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Accountable care organizations: a strategy for future success? 问责制医疗机构:未来成功的战略?
Q2 Social Sciences Pub Date : 2018-06-11 DOI: 10.1108/IJOTB-03-2018-0019
J. Harrison, A. Spaulding, Debra A Harrison
PurposeThe purpose of this paper is to assess the community dynamics and organizational characteristics of US hospitals that participate in accountable care organizations (ACO).Design/methodology/approachData were obtained from the 2015 American Hospital Association annual survey and the 2015 medicare final rule standardizing file. The study evaluated 785 hospitals which operate ACO in contrast to 1,446 hospitals without an ACO.FindingsIn total, 89 percent of hospitals using ACO’s are located in urban communities and 87 percent are not-for-profit. Hospitals with a higher case mix index are more likely to have an ACO.Practical implicationsACOs allow healthcare organizations to expand their geographic markets, achieve greater efficiencies, and enhance the development of new clinical services. They also shift the focus of care from acute care hospitalization to the full continuum of care.Originality/valueThis research found ACOs with hospital and physician networks are an effective mechanism to control healthcare costs and reduce medical errors.
目的本文的目的是评估社区动态和美国医院参与问责制护理组织(ACO)的组织特征。设计/方法/方法数据来自2015年美国医院协会年度调查和2015年医疗保险最终规则标准化文件。该研究评估了785家有ACO的医院和1446家没有ACO的医院。总的来说,89%的使用自动售货机的医院位于城市社区,87%是非营利性医院。病例混合指数较高的医院更有可能出现ACO。实际意义saco允许医疗保健组织扩展其地理市场,实现更高的效率,并加强新临床服务的开发。它们还将护理的重点从急性护理住院转移到全面的连续护理。独创性/价值本研究发现,与医院和医生网络合作的ACOs是控制医疗成本和减少医疗差错的有效机制。
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引用次数: 0
Georgia rural hospital authorities as “shadow governments” 格鲁吉亚乡村医院当局被称为"影子政府"
Q2 Social Sciences Pub Date : 2018-06-11 DOI: 10.1108/IJOTB-03-2018-0021
M. Wickersham, Robert Yehl
Purpose The tenuous financial viability of many of Georgia’s rural hospitals has driven increased scrutiny of the hospital authorities (HAs) that own and govern them. HAs are a type of “special district” established in state law to allow for specialization of function, while evading statutes that can limit local government borrowing and multi-year contracts. The paper aims to discuss this issue. Design/methodology/approach This paper uses a case example to introduce transparency and accountability in one local Georgia hospital and expands to include a descriptive analysis of transparency measures in 29 rural Georgia HAs. Findings Findings indicate that, like many other special districts in Georgia and the USA, Georgia’s rural HAs often act more like private entities than the public organizations they are. The lack of transparency demonstrated in this sector limits access to public information and reduces opportunities for citizen engagement, a necessary component of representative institutions. Research limitations/implications This case study is limited to Georgia HAs; however, the data support the lack of accountability and transparency found in many special district governments. Originality/value The lack of transparency in all of the organizations reviewed in this study demonstrates blurred lines between between public matters and private interests and raises questions of transparency, a key value in democracies.
目的:格鲁吉亚许多农村医院脆弱的财务生存能力促使拥有和管理它们的医院当局(has)受到越来越多的审查。HAs是一种“特区”,根据州法律设立,允许功能专业化,同时规避限制地方政府借款和多年期合同的法规。本文旨在对这一问题进行探讨。设计/方法/方法本文通过一个案例介绍了格鲁吉亚一家地方医院的透明度和问责制,并扩展到对格鲁吉亚29个农村医院透明度措施的描述性分析。调查结果调查结果表明,与格鲁吉亚和美国的许多其他特殊地区一样,格鲁吉亚的农村地区往往更像私人实体,而不是公共组织。该部门缺乏透明度,限制了获取公共信息的机会,减少了公民参与的机会,而公民参与是代议制机构的必要组成部分。研究局限性/意义本案例研究仅限于乔治亚州;然而,数据支持许多特区政府缺乏问责制和透明度。原创性/价值本研究审查的所有组织都缺乏透明度,这表明公共事务与私人利益之间的界限模糊,并提出了透明度问题,而透明度是民主的关键价值。
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引用次数: 0
Effective communication provides early intervention among Medicare patients 有效的沟通为医保患者提供了早期干预
Q2 Social Sciences Pub Date : 2018-06-11 DOI: 10.1108/IJOTB-03-2018-0018
H. O’Lawrence, M. Poyaoan-Linzaga
PurposeThe purpose of this paper is to determine the association between patients who talked to their doctor about their risk of falling, or occurrence of balance problem. This study analyzed a secondary data set based on the Medicare Health Outcomes Survey (HOS) for the Medicare Advantage patients of 65 years and older. This study guided by two hypotheses that: patients who talked to their doctor about falling or balance problem are more likely to have fallen in the past than those who did not talk to their doctor about their fall risk; and patients talking to their doctor about a fall or balance problem are more likely to receive an early intervention such as patient education to prevent a future fall.Design/methodology/approachThis study utilized a secondary data set to test its hypotheses. The Centers for Medicare and Medicaid Services (CMS) is dedicated to monitoring the quality of care provided to Medicare population in a managed care setting. Inter-University Consortium for Political and Social Research conducts the HOS to measure outcomes of quality improvement interventions developed by CMS in collaboration with the National Committee for Quality Assurance for Medicare Advantage Organizations (MAOs). The measures are focused on assessing the physical functioning and mental health being of Medicare beneficiaries and are aligned with reporting evidence of standards of care. Medicare HOS is administered in each Spring surveying a random sample of Medicare beneficiaries from MAOs that have a minimum of 500 enrollees; the cohort is surveyed again two years later as a follow-up measurement.FindingsReporting of a fall or balance problem is a critical component in fall prevention strategies. This study analyzed the distribution of beneficiaries who talked with their doctor about a fall or balance problem to understand if personal disposition (i.e. social class – educational level, gender, and race) would have been a factor in patients communicating with their doctor about their risk factors. The study found that 67.77 percent of patients who talked with their doctor about a fall or balance problem have at least a high school education compared with 32.23 percent who have less than a high school education or GED.Research limitations/implicationsAll patients who responded to the survey and fulfilled the inclusion criteria were included in the study. Therefore, the data presented a limitation due to a self-report of no doctor visits, which could indicate inopportunity for provider-patient communication to take place. Additionally, such an information on fall or balance problem, including actual fall occurrence in the past 12 months, was based on self-report that could present inaccuracy since the elderly population tend to have diminished or poor memory, which may also be problematic.Practical implicationsAlthough this specific interaction starts with patient reporting of a health problem such as a fall or balance problem, provider must take a proa
目的:本文的目的是确定与医生谈论跌倒风险或发生平衡问题的患者之间的关系。本研究分析了基于医疗保险健康结果调查(HOS)的65岁及以上医疗保险优惠患者的二级数据集。这项研究以两个假设为指导:与没有与医生谈论跌倒风险的患者相比,与医生谈论跌倒或平衡问题的患者过去摔倒的可能性更大;与医生谈论跌倒或平衡问题的患者更有可能接受早期干预,如患者教育,以防止未来跌倒。设计/方法学/方法本研究利用二手数据集来检验其假设。医疗保险和医疗补助服务中心(CMS)致力于监测在管理医疗环境中为医疗保险人口提供的医疗质量。大学间政治和社会研究联盟进行了HOS,以衡量CMS与国家医疗保险优势组织质量保证委员会(MAOs)合作开发的质量改进干预措施的结果。这些措施的重点是评估医疗保险受益人的身体功能和心理健康状况,并与医疗标准的报告证据保持一致。医疗保险居留权计划在每年春季进行,随机抽样调查至少有500名参保者的医疗保险受益人;该队列在两年后再次接受调查,作为后续测量。报告跌倒或平衡问题是预防跌倒策略的关键组成部分。本研究分析了与医生谈论跌倒或平衡问题的受益人的分布,以了解个人性格(即社会阶层-教育水平,性别和种族)是否会成为患者与医生沟通其风险因素的一个因素。研究发现,与医生讨论跌倒或平衡问题的患者中,67.77%至少受过高中教育,而高中教育程度以下或GED的患者中,这一比例为32.23%。研究局限性/意义所有响应调查并符合纳入标准的患者均被纳入研究。因此,由于没有医生就诊的自我报告,数据呈现出局限性,这可能表明提供者与患者之间没有机会进行沟通。此外,这些关于跌倒或平衡问题的信息,包括过去12个月的实际跌倒情况,是基于自我报告的,可能存在不准确性,因为老年人往往记忆力下降或差,这也可能是有问题的。虽然这种具体的互动始于患者报告的健康问题,如跌倒或平衡问题,但提供者必须采取积极主动的方法来部署预防策略,例如,无论患者报告的跌倒史如何,都要进行全面的跌倒风险评估。本研究建议进一步调查,以确定影响患者沟通的前倾向因素,以解决任何可能阻碍医患合作的障碍。尽管如此,加强医患沟通是任何高质量干预策略(如预防跌倒)的基础。社会意义本研究的另一个重要发现是患者沟通有助于预防跌倒。与医生谈论跌倒或步态问题的患者,医生会向他们提供如何预防跌倒的患者教育。提供者被告知患者的平衡问题,这导致进一步评估患者的健康状况,以便确定其他相关因素,因为可能会进行全面的跌倒风险评估,提供跌倒发生后的充分信息。这证实了医患沟通作为有效护理协调的弹射器的必要性,这在任何干预策略中都是有效的。由于跌倒和与跌倒相关的伤害很容易预防,因此预防跌倒越来越受到医疗机构(包括非管理型医疗机构)的关注并获得动力(Lachet al., 2011)。能够识别和准确分析患者健康状况,包括内在和外在风险因素的努力,促进了患者和提供者之间的有效互动。这项研究显示了患者沟通的积极作用,以便医生通过提供患者教育有效地干预(即防止未来跌倒)。
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引用次数: 2
Symposium on healthcare policy, financing, and economics 卫生保健政策、筹资和经济学专题讨论会
Q2 Social Sciences Pub Date : 2018-06-11 DOI: 10.1108/IJOTB-02-2018-0016
M. Younis
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引用次数: 0
Leaders’ intimidation impression management and subordinates’ affective job commitment in Nigeria 尼日利亚领导的恐吓印象管理与下属的情感工作承诺
Q2 Social Sciences Pub Date : 2018-03-20 DOI: 10.1108/IJOTB-03-2018-002
S. P. Asawo, B. George
Purpose The quality of the relationship between leaders and their followers appears to be one of the critical determinants of employees’ commitment at work. For instance, it has been empirically established that the impressions that managers convey of themselves to their subordinates, is a critical factor in the leader-follower relationship. The purpose of this paper is to examine the relationship between leaders’ intimidation impression management (IM) and subordinates’ affective job commitment in the telecommunications industry in Nigeria. Design/methodology/approach The design adopted for this study is the cross-sectional survey design. The questionnaire was utilized to generate data from a sample of 306 employees from the six major telecommunication companies in Nigeria. The Spearman Rank Correlation Coefficient was used as the inferential test statistic for assessing the relationship between leaders’ intimidation IM and subordinates’ affective job commitment. Findings The results showed that leaders’ threat, warning, fear-arousal, and discomfort-arousal all had significant but weak association with subordinates’ affective job commitment. The study thus found that as leaders apply intimidation IM strategies, workers’ sense of emotive attachment to their organization only improves minimally. Research limitations/implications Data were generated from employees, indicating that the outcome is based on their perception which may be skewed. Practical implications The outcome of the study will help managers in the Nigerian telecommunication industry to avoid the pitfalls that are associated with the arbitrary and excessive use of intimidation as an IM tactic. Rather, they would be guided to encourage good quality leader-member-exchange between them and their subordinates in enhancing individual and organizational performance. Originality/value This is the first main work to examine and identify the nature of the predictive effect of leaders’ intimidation IM on subordinates’ affective job commitment in the telecommunications industry in Nigeria.
领导者和追随者之间关系的质量似乎是员工工作承诺的关键决定因素之一。例如,经验证明,管理者向下属传达的对自己的印象,是领导与下属关系中的一个关键因素。本文的目的是研究尼日利亚电信行业领导者的恐吓印象管理(IM)与下属情感工作承诺之间的关系。设计/方法/方法本研究采用的设计是横断面调查设计。利用调查表从尼日利亚六个主要电信公司的306名雇员样本中产生数据。采用Spearman秩相关系数作为推论检验统计量来评估领导者的恐吓IM与下属的情感工作承诺之间的关系。结果发现,领导的威胁、警告、恐惧唤醒和不适唤醒对下属的情感工作承诺均有显著但微弱的关联。因此,研究发现,当领导者采用恐吓型即时通讯策略时,员工对组织的情感依恋感仅得到最低程度的改善。研究局限性/启示数据来自员工,表明结果是基于他们的感知,这可能是有偏差的。该研究的结果将有助于尼日利亚电信行业的管理人员避免与武断和过度使用恐吓作为即时通讯策略相关的陷阱。相反,他们会被引导去鼓励他们和下属之间进行高质量的领导-成员交换,以提高个人和组织的绩效。原创性/价值这是第一个主要的工作来检查和确定在尼日利亚电信行业的领导者的恐吓IM对下属的情感工作承诺的预测效果的性质。
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引用次数: 6
The different impact of personal social capital and intra-organizational SC: The Enron case study 个人社会资本与组织内决策的不同影响:以安然公司为例
Q2 Social Sciences Pub Date : 2018-03-12 DOI: 10.1108/IJOTB-03-2018-004
Batia Ben-Hador, Eyal Eckhaus
Purpose This study relates to two levels of organization social capital (SC): personal SC and intra-organizational SC. Personal SC is the utility derived from the person’s relationship, and his positioning in networks, inside and out of the organization. Intra-organizational SC is the benefit derived from interactions within, and between groups in the organization, and is based on trust, reciprocity, common goals, sharing information and knowledge. The purpose of this paper is to examine the difference between the SC levels by their connections to employee energy and success, before and after crisis. Design/methodology/approach In order to test the hypotheses, the authors used the Enron e-mails corpus, the texts were analyzed using SQL. Findings The findings suggest that the impact of personal SC and intra-organizational SC, on employee energy and success is different. Personal SC was found to have a higher impact on those two variables, than intra-organizational SC. After crisis, this gap became larger. Originality/value The importance of the findings is in the distinction between the SC levels, and their different impact on the employees. However, the situation of Enron employees at that time implies that the more important level of SC is the intra-organizational SC.
目的本研究涉及组织社会资本的两个层次:个人社会资本和组织内社会资本。个人社会资本是个人关系及其在组织内外网络中的定位所产生的效用。组织内供应链是从组织内和组织内团队之间的互动中获得的利益,基于信任、互惠、共同目标、共享信息和知识。本文的目的是通过危机前后SC水平与员工能量和成功的关系来检验它们之间的差异。设计/方法/方法为了检验这些假设,作者使用了安然电子邮件语料库,并使用SQL对文本进行了分析。研究结果表明,个人SC和组织内SC对员工能量和成功的影响是不同的。与组织内SC相比,个人SC对这两个变量的影响更大。危机后,这一差距变得更大。原创性/价值研究结果的重要性在于SC级别之间的区别,以及它们对员工的不同影响。然而,安然员工当时的情况表明,SC更重要的层面是组织内SC。
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引用次数: 15
Conceptualizing employees’ digital skills as signals delivered to employers 将员工的数字技能概念化为传递给雇主的信号
Q2 Social Sciences Pub Date : 2018-03-12 DOI: 10.1108/IJOTB-03-2018-003
Y. Bokek-Cohen
Purpose The purpose of this paper is to conceptualize employees’ digital skills as signals with which employees tacitly deliver information about their competence and suitability to the firm. Design/methodology/approach The paper draws on the Spence’s signaling theory. Findings Applying Spence’s signaling theory and Walther and Parks’s warranting theory enables the conceptualization of digital skills as signals and warrants among older workers who have been employed in their position for a longer period but nevertheless wish to demonstrate ongoing productivity. Practical implications It is recommended to use information about prospective or existent employees’ digital literacy as an indicator of high priority for the purpose of personnel selection, as it entails the acquisition of digital skills, which facilitate high productivity of most industries in today’s era. Social implications Older workers may wish to acquire digital skills in order to improve their career chances. Originality/value The paper is a theoretical contribution to the scholarship of digital literacy as well as to both signaling and warranting theories.
目的本文的目的是将员工的数字技能概念化为员工默认向公司传递有关其能力和适合性的信息的信号。设计/方法论/途径本文借鉴了Spence的信号理论。研究结果应用Spence的信号理论和Walters和Parks的保证理论,可以将数字技能概念化为老年工人的信号和保证,这些老年工人在其职位上工作了更长的时间,但仍希望展示持续的生产力。实际意义建议将未来或现有员工的数字素养信息作为人员选择的高度优先指标,因为这需要获得数字技能,这有助于当今时代大多数行业的高生产力。社会影响老年工人可能希望获得数字技能,以提高他们的职业机会。原创性/价值本文是对数字素养学术以及信号和保证理论的理论贡献。
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引用次数: 11
Job satisfaction versus job engagement: A comparative analysis on perceptions of accountability and turnover 工作满意度与工作敬业度:对责任感和离职率的比较分析
Q2 Social Sciences Pub Date : 2017-12-01 DOI: 10.1108/IJOTB-20-02-2017-B002
Dennis M. Daley
Job satisfaction assesses extrinsic and intrinsic motivation, leading to productivity. Job engagement internalizes an organizationʼs mission. Job engagement focuses an individualʼs efforts towards achieving meaningful results. Conceptually, job engagement must (1) establish the link between job engagement and organizational outcomes and (2) offer substantially more than currently provided by job satisfaction. Job engagement must be better than a common placebo or only a marginal improvement over job satisfaction. The Federal Employee View Survey (2013) includes global satisfaction and Job engagement indexes. Job satisfaction and job engagement are used as independent variables linked to productivity outcomes (accountability) and exit (intent to leave). Global satisfaction clearly provides a useful measure for productivity outcomes and exit. Job engagement adds usefully with regard to the accountability productivity outcome. However, using both constructs introduces redundancy.
工作满意度评估导致生产力的外在动机和内在动机。工作投入内化了一个组织的使命。工作投入是指个人为取得有意义的结果所付出的努力。从概念上讲,工作敬业度必须(1)建立工作敬业度与组织成果之间的联系;(2)提供比目前工作满意度多得多的东西。工作投入必须比普通的安慰剂更好,或者仅仅比工作满意度有些微的提高。联邦雇员观点调查(2013)包括全球满意度和工作投入指数。工作满意度和工作投入被用作与生产力结果(问责制)和退出(离职意图)相关的独立变量。全球满意度显然为生产率结果和退出提供了一个有用的衡量标准。工作投入有助于提高问责制和生产力。然而,使用这两种结构会引入冗余。
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引用次数: 14
An ontology-based goal framework to evaluate the level of the organizational goals achievement 基于本体的目标框架,用于评估组织目标实现的水平
Q2 Social Sciences Pub Date : 2017-12-01 DOI: 10.1108/IJOTB-20-02-2017-B003
Tengku Adil Tengku Izhar, T. Torabi, M. I. Bhatti
This paper is about gathering the measurement data and making an effectiveness results to assist decision-making process to evaluate the level of the organizational goals achievement. In order to achieve this aim, we designed GOAL framework as a platform represents five steps for domain experts and entrepreneurs to identify the relevant organizational data to assist decision-making process in relation to the organizational goals. The aim of this paper concentrates on the design of this framework. GOAL framework associated with the organizational goals ontology aim to identify the dependency relationship between organizational goals and dependency relationship between organizational data and organizational goals. Metrics is defined for this dependency to identify which organizational data is relevant to the organizational goals. The framework is flexible to change without affecting things around because the framework is applicable in any organizational data with different organizational goals.
本文是关于收集测量数据并做出有效性结果,以协助决策过程评价组织目标实现的水平。为了实现这一目标,我们将GOAL框架设计为一个平台,它代表了领域专家和企业家识别相关组织数据的五个步骤,以协助与组织目标相关的决策过程。本文的研究重点是该框架的设计。与组织目标本体相关联的目标框架旨在识别组织目标之间的依赖关系以及组织数据与组织目标之间的依赖关系。为此依赖项定义了度量,以确定哪些组织数据与组织目标相关。该框架可以灵活地进行更改,而不会影响周围的事物,因为该框架适用于具有不同组织目标的任何组织数据。
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引用次数: 1
The potential for paracrisis in corporate philanthropy and social media 企业慈善事业和社交媒体的潜在危机
Q2 Social Sciences Pub Date : 2017-12-01 DOI: 10.1108/IJOTB-20-01-2017-B002
Jeanne M. Persuit
Corporate philanthropy in the U.S. has emerged since the mid-19th century. This essay takes a historical and interpretive perspective on its practice. The author categorizes corporate philanthropy into four ethical models to examine each modelʼs communicative priorities and ethical concerns. These communicative priorities and ethical concerns become more complex as corporate philanthropic entities utilize social media. To this end, the potential for what Coombs and Holladay (2012) called a “paracrisis” emerges. This essay examines the potential for community partners to be affected by a corporationʼs presence on social media (and vice versa) through the interpretive lens of the paracrisis. The paper concludes with recommendations for future research.
美国的企业慈善事业自19世纪中期开始出现。本文从历史和解释的角度来看待它的实践。作者将企业慈善事业分为四种伦理模式,以考察每种模式的沟通重点和伦理问题。随着企业慈善实体利用社交媒体,这些沟通优先事项和道德问题变得更加复杂。为此,Coombs和Holladay(2012)所称的“副危机”的可能性出现了。本文通过对准危机的解释,考察了社区合作伙伴可能受到公司在社交媒体上的存在的影响(反之亦然)。论文最后对未来的研究提出了建议。
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引用次数: 6
期刊
International Journal of Organization Theory and Behavior
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