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EXECUTIVE SUMMARY: Little work has been done comparing the performance of hospitals with physician CEOs versus nonphysician CEOs, despite the ease of identifying this characteristic and extant leadership theories suggesting a relationship between technical expertise and success in leading highly technical organizations. We performed a detailed analysis of several widely accepted measures of clinical and financial performance across a randomly selected group of U.S. acute care hospitals with more than 40 beds and found no statistically significant differences between the two groups. The 30-day acute myocardial infarction mortality rate showed a positive statistically significant difference in the bivariate analysis (p < .001), but the effect was nullified in the multivariable regression analysis.

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OBJECTIVE: The purpose of this study is to examine the relationship between the greater need for information generated by bundled payment reimbursement and the use of Health Information Exchange (HIE). METHODS: The study is based on a secondary data analysis using theAmerican Hospital Association (AHA) Healthcare IT Database and the AHA Annual Survey. A logistic regression was used to test the likelihood of hospitals participating in HIE if they were involved in bundled payment reimbursement. Negative binomial, ordered logistic and Poisson regression models were used to determine the associations between bundled payment reimbursement and health information sharing in terms of breadth, volume, and diversity, respectively. RESULTS: Hospitals in bundled payment programs were more likely to send and receive information through HIE and tosend information to different types of health providers but not to receive. They were also more likely to exchange different types of health information and to use HIE more often. CONCLUSIONS: The greater need for collaboration of hospitals participating in bundled payment programs was associated with greater information sharing among organizations through HIE, but different providers involved in the episode of care play different roles in HIE.

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EXECUTIVE SUMMARY: Hospitals experiencing financial pressures are seeking to gain efficiencies through innovation. One solution is to engage hospitalists to help reduce the average length of stay (ALOS). This study considers whether and to what extent hospitalists affect ALOS and whether an association exists between the number of hospitalists per occupied bed (density) and ALOS. We examined 2,858 hospitals nationwide, including 20,180 hospital-years of data from 2007 through 2015 derived from the American Hospital Association Annual Survey database. Key findings showed that hospitals using hospitalists reported a statistically significant shorter ALOS than hospitals without hospitalists. The results also indicated a statistically significant decrease in ALOS for an increase in hospitalist full-time equivalent per occupied bed. This study is important because of the generalizability of its results and suggests that hospitals may form partnerships with hospitalists to improve hospital efficiency.

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Despite the increasingly global nature of health care, much of the research about journal rankings and directions for future research in health care management is from a United States based viewpoint. There is a lack of information about influential journals and trends for health care management research from a global perspective. This exploratory study gathered the opinions of health care management researchers from 17 countries regarding which journals are considered most influential, popular research topics and areas needing more attention from the research community. An online survey was sent to individuals in high-income Organisation for Economic Co-operation and Development countries who were identified through author relationships, academic institution websites, editorial boards of international journals, and academic and practitioner associations in the countries of interest. Results indicate that journal rankings vary substantially from prior published studies evaluating health care management journals and international ranking lists, and the list of influential journals includes a much more diverse array of publications. Respondents also indicated a diverse number of topics for current and future research, highlighting the global complexity of the field. The implications of this study are valuable to scholars evaluating outlets for disseminating research, and highlighting areas for collaborative research in health care management globally.

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This study examines patient perceptions of emergency department wait times and inpatient experiences. For many hospitals across the United States, the emergency department (ED) is now the "front door"; therefore, understanding the impact of ED experience on the inpatient experience is critical for leaders managing these complex settings today. Results showed statistically significant relationships between a very good ED experience and a very good inpatient experience. Perceived wait times in the ED, more so than actual ED wait times, served as a predictor of a very good ED rating as well as a very good rating of the inpatient experience.

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Self-reported changes in physical and mental health by members are an important dimension by which the quality of a Medicare Advantage (MA) plan is rated by the Centers for Medicare & Medicaid Services. To better target their interventions, MA plans need a better understanding of what observed characteristics-including clinical health conditions-predict self-reported changes in physical and mental health. This study explored how one MA plan's survey of participants' responses regarding changes in physical and mental health is associated with a set of chronic conditions as well as sociodemographic characteristics. Multinomial logistic regressions were used to examine the influence of 9 chronic conditions and age, sex, race, education, dual eligibility status (Medicare/Medicaid eligible), marital and living status, and assistance with survey completion on changes in patient-reported physical and mental health. Six conditions-dementia (P < 0.001), diabetes (P = 0.003), congestive heart failure (P = 0.002), cerebrovascular disease (P = 0.001), coronary artery disease (CAD) (P < 0.001), and rheumatoid arthritis (P < 0.001)-were associated with self-reported worsening of overall physical health. Four conditions-dementia (P < 0.002), diabetes (P = 0.047), CAD (P = 0.001), and decubitus ulcers (P = 0.033)-were associated with self-reported worsening of overall mental health. Females, married respondents, and those needing assistance with survey completion were more likely to report worsening of their mental health. Enrollees older than age 65 actually were less likely to report worsening of overall mental health. Findings provide insight into which members may be more susceptible to reporting that their physical or mental health is worsening.

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OBJECTIVE: To examine concordance between member self-reports and the organization's administrative claims data for two key health factors: number of chronic conditions, and number of prescription drugs. DATA: Medicare Advantage plan claims data and member survey data from 2011 to 2012. DESIGN: Mailed surveys to 15,000 members, enrolled minimum 6 months, drawn from a random sample of primary care physician practices with at least 200 members. METHODS: Descriptive statistics were generated for extent of concordance. Multivariable logistic regressions were used to analyze the association of selected respondent characteristics with likelihood of concordance. FINDINGS: Concordance for number of chronic conditions was 58.4 percent, with 27.3 percent under-reporting, 14.2 percent over-reporting. Concordance for number of prescription drugs was 56.6 percent with 38.9 percent under-reporting, 4.5 percent over-reporting. Number of prescriptions and assistance in survey completion were associated with higher likelihood of concordance for chronic conditions. Assistance in survey completion and number of chronic conditions were associated with higher concordance, and age and number of prescriptions were associated with lower concordance, for prescription drugs. CONCLUSIONS: Self-reported number of chronic conditions and prescription medications are not in high concordance with claims data. Health care researchers and policy makers using patient self-reported data should be aware of these potential biases.

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Contemporary organizations increasingly recognize human resource (HR) capabilities as a source of sustained competitive advantage; about 80% of an organization's value is attributable to intangible assets, including human assets and capital. Some scholars consider effective human resource management (HRM) the single most important factor affecting organizational performance. This study examined (1) the extent to which HRM strategies were included in organizational strategic planning and (2) the association between the involvement of senior HR professionals in strategic planning and the use of innovative HR practices in U.S. hospitals employing strategic HRM theory. A survey was administered to 168 chief executive officers and HR executives from 85 hospitals during spring 2005. Binary logistic regression was conducted to determine whether HRM involvement was associated with the use of innovative HRM strategies in the hospitals. We found significant associations between HRM strategy inclusion in the strategic planning process and senior HR professionals' involvement in organizational strategic planning and in three innovative HR activities: finding talent in advance for key job openings (odds ratio [OR] = 4.61, 95% confidence interval [CI]: 1.10-7.38), stressing organizational culture and values in the selection process (OR = 3.97, 95% CI: 1.01-3.97), and basing individual or team compensation on goal-oriented results (OR = 6.17, 95% CI: 1.17-3.37). Our data indicate that innovative HR practices were underused in some U.S. hospitals despite their potential to improve overall hospital performance. Hospitals that emphasized effective HRM were more likely to use some of the innovative HR approaches. In this article, we discuss this research and the practical implications of the findings.

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Health-care organizations, particularly hospitals, are among the most complex organizations to manage. However, the executive selection processes these organizations have in place are poorly understood. The purpose of this study is to explore the executive selection processes employed by USA acute care hospitals and discern if such processes are related to environmental, structural and strategic organizational characteristics. We conceptualize this model using a configurational approach. We present an empirically derived taxonomy of hospitals based on executive selection processes, structural and environmental characteristics, and organizational strategy based on the Porter framework. Based on the analyses, three types of hospitals are identified: (1) small, rural, cost leaders with limited selection processes; (2) large, urban, differentiators, with a plan; and (3) small, rural, caught in the middle muddlers.

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This study examines how perceptions of organizational culture influence organizational outcomes, specially, individual employee job satisfaction. The study was conducted in the health care industry in the United States. It examined the data on employee perceptions of job attributes, organizational culture, and job satisfaction, collected by Press Ganey Associates from 88 hospitals across the country in 2002-2003. Hierarchical linear modeling was used to test how organizational culture affects individual employee job satisfaction. Results indicated that some dimensions of organizational culture, specifically, job security and performance recognition, play a role in improving employee job satisfaction.

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