patients is affected as organizations respond to environmental pressures for innovative and efficient business practices.
  
  
  METHODS
  This study uses hierarchical regression to analyze data from 111 hospices in California.
  
  
  RESULTS
  Innovative practices are positively related to quality of care. However, efficient practices have no significant relationship with quality of care.
  
  
  CONCLUSIONS
  It appears that incorporating innovative practices is positively related to quality of care. Although cost containment may be necessary for continued survival, efficiency improvement efforts do not seem to lead to improved quality of care.
authors: Department of Management, McCoy College of Business Administration, Texas State University, San Marcos, TX, USA. egkirby@txstate.edu
authors: Eric G
authors: EG
authors: Kirby
authors: Michael J
authors: MJ
authors: Keeffe
authors: Kay M
authors: KM
authors: Nicols
mesh_terms: D002140:California; D017598:Efficiency, Organizational; D019981:Health Care Sector / Q000458:organization & administration / Q000639:trends; D019538:Health Care Surveys; D006738:Hospices / Q000458:organization & administration* / Q000592:standards / Q000639:trends; D006801:Humans; D009874:Operations Research; D015279:Organizational Culture; D009936:Organizational Innovation; D010166:Palliative Care; D011787:Quality of Health Care / Q000458:organization & administration* / Q000639:trends; D012044:Regression Analysis; D012922:Social Change; D012931:Social Environment