Resource Partitioning and Hospital Specialization

Abstract

Background:

Organizational scholars have been debating over specialism and generalism, and which environment is better for specialists and for generalists.

Methods:

This study relies heavily on the work of Okasha (Okasha, 1995, Modeling the determinants of hospital services differentiation and specialization (Dissertation). Virginia Commonwealth University, Richmond) and enhances it with available current literature on the topic. Okasha’s (Modeling the determinants of hospital services differentiation and specialization (Dissertation). Virginia Commonwealth University, Richmond) study tested the use of resource partitioning theory to explain the conversion of generalists to specialists under competitive environments.

Results:

The anticipated effect of buyers of care on hospital specialization was evident. Recent work on specialization (Eastaugh, 2014, Journal of Healthcare Finance) confirmed the trend.

Conclusion:

Buyer-related factors and organizational factors were the most important predictors of the positive change in hospital specialization between 1987 and 1993. High competition, the increased pressure from buyers of care, and organizational factors were the most important predictors of the positive change in the hospital specialization measures during that time period.

Keywords

Hospital specialization hospital partitioning hospital efficiency

References

Aldrich

H. E.

Auster

(1986). Even dwarfs started small: Liabilities of size and age and their strategic implications. In Staw

Cummings

(Eds.), Research in organizational behavior (pp. 165–198). Greenwich, UK: JAI Publisher.

Becker

G. S.

Murphy

K. M.

(1992). The division of labor, coordination costs, and knowledge. Quarterly Journal of Economics, CVII(4), 1137–1160.

Bhagat

Shleifer

Vishny

(1980). Brookings Papers on Economic Activity. Microeconomics, 1–84.

Borland

Xiaokai

(1992). Specialization and new approach to economic organization and growth. American Economic Review, 82(2), 386–391.

Borland

Shleifer

Vishny

(1990). Hostile takeover in the 1980s: The return to corporate specialization. In Brookings papers on economics activity (pp. 1–84).

Carroll

G. R.

(1985). Concentration and specialization: Dynamics of niche width in populations of organizations. American Journal of Sociology, 90(6), 1262–1283.

Daidone

D’Amico

(2009). Technical efficiency, specialization and ownership form: Evidences from a pooling of Italian hospitals. Journal of Production Analysis, 32(3), 203–216.

Dayhoff

D. A.

Cromwell

(1993). Measuring differences and similarities in hospital caseloads: A conceptual and empirical analysis. Health Services Research, 28(3), 293–402.

DiMaggio

P. J.

Powell

W. W.

(1983). The iron cage revisited: Institutional isomorphism and collective rationality in organizational fields. American Sociological Review, 48(2), 147–160.

10.

Eastaugh

S. R.

(1992). Hospital specialization and cost efficiency: Benefit of trimming product lines. Hospital & Health Services Administration, 37(2), 223–235.

11.

Eastaugh

S. R.

(2014). Hospital specialization: Benefits-focused product line planning. Journal of Healthcare Finance, 41(3), 1–15.

12.

Farley

D. E.

Hogan

(1990). Case-mix specialization in the market for hospital services. Health Services Research, 25(5), 757–783.

13.

Fennell

M. L.

(1980). The effects of environmental characteristics on the structure of hospital clusters. Administrative Science Quarterly, 25(3), 485–510.

14.

Guterman

Dobson

(1986). Impact of the medicare prospective payment system for hospitals. Healthcare Financing Review, 7(3), 97–114.

15.

Hannan

M. T.

Freeman

J. H.

(1984). Structural inertia and organizational change. American Sociological Review, 49(2), 149–164.

16.

Hannan

M. T.

Freeman

J. H.

(1989). Organizational ecology. Cambridge, MA: Harvard University Press.

17.

Kim

Mohtadi

(1992). Labor specialization and endogenous growth. American Economic Review, 82(2), 404–408.

18.

Litchenberg

F. R.

(1990). Want more productivity? Kill that conglomerate. Wall Street Journal, p. A-16.

19.

Markides

C. C.

(1993). Corporate refocusing. Business Strategy Review, 4(1), 1–5.

20.

Markides

C. C.

(1995). Diversification, restructuring and economic performance. Strategic Management Journal, 16(2), 101–118.

21.

Okasha

(1995). Modeling the determinants of hospital services differentiation and specialization (Dissertation). Virginia Commonwealth University, Richmond.

22.

Porter

M. E.

(1980). Competitive strategy. New York, NY: Collier Macmillan.

23.

Ruef

Mendel

Scott

W. R.

(1998). An organizational field approach to resource environments in healthcare: Comparing entries of hospitals and home health agencies in the San Francisco Bay Region. Health Services Research, 32(6), 775–803.

24.

Scott

W. R.

(1992). Organizations: Rational, natural, and open systems. Englewood Cliffs, NJ: Prentice Hall.

25.

Singh

J. V.

(1990). Organizational evolution: New directions. Newbury Park, CA: SAGE Publications.

26.

Swaminathan

(2001). Resource partitioning and the evolution of specialist organizations: The role of location and identity in the U.S. wine industry. Academy of Management Journal, 44(6), 1169–1185.

27.

Swaminathan

Carroll

C. R.

(1995). Beer brewers. In Carroll

C. R.

(Ed.), Organizations in industry: Strategy, structure, and selection (pp. 223–243). New York, NY: Oxford University Press.

28.

Walter

G. H.

(1991). What is resource partitioning? Journal of Theoretical Biology, 150(2), 137–143.

29.

Weber

(1947). The theory of social and economic organization. New York, NY: The Free Press.

30.

Wholey

D. R.

Sanchez

S. M.

(1991). The effect of regulatory tools on organizational populations. Academy of Management Review, 16(4), 743–767.

31.

Willams

J. R.

Paez

B. L.

Sanders

(1988). Conglomerates revisited. Strategic Management Journal, 9(5), 403–414.

32.

Xiaokai

(1993). Specialization and economic organization: A new classical microeconomics framework. Amsterdam, Holland: North-Holland.

33.

Xiaokai

Shi

(1992). Specialization and product diversity. American Economic Review, 82(2), 392–389.

34.

Zucker

L. G.

(1983). Organizations as institutions. In Bacharach

S. B.

(Ed.), Research in the sociology of organizations (pp. 1–47). Greenwich: JAI Press.