Exploring the relationship of hospital and market characteristics and organ donation in U.S. hospitals.

Unmet demand for organ transplantation is, in part, a result of low rates of organ donation. While the transplant community works diligently to improve rates of organ donation, patients on waiting lists for transplantation continue to die. This article reviews factors that are associated with rates of organ donation at U.S. hospitals. We analyzed two years of data on the numbers of actual and potential donors at U.S. hospitals to discern whether hospital or market attributes are directly related to a hospital's rate of securing organ donations. We found that certain hospital characteristics are related to higher donation rates. Further research and a deeper understanding of organizational and environmental influences on the complex nature of securing organ donations are needed to help alleviate transplantation waiting lists.

Approaches to organizing public relations functions in healthcare.

This article provides health care audiences with a framework for understanding different perspectives of the role and functions of public relations in healthcare organizations and the resultant alternatives for organizing and enacting public relations functions. Using an example of a current issue receiving much attention in US healthcare (improving rates of organ donation), the article provides examples of how these different perspectives influence public relations goals and objectives, definitions of 'public', activities undertaken, who undertakes them and where they fit into the organizational hierarchy.

Adoption of hospital case management: economic and institutional influences.

Case management became prevalent in US hospitals in the 1990s and is believed to be beneficial in controlling resource utilization, improving quality of care, reducing variation of care processes and enhancing both patient and staff satisfaction. This research investigates the adoption of case management by US hospitals at three time periods: 1994, 1997, and 2000. We propose that both economic and institutional factors influence the adoption of this management innovation, with economic factors being more influential in early and mid-periods (1994-1997) and institutional factors being more influential in later periods (after 1997). Using American Hospital Association Annual Survey Data and community data from the Area Resources File, we assess the relationship of baseline (1994) hospital and market characteristics to the likelihood of early adoption compared to late adoption, and mid-adoption compared to late adoption. We confirm that both economic and institutional forces influence the likelihood of early and mid-period adoption of case management compared to late adoption. We conclude that institutional influences aimed at achieving or maintaining legitimacy may be as strong a motivator for hospitals to adopt case management as are economic incentives. Implications for practice and further research are discussed.

Does case management matter as a hospital cost-control strategy?

Using an evidence-based model for management research, we examine the relationship of case management adoption and the expected nonclinical outcomes in nationwide hospitals operating continuously between 1994 and 2000. Although case management may be beneficial for certain populations, institution-wide effects in the form of decreased costs or decreased length of stay do not appear to be present in the study hospitals.

An assessment of the usability of undergraduate healthcare management program websites.

Prospective students in higher education programs increasingly use the Internet as a source of information to assist in the selection of both university and major programs of study. Therefore, having an informative and well designed website is now an integral component of a higher education program's marketing mix. This article attempts to inform undergraduate health administration programs about the elements of good website design, namely content that is important and relevant to users, site layout appeal, and ease of navigation. Content analyses of undergraduate health administration program websites in 2002 and 2005 assessed both the extent of content from a standard list of twenty-five information elements and usability features of the sites. Implications for improvements to program websites are discussed.

A post-1990s assessment of strategic hospital alliances and their marketplace orientations: time to refocus.

In past years, many SHAs formed in local urban markets to better compete for managed care contracts. In response to 1990s forces, these SHAs appear to have adapted product, production, and selling orientations to their markets, aimed at large institutional purchasers of health care. However, health care markets have evolved differently than anticipated. SHAs and their hospitals should now adopt the marketing orientation and focus more on patients and enrollees.

Urban U.S. hospitals and the mission to provide HIV-related services: changes and correlates.

In 1988, the vast majority of urban U.S. hospitals (84 percent) exhibited some formal response to the demand for HIV-related services. Despite the fact that HIV-related care is now normative in many respects and the demand for inpatient care has decreased, nearly half of hospitals surveyed in 1997 (42 percent) report no formalized service provision, suggesting a heightened distinction between hospitals in terms of their varying commitments to providing HIV-related services. Certain organizational variables (such as ownership, size, system affiliation, and stigmatized services and post-acute care services indices) were connected to HIV-related services provision. When the sample was controlled for other variables, the study found that changes in teaching status, changes in bed size, and changes in post-acute services from 1988 to 1997 did influence the provision of HIV-related services. Despite significant changes over the study period in the treatment of persons living with HIV/AIDS, and structural changes in the delivery of U.S. healthcare, the organizational-level predictors of HIV-related service provision have remained remarkably stable among U.S. hospitals in urban settings. These data also suggest that organizational missions consistent with serving indigent and socially marginalized populations continue to influence the ways that the pluralistic U.S. hospital system organizes HIV-related care.