Using data from hospitals in ten states, this study examines the effects of organizational and market factors on the likelihood of becoming high-quality/low-cost providers during the period of 1997-2001. The findings highlight the important role of previous performance, internal operations, and market competition in hospital performance improvement. Achieving high-quality/low-cost performance is also incidentally found to be associated with improved profit margins.
H. Joanna Jiang, PhD, is Social Scientist, Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, Rockville, Maryland. E-mail firstname.lastname@example.org.
Bernard Friedman, PhD, is Senior Economist, Center for Delivery, Organization and Markets, Agency for Healthcare Research and Quality, Rockville, Maryland.
James W. Begun, PhD, is James A. Hamilton Term Professor, Division of Health Policy and Management, School of Public Health, University of Minnesota, Minneapolis.
This study was funded by the Agency for Healthcare Research and Quality. The views expressed in this article are those of the authors and do not necessarily reflect those of the Agency for Healthcare Research and Quality or the U.S. Department of Health and Human Services or the University of Minnesota.