Project Categories

Reconfiguring the US Health Care System: Function, Form, and Feasibility

Award Year: 2004 Investigator: Harold Luft
In Reconfiguring the U.S. Health Care System: Function, Form, and Feasibility, Harold S. Luft, Ph.D. searches for workable approaches to reorganizing American health care. Recognizing the daunting nature of this task, Dr. Luft starts with what works well, considers how key functions can be reorganized and financed, and examines how to engage and influence multiple stakeholders and use new technologies to promote change.

Rural Models for American Health Care: Is Our Problem the Solution?

Award Year: 2001 Investigator: George Wright, Ira Moscovice
Rural health care is often viewed solely as a perennial problem and the object of special needs. This study takes a different perspective many rural communities have also developed cost-effective, primary care-oriented, high-quality models that deserve careful attention. They represent America's homegrown alternative to the consolidation of health services and institutions, and to what patients often perceive as increasingly impersonal care.

Nonprofit, For-Profit, and Governmental Provision of Health Care: Does Institutional Form Matter?

Award Year: 2000 Investigator: Burton Weisbrod
Health care services in the U.S. are provided by an amalgam of for-profit, nonprofit, and governmental institutions. Dr. Weisbrod's project examines whether and, if so, how institutional form matters in health care delivery and what it suggests for improved policymaking. Building on his and other's earlier work, he explores the fundamental question of what nonprofit and governmental organizations contribute to health care that is not provided by the private sector.

Implementing and Sustaining Change in Health Care Organizations

Award Year: 1999 Investigator: Gloria Bazzoli, Lawton Burns
Conducting an interdisciplinary, broad-based examination of organizational change, the investigators place special emphasis on understanding why some organizations implement and sustain fundamental changes while others do not. A conceptual framework is developed to explain the causes and consequences of organizational restructuring, synthesizing a substantial body of recent research.

Hospital Restructuring: Implications for Patient Outcomes and Workforce Policy

Award Year: 1998 Investigator: Linda Aiken
Market-driven restructuring of the U.S. hospital sector is raising doubts about quality of care, affecting worker morale, and weakening the public's trust. Dr. Aiken seeks to understand the mechanisms by which hospital organizational structure and processes affect patient outcomes. Her project focuses on how aspects of human resource allocation and hospital organization might be modified or shaped to yield better outcomes given financial constraints. As part of her study, Dr.

Integration of Long-Term Care into the Mainstream: The Case of Nursing Homes

Award Year: 1996 Investigator: Vincent Mor, Jacqueline Zinn
Few integrated delivery systems, products of the consolidation of health care delivery and financing, have focused on the role of long-term care (LTC) in general, and nursing homes in particular. Yet many nursing facilities across the nation are contracting with managed care organizations. Drs. Mor and Zinn chronicle how nursing home providers are adapting to changes in the environment and measure the effects on patient care.

Organizational Structures, Cultures, and System Aspects of Safety in Tertiary Health Care: A Comparison with Other High Risk-Industries

Award Year: 1996 Investigator: David Gaba
Preventable accidents occur frequently in health care, especially in comparison with the rate of serious mishaps in commercial and military aviation, space flight, and nuclear power production. Dr. Gaba's systematic comparison of health care to these industries is guided by a synthesis of recent theoretical models of safety and error in complex organizations.

The Corporate Consolidation of American Managed Care

Award Year: 1996 Investigator: Bradford Gray
Among the most sweeping changes in health care during the last two decades is the horizontal integration of managed care. Over two-thirds of HMOs are now part of for-profit national or multi-plan firms. Dr. Gray examines how the corporate consolidation of the HMO industry has changed responsiveness, power, and accountability in the health care system.

Health Policy and the Creation, Distribution and Destruction of Value in the Changing Health Care Market

Award Year: 1995 Investigator: J.B. Silvers
Dr. Silvers seeks to better understand what is happening and why in the changing health care environment by following the dollars. He: 1) identifies critical ownership and capital transactions in health care (sales, mergers, and discontinuance of operations); 2) estimates resulting changes in economic value; and 3) assesses the underlying environmental and policy drivers behind industry restructuring.

Accountable Health Care: Competing Interests, Goals and Policy Approaches

Award Year: 1994 Investigator: Marc Rodwin
This project explores the quest for responsible health care by examining the accountability of physicians, administrators, and organizations to consumers of health care, payers, and the general public. Accountability is looked at in the context of managed care organizations. Particular emphasis is placed on examining tensions and trade-offs among competing parties, and how changes in health policy affect accountability. Dr.