Management and Performance in U.S. Healthcare Institutions: Do Sector-Differences Matter?

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2016-08-02

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Abstract

This dissertation includes three essays that focus on a number of central themes in public management and performance. Using American hospitals and nursing homes, I explore how sector-differences matter in healthcare service delivery. I propose theoretical frameworks on how managers respond to performance information in the cyclical process and how they employ the information in their managerial decisions. The three essays explore how public, nonprofit, and for-profit organizations perform differently in various performance dimensions, and how sector-differences leverage the ways of utilizing performance information on managerial decisions, networking and strategy. The first essay, Do Public Hospitals Outperform Nonprofit and For-profit Hospitals?, indicates that sector-differences matter in organizational performance where a trade-off relationship exists. The second essay, Help! I Need Somebody, provides evidence that managers strategically choose networking nodes in response to performance information. The third essay, Looking for Strategy in All the Wrong Places, reveals that performance information shapes managerial strategy, either prospecting or defending, but the impact is contingent on sectors. The findings contribute to public management literature that even if organizations have similar functions, tasks, rules and clients, sector-differences influence managerial decisions related to outcomes.

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Keywords

Management, Performance, Ownership, Networking, Strategy, Healthcare Organizations

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