IDEAS home Printed from https://ideas.repec.org/a/eee/hepoli/v117y2014i2p239-246.html
   My bibliography  Save this article

Defining hospital's internal boundaries. An organisational complexity criterion

Author

Listed:
  • Mariani, Laura
  • Cavenago, Dario

Abstract

The aim of this paper is to provide empirical evidences supporting the definition of hospital wards’ boundaries in organisational designing processes, by suggesting services aggregation criteria that are focused on organisational complexity. In order to test the research hypotheses, a panel data analysis was conducted on Lombardy hospitals in Italy. Information was gathered both from administrative records – aggregated at in-patient ward level – and general registry offices. The results highlight that the wards offering integrated services perform better than those that are more specialised. However, for growing levels of within-complexity, the positive effects of formal integration between wards tend to reduce. Some guidelines for practitioners engaged in defining hospitals’ organisational structures can be drawn from the empirical analysis.

Suggested Citation

  • Mariani, Laura & Cavenago, Dario, 2014. "Defining hospital's internal boundaries. An organisational complexity criterion," Health Policy, Elsevier, vol. 117(2), pages 239-246.
  • Handle: RePEc:eee:hepoli:v:117:y:2014:i:2:p:239-246
    DOI: 10.1016/j.healthpol.2014.04.008
    as

    Download full text from publisher

    File URL: http://www.sciencedirect.com/science/article/pii/S0168851014001079
    Download Restriction: Full text for ScienceDirect subscribers only

    File URL: https://libkey.io/10.1016/j.healthpol.2014.04.008?utm_source=ideas
    LibKey link: if access is restricted and if your library uses this service, LibKey will redirect you to where you can use your library subscription to access this item
    ---><---

    As the access to this document is restricted, you may want to search for a different version of it.

    References listed on IDEAS

    as
    1. Stefano Villa & Marta Barbieri & Federico Lega, 2009. "Restructuring patient flow logistics around patient care needs: implications and practicalities from three critical cases," Health Care Management Science, Springer, vol. 12(2), pages 155-165, June.
    2. Sarv Devaraj & Rajiv Kohli, 2003. "Performance Impacts of Information Technology: Is Actual Usage the Missing Link?," Management Science, INFORMS, vol. 49(3), pages 273-289, March.
    3. Whitacre, Brian E. & Fannin, James Matthew & Barnes, James N., 2008. "Factors Affecting Outsourcing for Information Technology Services in Rural Hospitals: Theory and Evidence," 2008 Annual Meeting, February 2-6, 2008, Dallas, Texas 6393, Southern Agricultural Economics Association.
    4. Alfredo Esposto, 2004. "Contractual Integration of Physician and Hospital Services in the U.S," Journal of Management & Governance, Springer;Accademia Italiana di Economia Aziendale (AIDEA), vol. 8(1), pages 49-69, March.
    5. Robert G. Evans & Hugh D. Walker, 1972. "Information Theory and the Analysis of Hospital Cost Structure," Canadian Journal of Economics, Canadian Economics Association, vol. 5(3), pages 398-418, August.
    6. Sendil K. Ethiraj & Daniel Levinthal, 2004. "Modularity and Innovation in Complex Systems," Management Science, INFORMS, vol. 50(2), pages 159-173, February.
    7. Lee, Kwang-soo & Chun, Ki-hong & Lee, Jung-soo, 2008. "Reforming the hospital service structure to improve efficiency: Urban hospital specialization," Health Policy, Elsevier, vol. 87(1), pages 41-49, July.
    8. Farley, Dean E., 1989. "Measuring casemix specialization and the concentration of diagnoses in hospitals using information theory," Journal of Health Economics, Elsevier, vol. 8(2), pages 185-207, June.
    9. Paolo Berta & Chiara Seghieri & Giorgio Vittadini, 2013. "Comparing health outcomes among hospitals: the experience of the Lombardy Region," Health Care Management Science, Springer, vol. 16(3), pages 245-257, September.
    10. Brahm, Francisco & Tarziján, Jorge, 2012. "The impact of complexity and managerial diseconomies on hierarchical governance," Journal of Economic Behavior & Organization, Elsevier, vol. 84(2), pages 586-599.
    11. Wood, Robert E., 1986. "Task complexity: Definition of the construct," Organizational Behavior and Human Decision Processes, Elsevier, vol. 37(1), pages 60-82, February.
    12. Lega, Federico & DePietro, Carlo, 2005. "Converging patterns in hospital organization: beyond the professional bureaucracy," Health Policy, Elsevier, vol. 74(3), pages 261-281, November.
    13. Alfons Palangkaraya & Jongsay Yong, 2013. "Effects of competition on hospital quality: an examination using hospital administrative data," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 14(3), pages 415-429, June.
    14. Annette Tomal, 1998. "The relationship between hospital mortality rates, and hospital, market and patient characteristics," Applied Economics, Taylor & Francis Journals, vol. 30(6), pages 717-725.
    Full references (including those not matched with items on IDEAS)

    Most related items

    These are the items that most often cite the same works as this one and are cited by the same works as this one.
    1. Christoph Strumann & Alexander Geissler & Reinhard Busse & Christoph Pross, 2022. "Can competition improve hospital quality of care? A difference-in-differences approach to evaluate the effect of increasing quality transparency on hospital quality," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 23(7), pages 1229-1242, September.
    2. Ivonne Lindlbauer & Jonas Schreyögg, 2014. "The relationship between hospital specialization and hospital efficiency: do different measures of specialization lead to different results?," Health Care Management Science, Springer, vol. 17(4), pages 365-378, December.
    3. Liberati, Elisa Giulia & Gorli, Mara & Scaratti, Giuseppe, 2016. "Invisible walls within multidisciplinary teams: Disciplinary boundaries and their effects on integrated care," Social Science & Medicine, Elsevier, vol. 150(C), pages 31-39.
    4. Conrad Kobel & Engelbert Theurl, 2013. "Hospital specialisation within a DRG-Framework: The Austrian Case," Working Papers 2013-06, Faculty of Economics and Statistics, Universität Innsbruck.
    5. Sung-hun Park & Joong Hoon Ko & Eun-song Bae & Meehyang Chang & Daecheol Kim, 2019. "The Impact of Hospital Specialization on Congestion and Efficiency," Sustainability, MDPI, vol. 11(5), pages 1-14, March.
    6. Helmut Herwartz & Christoph Strumann, 2014. "Hospital efficiency under prospective reimbursement schemes: an empirical assessment for the case of Germany," The European Journal of Health Economics, Springer;Deutsche Gesellschaft für Gesundheitsökonomie (DGGÖ), vol. 15(2), pages 175-186, March.
    7. Justin T. Kistler & Ramkumar Janakiraman & Subodha Kumar & Vikram Tiwari, 2021. "The Effect of Operational Process Changes on Preoperative Patient Flow: Evidence from Field Research," Production and Operations Management, Production and Operations Management Society, vol. 30(6), pages 1647-1667, June.
    8. Villa, Stefano & Prenestini, Anna & Giusepi, Isabella, 2014. "A framework to analyze hospital-wide patient flow logistics: Evidence from an Italian comparative study," Health Policy, Elsevier, vol. 115(2), pages 196-205.
    9. Andrew Burton-Jones & Camille Grange, 2013. "From Use to Effective Use: A Representation Theory Perspective," Information Systems Research, INFORMS, vol. 24(3), pages 632-658, September.
    10. Narayan Ramasubbu & Chris F. Kemerer, 2016. "Technical Debt and the Reliability of Enterprise Software Systems: A Competing Risks Analysis," Management Science, INFORMS, vol. 62(5), pages 1487-1510, May.
    11. Han-Sung Kim & Young-Hoon Kim & Jung-Sik Woo & Sook-Jung Hyun, 2015. "An Analysis of Organizational Performance Based on Hospital Specialization Level and Strategy Type," PLOS ONE, Public Library of Science, vol. 10(7), pages 1-14, July.
    12. Helmut Herwartz & Christoph Strumann, 2012. "On the effect of prospective payment on local hospital competition in Germany," Health Care Management Science, Springer, vol. 15(1), pages 48-62, March.
    13. Davide Consoli & Pier Paolo Patrucco, 2011. "Complexity and the Coordination of Technological Knowledge: The Case of Innovation Platforms," Chapters, in: Handbook on the Economic Complexity of Technological Change, chapter 8 Edward Elgar Publishing.
    14. Hilal Atasoy & Rajiv D. Banker & Paul A. Pavlou, 2016. "On the Longitudinal Effects of IT Use on Firm-Level Employment," Information Systems Research, INFORMS, vol. 27(1), pages 6-26, March.
    15. Francesco Ventrella & Francesca Fortunato, 2019. "Organizzazione della Struttura Complessa di Medicina interna per intensit? di cure: l?Area critica di Medicina interna," MECOSAN, FrancoAngeli Editore, vol. 2019(112), pages 7-39.
    16. Ewa Lechman, 2012. "Technology convergence and digital divides. A country-level evidence for the period 2000–2010," Ekonomia journal, Faculty of Economic Sciences, University of Warsaw, vol. 31.
    17. Muhammad Khalid Anser & Zahid Yousaf & Muhammad Usman & Seemab Yousaf, 2020. "Towards Strategic Business Performance of the Hospitality Sector: Nexus of ICT, E-Marketing and Organizational Readiness," Sustainability, MDPI, vol. 12(4), pages 1-17, February.
    18. Matthijs J. Verhulst & Anne-Françoise Rutkowski, 2018. "Decision-Making in the Police Work Force: Affordances Explained in Practice," Group Decision and Negotiation, Springer, vol. 27(5), pages 827-852, October.
    19. Battke, Benedikt & Schmidt, Tobias S. & Stollenwerk, Stephan & Hoffmann, Volker H., 2016. "Internal or external spillovers—Which kind of knowledge is more likely to flow within or across technologies," Research Policy, Elsevier, vol. 45(1), pages 27-41.
    20. Zand, Fardad & Van Beers, Cees & Van Leeuwen, George, 2011. "Information technology, organizational change and firm productivity: A panel study of complementarity effects and clustering patterns in Manufacturing and Services," MPRA Paper 46469, University Library of Munich, Germany.

    Corrections

    All material on this site has been provided by the respective publishers and authors. You can help correct errors and omissions. When requesting a correction, please mention this item's handle: RePEc:eee:hepoli:v:117:y:2014:i:2:p:239-246. See general information about how to correct material in RePEc.

    If you have authored this item and are not yet registered with RePEc, we encourage you to do it here. This allows to link your profile to this item. It also allows you to accept potential citations to this item that we are uncertain about.

    If CitEc recognized a bibliographic reference but did not link an item in RePEc to it, you can help with this form .

    If you know of missing items citing this one, you can help us creating those links by adding the relevant references in the same way as above, for each refering item. If you are a registered author of this item, you may also want to check the "citations" tab in your RePEc Author Service profile, as there may be some citations waiting for confirmation.

    For technical questions regarding this item, or to correct its authors, title, abstract, bibliographic or download information, contact: Catherine Liu or the person in charge (email available below). General contact details of provider: http://www.elsevier.com/locate/healthpol .

    Please note that corrections may take a couple of weeks to filter through the various RePEc services.

    IDEAS is a RePEc service. RePEc uses bibliographic data supplied by the respective publishers.