In response to today's health care environment, hospitals have started to re-evaluate their existing care operations by placing greater emphasis on employee productivity, replacing inefficient methods of providing services, and improving the quality of services. An analysis of hospital capacity resource management (CRM) can help identify specific opportunities for revenue enhancement, cost containment, and service quality improvement.
The purpose of this dissertation is to investigate the effects of hospital demographic and service characteristics on hospital capacity resource management decisions and practices in the changing health care environment, and the effects of capacity resource management decisions on hospital performance. The capacity resources studied include facility, work force, and equipment/ technology.
Data was collected using a structured survey instrument administrated through the mail. The unit of analysis is at hospital level. The sample of hospitals contacted to participate is community hospitals. A total of 492 hospitals were contacted. One hundred and fifty-seven hospitals responded. This gave a response rate of 32%.
A covariance structure model of Hospital Capacity Resource Management and Performance (CRMP) was developed to test the theoretical model that specifies causal relationships between a number of observed variables. A two-step approach has been taken to perform the covariance structure model. In step one, an acceptable CRMP measurement model was developed through a number of iterations using confirmatory factor analysis method. In step two, the measurement model was modified and causal relationships between some of the latent constructs and manifest variables were specified. The goodness-of-fit of the model was assessed using a number of fitting indices. Model parsimony and fit were measured and was acceptable.
The study has a number of contributions. First, the study provides a number of managerial insights and policy implications for managing hospital capacity resources. Second, the results from the empirical study provide us with a basis for developing the causal theory of hospital capacity resource management and performance. This causal theory can be used to evaluate the effects of hospital facility, equipment/ technology, and workforce decisions on hospital cost and quality performance in the changing health care environment. The third contribution of this study is the development of the CRMP instrument and measurement scales. The measurement scales can be employed to measure data on hospital facility, equipment, and workforce management decisions and performance, and to statistically quantify the causal relationships between capacity management decisions and performance.