Health Care Management Review最新文献

{"title":"The interplay of nurse staffing, financial performance, and patient outcomes in rural hospitals: A longitudinal analysis from Pennsylvania.","authors":"Dinesh R Pai, Esmaeil Bahalkeh","doi":"10.1097/HMR.0000000000000506","DOIUrl":"10.1097/HMR.0000000000000506","url":null,"abstract":"<p><strong>Background: </strong>Nurse staffing directly affects patient outcomes and hospital performance, creating a cost-versus-care dilemma, especially in rural areas with nursing shortages.</p><p><strong>Purpose: </strong>To examine the impact of nurse staffing patterns on Pennsylvania's rural hospital performance using 2000-2023 data.</p><p><strong>Data source/study setting: </strong>Data from 2000 to 2023 on Pennsylvania rural hospitals were drawn from several sources, including the Pennsylvania Department of Health, the Pennsylvania Healthcare Cost Containment Council, and the American Hospital Directory. After excluding hospitals with incomplete or unavailable data, the final sample comprised 1,606 hospital-year observations.</p><p><strong>Methodology/approach: </strong>This retrospective, longitudinal study analyzed acute care hospitals in Pennsylvania's rural counties using unbalanced panel data. We use robust econometric modeling to investigate how nurse staffing levels, skill mix, and flexibility influence financial sustainability, operational efficiency, and quality of care.</p><p><strong>Results: </strong>Increased staffing and a higher skill mix increased costs per adjusted patient day but significantly reduced readmissions, mortality, and average length of stay (ALOS). Interestingly, staffing flexibility, while not impacting costs, increased ALOS, a finding consistent with previous research. Staffing decisions and patient outcomes are intertwined, demanding careful consideration in resource-constrained rural settings.</p><p><strong>Conclusions: </strong>Rural hospital performance is strongly linked to nurse staffing. While increasing staffing and skill mix may incur higher initial costs, they ultimately enhance patient outcomes and operational efficiency, contributing to long-term financial stability despite any short-term expenses.</p><p><strong>Practice implications: </strong>The insights from this study are vital for administrators and policymakers focused on enhancing healthcare in rural areas. Therefore, a shift is required: from cost-centric to value-based staffing, emphasizing RNs, a balanced skill mix, data-driven decisions, and policy support to address rural health care challenges.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"366-374"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148674536","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the underlying mechanisms through which financial strategies translate into improved performance in U.S. health care organizations.","authors":"Manisha Mathur, Ethan Burns, Andrew Farach, Sunil Mathur","doi":"10.1097/HMR.0000000000000501","DOIUrl":"10.1097/HMR.0000000000000501","url":null,"abstract":"<p><strong>Background: </strong>Prior studies have examined the relationship between financial strategies and organizational performance in health care facilities; however, the underlying mechanisms through which financial strategies translate into improved performance remain largely unexplored. In particular, value appropriation mechanisms, such as advertising intensity and relationship investment, have received limited attention in health care management and marketing literature despite their potential importance for managerial and policy decision-making.</p><p><strong>Purpose: </strong>This study investigates the mechanisms through which financial strategies translate into improved organizational performance by examining the mediating role of value appropriation mechanisms, specifically, advertising intensity and relationship investment. By focusing on these underexplored pathways, the study aims to examine how financial resources are effectively leveraged to generate performance gains in U.S health care organizations.</p><p><strong>Methodology: </strong>This cross-sectional study uses secondary data from U.S. health care organizations, including hospitals, ambulatory care centers, and long-term care facilities. Drawing on the resource-based view and financial ratio theory, we analyzed 10 years of financial and operational data from Standard & Poor's Global Market Intelligence and the Center for Research in Security Prices databases. Structural equation modeling was used to estimate direct and indirect effects through two mediation pathways.</p><p><strong>Findings: </strong>Results show that value appropriation mechanisms support financial sustainability by enhancing patient awareness and retention. Financial flexibility, distress risk, and operating efficiency had significant direct effects on performance. Relationship investment strengthened connections between financial metrics and performance, while advertising intensity amplified these effects. Although service orientation had a negative direct effect, it showed a positive indirect effect through relationship investment.</p><p><strong>Practice implications: </strong>health care managers may enhance organizational performance by aligning financial strategies with targeted advertising and relationship-building initiatives that strengthen patient engagement and organizational reputation.</p><p><strong>Conclusions: </strong>This study demonstrates that value appropriation mechanisms play a central role in translating financial resource management into improved firm performance in health care organizations.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"326-335"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148399580","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The patient participation puzzle: Organizing patient participation in health care networks.","authors":"Roos G F M van der Ven, Robin Peeters, Aggie T G Paulus, Lisann de Ruijsscher, Felice N van Erning, Ignace H J T de Hingh, Daan D Westra","doi":"10.1097/HMR.0000000000000498","DOIUrl":"10.1097/HMR.0000000000000498","url":null,"abstract":"<p><strong>Introduction: </strong>Health care is increasingly organized in interorganizational networks, with patient participation gaining prominence to better tailor care to patient needs. However, these often occur independently, limiting understanding of how to organize interorganizational patient participation. Poorly implemented participation risks draining time and energy from vulnerable groups without creating meaningful change.</p><p><strong>Methods: </strong>We conducted an in-depth case study of a multihospital network, using 23 semistructured interviews with patients, health care staff, and network administrators, 77 hours of observations, and 276 documents to explore how interorganizational patient participation functions.</p><p><strong>Results: </strong>Our findings reveal the patient participation puzzle : the tension between the aspiration for patient participation at all interorganizational levels and its potential burden and unclear impact. Four interrelated themes emerged: aim, organizational structure, participant attributes, and impact. We distinguished participation within the network's operational level, closely tied to care delivery, and in network strategy, where patients' contributions are less clearly defined.</p><p><strong>Conclusion: </strong>Patient participation in network strategy often lacks clear aims, leaving patients' roles unclear and imposing undue burden. Key participant attributes like experiences and perspectives influence engagement but can also pose challenges. Participation's impact is not inherent; without clear aims, structures, and roles, it risks becoming symbolic and burdensome without meaningful impact.</p><p><strong>Practice implications: </strong>Organizing patient participation in health care networks is quite the puzzle. To avoid window dressing, network managers should acknowledge patient burden, set clear goals, act on patient input, and organize carefully to prevent tokenism. Accreditation bodies and policymakers should prioritize guidance and support over mandates to ensure meaningful impact.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"295-306"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492651/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148521231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Meeting demands & bridging gaps: The relationship between market characteristics and the utilization of enabling services in Federally Qualified Health Centers.","authors":"Shanequa S Roscoe-Nelson, Nancy Borkowski, Monica Aswani, Philip Cendoma, Michelle Brown, Geoffrey A Silvera","doi":"10.1097/HMR.0000000000000496","DOIUrl":"10.1097/HMR.0000000000000496","url":null,"abstract":"<p><strong>Background: </strong>Health education and community outreach provided through enabling services help increase access to care, promote preventive services, and improve health outcomes. Given the vulnerable populations served by Federally Qualified Health Centers (FQHCs), it is critical to examine how resources, like enabling services staffing, are utilized to address patient needs.</p><p><strong>Purpose: </strong>This study aimed to explore whether market characteristics indicating resource availability and resource demands are related to the utilization of enabling services workers providing health education and community outreach in FQHCs.</p><p><strong>Methodology/approach: </strong>A two-part model using data from the 2022 Uniform Data System (UDS) was conducted to estimate the probability of FQHCs utilizing enabling services workers with logistic regression and the extent of utilization of these workers if present using linear regression.</p><p><strong>Findings: </strong>Study findings revealed variability in resource availability and resource demand factors that are related to the utilization of enabling services workers, with several factors not found to be significant.</p><p><strong>Conclusion: </strong>The findings suggest that FQHCs may not be sufficiently responsive to patients and community needs or organizational resource levels with the current staffing patterns. This misalignment may lead to negative impacts on patient health outcomes and process measures.</p><p><strong>Practice implications: </strong>There is a need for policy to prioritize non-clinical support roles and ensure sustainable funding to support the delivery of comprehensive, equitable care to the patients served by FQHCs. There is also a need to understand how other healthcare organizations might be employing resources beyond traditional clinical roles.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 4","pages":"284-294"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148809170","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cut them some slack: Examining the effects of slack resources on the hospital workforce.","authors":"Frank van de Baan, Niels Hameleers, Rachel Gifford, Bram Fleuren, Dirk Ruwaard, Daan Westra","doi":"10.1097/HMR.0000000000000504","DOIUrl":"10.1097/HMR.0000000000000504","url":null,"abstract":"<p><strong>Background: </strong>Resource and capacity constraints can hamper the functioning of health care organizations and adversely affect the workforce, particularly during a shock. To mitigate the workforce crisis and enhance the ability to deal with shocks, slack resources (surplus resources accumulated by organizations) may be beneficial.</p><p><strong>Purpose: </strong>This paper seeks to identify how slack may benefit hospital staff in terms of reduced absenteeism and turnover, and how slack may buffer against the negative effects of shocks on staff.</p><p><strong>Methodology/approach: </strong>Using a nationwide dataset including annual reports of all Dutch hospitals from 2017 to 2021, this paper studies the relationships between three types of slack resources and absenteeism and turnover rates of hospitals. Specifically, linear mixed-effects modeling is used to estimate direct effects of slack resources and to test how COVID-19 (vs. non-COVID-19 years) moderates these resources' effects based on 342 hospital-year combinations.</p><p><strong>Results: </strong>The analyses reveal a significant curvilinear U-shaped relationship between absorbed slack (i.e., staff levels) and turnover rates. In addition, unabsorbed slack (i.e., financial reserves) and potential slack (i.e., capacity for additional loans) buffered significantly against the increasing effect of COVID-19 on absenteeism rates.</p><p><strong>Practice implications: </strong>Our study shows that incentivizing health care organizations to acquire slack resources can enable them to reduce turnover rates and, during shocks, mitigate shocks' adverse impact on absenteeism rates. As such, this studu suggests a need to reconsider the common policies and organizational practices of constraining resources to reduce costs.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 4","pages":"346-356"},"PeriodicalIF":2.6,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13492647/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148808889","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Casting a vote for middle managers as most valuable players (MVPs) in shaping how health care employees feel about top leaders and workgroup performance.","authors":"Kim C Brimhall, Kelley Cook, Gauri MacDonald, Matthew L Christensen","doi":"10.1097/HMR.0000000000000509","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000509","url":null,"abstract":"<p><strong>Background: </strong>Evidence indicates inclusive leadership as an effective strategy for improving health care organizational functioning and effectiveness; however, little is known about whether individuals in different leadership positions (middle managers versus top organizational leaders) shape employee perceptions of leader inclusiveness and workgroup performance.</p><p><strong>Purposes: </strong>This study examined whether middle manager inclusiveness influences employee perceptions of top leadership, and if middle manager and/or top leader inclusiveness influences perceptions of workgroup performance.</p><p><strong>Methodology/approach: </strong>Data were collected at three points in 6-month intervals from a US hospital department. Response rates ranged from 71% to 74% (213-245 health care employees). Longitudinal multilevel path analyses were used to answer hypotheses.</p><p><strong>Findings: </strong>A positive relationship was found between perceived middle manager inclusiveness at Time 1 and employee perceptions of top leader inclusiveness at Time 2 (6 months later). The inverse relationship was not supported (top leader inclusiveness at Time 1 was not related to perceptions of middle manager inclusiveness at Time 2), suggesting the critical role of middle managers as sensegivers for how employees perceive top leader inclusiveness. Top leader and middle manager inclusiveness positively influenced perceptions of workgroup performance at Time 3.</p><p><strong>Practice implications: </strong>While top leaders' and middle managers' inclusiveness positively influences employee perceptions of workgroup performance, middle managers serve as the most valuable players in shaping employee perceptions. Organizations that align their resources to target inclusive leadership development at the middle manager level can have a dual impact on improving perceptions of top leadership and middle management inclusiveness, ultimately enhancing perceptions of workgroup performance.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-09-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148945981","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development of the physician-pharmacist partnership intervention to deprescribe medications (P3iD) and its feasibility in clinical practice: Erratum.","authors":"Sheron Sir Loon Goh, Siti Nurkamilla Ramdzan, Kit Mun Tan, Maw Pin Tan, Pauline Siew Mei Lai","doi":"10.1097/HMR.0000000000000508","DOIUrl":"https://doi.org/10.1097/HMR.0000000000000508","url":null,"abstract":"","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":""},"PeriodicalIF":2.6,"publicationDate":"2026-07-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148632285","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"HCMR's contributions to the study of AI in health care organizations.","authors":"Jennifer L Hefner, Christy Harris Lemak","doi":"10.1097/HMR.0000000000000492","DOIUrl":"10.1097/HMR.0000000000000492","url":null,"abstract":"","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"171"},"PeriodicalIF":2.8,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785636","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Two dimensions of information technology sourcing strategies and hospital performance: Vendor turnover and application concentration.","authors":"Joonghee Lee, Aaron Ratcliffe, Trent Spaulding","doi":"10.1097/HMR.0000000000000489","DOIUrl":"10.1097/HMR.0000000000000489","url":null,"abstract":"<p><strong>Background: </strong>Health information technology (HIT) investments are on the rise, yet research on the impact of HIT sourcing strategies on hospital performance is limited.</p><p><strong>Purposes: </strong>This study defines a two-dimensional framework for assessing a hospital's IT sourcing strategy using vendor turnover and concentration of applications among vendors. We study the impact of these dimensions on hospital performance metrics, including costs and quality outcomes.</p><p><strong>Methodology/approach: </strong>We analyze HIT sourcing patterns using a data setof over 2,500 U.S. hospitals from the Healthcare Information and Management Systems Society database, the Centers for Medicare and Medicaid Services Hospital Compare Data, and the American Hospital Association Annual Survey Database. We apply ordinary least squares and two-stage least squares analysis to evaluate the effects of vendor turnover and application concentration on hospital ratings, readmission rates, IT operating expenses, and total operating costs.</p><p><strong>Findings: </strong>Greater application concentration among fewer vendors and reductions in the number of vendors are associated with lower readmission rates and lower operating costs. In contrast, adding vendors is associated with higher operating expenses. The findings suggest that vendor consolidation can improve efficiency and selected quality outcomes, whereas frequent vendor expansion may increase financial and operational burdens.</p><p><strong>Practice implications: </strong>Managers should adopt strategic approaches to HIT sourcing. Prioritizing application concentration and managing vendor turnover effectively can boost quality and efficiency. Although multisourcing offers flexibility, evidence favors concentration for performance gains. Future research should explore the broader impact of sourcing strategies on innovation, patient outcomes, and HIT adaptability in evolving health care environments.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":" ","pages":"243-252"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147785613","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Innovation districts and transformative workspaces: A scoping review of AI-pet robots companionship for aging employees balancing productivity and wellbeing.","authors":"Bruno Pereira, Adela McMurray, Ashokkumar Manoharan, Johnsam Rajesh Irudhaya, Ryan Jang","doi":"10.1097/HMR.0000000000000484","DOIUrl":"10.1097/HMR.0000000000000484","url":null,"abstract":"<p><strong>Background: </strong>Considering the future of work and an aging workforce, emerging technologies such as artificial intelligence (AI) and robots are promising fields to promote wellbeing, companionship, and care, together with operational efficiency in workplaces.</p><p><strong>Purpose: </strong>Using Design theory, this review examines how AI-pet robots can be adopted to interact with aging workers in innovation districts and health care innovative environments, considering the Human-robot attachment and Ethorobotics approaches.</p><p><strong>Methodology/approach: </strong>A scoping review was guided by the Population, Concept, Context (PCC) framework, as suggested by the Joanna Briggs Institute (JBI), to explain the scope and eligibility criteria, followed by the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR). Academic peer-reviewed transdisciplinary studies that were published on or before 2024 were sourced from the Scopus and Web of Science databases. The review included empirical and non-empirical studies, published in the English language, and excluded non-peer-reviewed publications.</p><p><strong>Results: </strong>A total of 31 studies were reviewed. The key findings revealed that AI-pet robots enhance emotional wellbeing through human-robot attachment. By adopting a human-centric perspective, organizations can implement advanced technologies that promote not only productivity but also companionship and support for aging workers. These findings provide a strategic health care management pathway for innovative solutions that integrate AI-driven pet robotics into workspaces, specifically in innovation districts.</p><p><strong>Practice implications: </strong>The study emphasizes the transformative potential of AI-pet robots, in addressing the challenges of an aging workforce within innovation districts. While most of the reviewed studies are situated in general innovation environments and health care, the findings have strong applicability to innovation districts. The results reveal that human-robot attachment, supported by AI and the Ethorobotics approach enhances emotional wellbeing and operational efficiency in workplaces. These insights are particularly relevant to innovation districts, where human-centered technologies can be trialed and embedded to support inclusive workforce transitions.</p>","PeriodicalId":47778,"journal":{"name":"Health Care Management Review","volume":"51 3S","pages":"S24-S33"},"PeriodicalIF":2.6,"publicationDate":"2026-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148363058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}