|
Executive
Summary: Change in the Population of Health Systems: From 1985 to 1998
Melissa J. Succi, Ph.D., assistant professor, Health Administration,
Chapman University, Orange, California; Jeffrey A. Alexander Ph.D., Richard
Carl Jelinek, Professor of Health Management and Policy, The University
of Michigan, Ann Arbor and Shoou-Yih D. Lee, Ph.D., assistant professor,
Department of Health Policy and Administration, The University of North
Carolina at Chapel Hill
This
article compares the predictions in Stephen Shortell's 1988 seminal article,
The Evolution of Hospital Systems: Unfulfilled Promises and Self-Fulfilling
Prophesies, with current data on health systems over a 14-year period
from 1985 to 1998. Specifically, we review five of Shortell's predictions
related to the horizontal growth of health systems and compare these predictions
with empirical data on structural changes in the population of health
systems. Our analyses suggest that Shortell's predictions corresponded
too much of the actual behavior demonstrated in the population over the
past one-and-a-half decades.
Support was found for the following: (1) Health systems form in two recurring
stages; (2) previously unaffiliated hospitals are affiliating with existing
systems rather than participating in the creation of new systems; and
(3) health systems have evolved into five different strata, each of which
represents different shares of the population; such population patterns
have important implications for individual hospitals and health systems.
By attending to patterns of change in the industry's social structure,
hospitals and health systems can determine whether it is likely to continue
along past trajectories or whether it shows signs of change that may pave
way for the breakdown of existing organizational forms, entry of new organizational
players, and the emergence of new governance structures.
Executive
Summary: Race, Ethnicity and Careers in Healthcare Management
Janice L. Dreachslin, Ph.D., associate professor of Health Policy and
Administration, Penn State Great Valley School of Graduate Professional
Studies, Malven,, Pennsylvania; Gloria E. Jimpson, R.N., M.H.S.A., CHE,
special assistant, New York State Health Department, Albany, New York;
and Elaine Sprainer, M.Mgt., research assistant and vice president of
operations, ReMed, Malvern, Pennsylvania
This
article discusses the result of a study we conducted to investigate the
factors that facilitate or impede healthcare management career opportunities
and satisfaction from the perspective of racially and ethnically diverse
healthcare managers. These healthcare managers were invited to participate
in focus groups wherein they engaged in a structured discussion of six
questions germane to race, ethnicity and healthcare management careers.
Nineteen themes were identified in the study anal-ysis, eight of which
emerged in all focus groups irrespective of race and ethnicity In this
article, we discuss the implications of the results for research and organization
change and development and we recommend plans of action in four areas
identified from the 19 themes: (1) industry leadership, (2) health administration
education, (3) health management research, and (4) best practices.
|
