Melissa J. Succi

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OBJECTIVE To examine the dynamic effects of competition and hospital market position on rural hospital closures. DATA SOURCE/STUDY SETTING Analysis of all rural community hospitals operating between 1984 and 1991, with the exception of sole-provider hospitals. Data for the study are obtained from four sources: the AHA Annual Surveys of Hospitals, the HCFA(More)
Many hospitals are actively pursuing strategies that integrate physicians into their management and governance structures. Despite expectations that these strategies improve hospital efficiency, empirical studies have failed to provide consistent evidence that physician involvement in hospital management and governance improves hospital efficiency. This(More)
Because of severe operating and resource constraints, many rural community hospitals are confronted with pressures to abandon core strategies related to acute inpatient care. Little is known, however, about why hospitals would choose to convert to organizations that provide non-acute care health services as an alternative to closure. We argue that rural(More)
Trust is a key element of effective work relationships between managers and physicians. Despite its importance, little is known about the factors that promote trust between these two professional groups. We examine whether manager and physician power over hospital decisions fosters manager-physician trust. We expect that with more power, managers and(More)
Many rural hospitals have closed or converted to organizations that provide health services other than general, acute inpatient care. However, little is known about why rural hospitals convert rather than close. This study evaluates the relationship between state policy and rates of rural hospital conversion relative to rates of rural hospital closure. The(More)
One widely discussed response to the severe problems faced by many rural hospitals is to convert them into organizations that provide health services other than general, acute inpatient care. This study identifies conversions that occurred nationally from 1984 to 1991. The study also empirically examines the determinants of conversion, using rural hospitals(More)
The shift from local, community-based hospitals to more complex, multilevel delivery systems raises questions about the community accountability exercised by hospitals. A national sample of community hospitals is the basis of this study, which examines the ways that community accountability is exercised by the governing boards of hospitals affiliated with(More)
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(More)
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