An Analysis of U.S. Health Systems: Factors Associated with Profitability, Efficiency and Quality Performance
Murray, Roslyn C.
This thesis uses the Agency for Healthcare Research and Quality’s (AHRQ) Compendium of U.S. Health Systems files for years 2016 and 2018, called the Comparative Health System Performance Compendium to explore the factors that are associated with health system financial and clinical performance, as well as efficiency. Both the current trends in provider consolidation and the movement toward value-based payment, in an attempt to integrate care, have led to the formation of large health systems. Researchers have developed an extensive evidence base about the justifications for system formation and the immediate effects, including greater negotiating power and potential economies of scale. But health systems vary in size and across other dimensions. These characteristics, along with the characteristics of affiliated hospitals, may have implications for the profitability, efficiency and quality performance of the hospitals that are affiliated with U.S. health systems. This thesis finds that some dimensions of health system size and other system or hospital characteristics, such as ownership status, and the presence of an accountable care organization contract, are associated with higher profitability, greater efficiency and higher quality performance.
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