This article examines hospital reorganization and restructuring activities following merger for two study periods: 1983-1988 and 1989-1996. In both periods, hospitals rated strengthening hospital financial position as the most important reason for merger. There were also similarities in reorganizing actions, especially reductions in service duplication, consolidation of departments and programs, reductions in medical and support FTEs, and reductions in administrative staffing. Hospital mergers during 1989-1996, however, focused increasingly on reducing nursing FTEs and less on converting acquired hospitals to new service lines.
Gloria J. Bazzoli, Ph.D., is Professor, Department of Health Administration, Virginia Commonwealth University, Richmond, Virginia.
Anthony LoSasso, Ph.D., is Research Assistant Professor, Institute for Health Services Research & Policy Studies, Northwestern University, Evanston, Illinois.
Richard Arnould, Ph.D., is Professor and Chair, University of Illinois—Champaign, Department of Economics, Champaign, Illinois.
Madeleine U. Shalowitz, M.D., M.B.A., is Director of Health Services Research, Department of Pediatrics, Evanston Northwestern Healthcare, and Assistant Professor of Pediatrics, Northwestern Medical School.
The research on which this article is based was supported by the Agency for Health Research and Quality (R01-HS 09201-01). The survey undertaken for this research was conducted when the lead author was vice president for research with the American Hospital Association's Health Research and Educational Trust. Min Guo and John Kim of Northwestern University provided valuable assistance in the data collection process.