Type of Document	Dissertation
Author	Crowell, Elsie Bradwell
URN	etd-07142008-131240
Title	Florida's Community Hospitals: Service Delivery Choices and Policy Implications
Degree	Doctor of Philosophy
Department	Public Administration and Policy, School of
Advisory Committee	Advisor Name Title Mary E. Guy Committee Chair Lance deHaven-Smith Committee Member Marie E. Cowart Committee Member Robert Bradley Committee Member
Keywords	Institutional Theory Transaction Cost
Date of Defense	2008-06-23
Availability	unrestricted
Abstract During the past quarter century, efforts have been made to control rising hospital costs, which are the largest component of U.S. health care expenditures. The purpose of this research is to examine the relationship among five community characteristics and hospital ownership types; determine whether there are differences in operational performance (cost and efficiency) between private nonprofit and private for-profit hospitals; and propose an answer to the question - Why do local governments contract-manage their hospital operation? Using a mixed-method research design, the findings are: (1) there are mixed results in the relationship between community characteristics and hospital ownership types; (2) there are no significant differences in operational performance of private nonprofit and private for-profit hospitals; and (3) hospitals pursue contract management services to gain hospital management expertise, financial management, medical and information technology, and human resource management and recruitment. The implications of this study calls for a broader examination of operational performance among hospital ownership types and policy direction on the goals and mission of a public private venture such as contract management.
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