For-profit hospitals in California contract out services much more intensely than either private nonprofit or public hospitals. To explain why, we build a model in which the outsourcing decision is a trade-off between cost and control. Since nonprofit firms are more restricted in how they consume net revenues, they experience more rapidly diminishing value of a dollar saved, and they are less a...

Objectives: This paper evaluates the drivers of profitability for a large sample of U.S. hospitals. Following a methodology frequently used by financial analysts, we use a DuPont analysis as a framework to evaluate the quality of earnings. By decomposing returns on equity (ROE) into profit margin, total asset turnover, and capital structure, the DuPont analysis reveals what drives overall profi...

The modern hospital bears little resemblance to its ancestors. The charitable institutions of the 19th century mainly tended, rather than treated, the sick, and they served mostly poor patients, whereas the wealthy received care at home. The transformation of hospitals “from places of dreaded impurity and exiled human wreckage into awesome citadels of science and bureaucratic order”1 occurred d...

The organization of medical care is changing more rapidly now than at any point in the last century. For decades, health care was a cottage industry: physicians practiced independently or in small groups and had arms-length relationships with hospitals, imaging and laboratory facilities, and other health care entities. Those organizations alternately competed and cooperated as part of an inform...

A LONGITUDINAL EXAMINATION OF HOW HOSPITAL PROVISION OF HOME HEALTH SERVICES CHANGED AFTER THE IMPLEMENTATION OF THE BALANCED BUDGET ACT OF 1997: DOES OWNERSHIP MATTER? By Tiang-Hong Chou, Ph.D. A dissertation submitted in partial fulfillment of the requirements for the degree of Doctor of Philosophy at Virginia Commonwealth University. Virginia Commonwealth University, 2009 Dissertation Direct...

BACKGROUND During the 1990's hospitals in the U.S were faced with cost containment charges, which may have disproportionately impacted hospitals that serve poor patients. The purposes of this paper are to study the impact of safety net activities on total profit margins and operating expenditures, and to trace these relationships over the 1990s for all U.S urban hospitals, controlling for hospi...

Two-stage utility maximization theory has been widely used in the literature to estimate import demand for agricultural commodities that are often inputs. This article examines the overlooked conceptual and empirical limitations of applying two-stage utility maximization theory to model the demand for imported commodities that are inputs. A discussion is presented about how the underutilized th...

BACKGROUND The Joint Commission on Accreditation of Healthcare Organizations and the Centers for Medicare and Medicaid Services recently began reporting on quality of care for acute myocardial infarction, congestive heart failure, and pneumonia. METHODS We linked performance data submitted for the first half of 2004 to American Hospital Association data on hospital characteristics. We created...