RESEARCH ARTICLE
Predictors of online accountability practices in US hospitals: An exploratory investigation
Asya Cooley,
Corresponding Author
Asya Cooley
School of Media and Strategic Communications, Oklahoma State University, Stillwater, Oklahoma, USA
Correspondence
Asya Cooley, School of Media and Strategic Communications, Oklahoma State University, 206 Paul Miller Journalism Building, Stillwater, OK 74078, USA.
Email: [email protected]
Search for more papers by this authorAsya Cooley,
Corresponding Author
Asya Cooley
School of Media and Strategic Communications, Oklahoma State University, Stillwater, Oklahoma, USA
Correspondence
Asya Cooley, School of Media and Strategic Communications, Oklahoma State University, 206 Paul Miller Journalism Building, Stillwater, OK 74078, USA.
Email: [email protected]
Search for more papers by this authorSummary
The purpose of this research paper is to explore variations in online accountability practices in US hospitals and determine the factors that are associated with higher levels of online accountability practices. This project employed a quantitative content analysis of 240 US hospital websites. Additionally, secondary data were obtained from the American Hospital Association and the American Hospital Directory. The results show that the external environment somewhat impacted hospitals' online accountability practices, with hospital volume (measured through the number of annual admissions) as an unquestionable predictor. Another key finding is that some of the governance forms impacted online accountability practices. Particularly, hospitals with private ownership structures tended to disclose less accountability information in an online environment, compared with their public and nonprofit counterparts. The financial situation of hospitals did not have any significant impact on overall online accountability practices but was influencing performance disclosure practices. Online accountability studies have not been conducted in a health care setting. This research theoretically relates online accountability practices to organizational characteristics (such as size, volume, financial performance, system affiliation, ownership, and rurality). Knowledge of the online accountability landscape might benefit future policy decisions on accountability models.
REFERENCES
- 1Ahmadi H, Nilashi M, Shahmoradi L, et al. The moderating effect of hospital size on inter and intra-organizational factors of Hospital Information System adoption. Technol Forecast Soc Change. 2018; 134: 124-149. https://doi.org/10.1016/j.techfore.2018.05.021
- 2Brinkerhoff DW. Accountability and health systems: toward conceptual clarity and policy relevance. Health Policy Plan. 2004; 19(6): 371-379. https://doi.org/10.1093/heapol/czh052
- 3Musau S, Vian T. Fraud in Hospitals, Anticorruption Brief by U4 Anticorruption Resource Centre; 2008.
- 4 National Health Expenditures 2017 Highlights; 2017.
- 5Wright J, Franks A, Ayres P, Jones K, Roberts T, Whitty P. Public Health Specialist Newcastle and North Tyneside Health Authority. Vol 24.; 2002.
- 6Jencks SF, Brock JE. Hospital accountability and population health: lessons from measuring readmission rates. Ann Intern Med. 2013; 159(9): 629-630.
- 7Axon RN, Williams MV. Hospital readmission as an accountability measure. JAMA. 2011; 305(5): 504-505.
- 8Pross C, Geissler A, Busse R. Measuring, reporting, and rewarding quality of care in 5 nations: 5 policy levers to enhance hospital quality accountability. Milbank Q. 2017; 95(1): 136-183.
- 9Kane NM, Magnus SA. The medicare cost report and the limits of hospital accountability: improving financial accounting data. J Health Polit Policy Law. 2001; 26(1). http://jhppl.dukejournals.org/cgi/content/abstract/26/1/81): 81-106.
- 10Sutton JP, Stensland J. Promoting accountability: hospital charity care in California, Washington state, and Texas. J Health Care Poor Underserved. 2004; 15(2): 237-250.
- 11Eeckloo K, Van Herck G, Van Hulle C, Vleugels A. From corporate governance to hospital governance: authority, transparency and accountability of Belgian non-profit hospitals' board and management. Health Policy (New York). 2004; 68(1): 1-15.
- 12Raffoul MC, Phillips RL. Increased public accountability for hospital nonprofit status: potential impacts on residency positions. J Am Board Fam Med. 2017; 30(4): 537-543.
- 13Dumont GE. Nonprofit virtual accountability: an index and its application. Nonprofit Volunt Sect Q. 2013; 42(5): 1049-1067. https://doi.org/10.1177/0899764013481285
- 14Dumont GE. Evaluating and Understanding Virtual Accountability: An Exploratory Study of Human Service, Arts and Culture, and Societal Benefit Nonprofit Organizations' Virtual Accountability in Illinois; 2010. http://gradworks.umi.com/34/19/3419349.html. Accessed June 12, 2017.
- 15Guo C, Saxton G. Accountability Online: The Web-Based Accountability Practices of Nonprofit Organizations. Chicago, IL; 2009.
- 16Saxton GD, Guo C. Accountability online: understanding the web-based accountability practices of nonprofit organizations. Nonprofit Volunt Sect Q. 2011; 40(2): 270-295. https://doi.org/10.1177/0899764009341086
- 17Dainelli F, Manetti G, Sibilio B. Web-based accountability practices in non-profit organizations: the case of national museums. Volunt Int J Volunt Nonprofit Organ. 2013; 24(3): 649-665.
- 18Huerta TR, Hefner JL, Ford EW, McAlearney AS, Menachemi N. Hospital website rankings in the United States: expanding benchmarks and standards for effective consumer engagement. J Med Internet Res. 2014; 16(2):e64. https://doi.org/10.2196/jmir.3054
- 19Gray B, Schlesinger M. The accountability of nonprofit hospitals: lessons from Maryland's community benefit reporting requirements. Inq J Heal Care Organ Provision, Financ. 2009; 46(2): 122-139. https://doi.org/10.5034/inquiryjrnl_46.02.122
- 20Palmer E. Mechanisms of health care accountability, marketisation and the elusive state. Med Law Int. 2011; 11(1): 69-92. https://doi.org/10.1177/096853321101100105
10.1177/096853321101100105 Google Scholar
- 21Jackman M. Charter review as a health care accountability mechanism in Canada. Health Law J. 2010; 18: 1-29.
- 22Pettersen IJ, Nyland K. Reforms and accounting system changes: a study on the implementation of accrual accounting in Norwegian hospitals. J Account Organ Chang. 2011; 7(3): 237-258. https://doi.org/10.1108/18325911111164196
10.1108/18325911111164196 Google Scholar
- 23Genovese U, Del Sordo S, Pravettoni G, Akulin IM, Zoja R, Casali M. A new paradigm on health care accountability to improve the quality of the system: four parameters to achieve individual and collective accountability. J Glob Health. 2017; 7(1):010301.
- 24Degeling P. Reconsidering clinical accountability. An examination of some dilemmas inherent in efforts to bolster clinician accountability. Int J Health Plann Manage. 2000; 15(1): 3-16.
10.1002/(SICI)1099-1751(200001/03)15:1<3::AID-HPM568>3.0.CO;2-R CAS PubMed Web of Science® Google Scholar
- 25Brommels M. A ‘stethoscope' for the physician manager—conditions for clinical accountability in the nordic setting. Int J Health Plann Manage. 1989; 4(2): 97-106. https://doi.org/10.1002/hpm.4740040204
- 26Mulgan R. “Accountability”: an ever-expanding concept? Public Adm. 2000; 78(3): 555-573.
- 27Tremblay-Boire J, Prakash A. Accountability.org: online disclosures by U.S. nonprofits. Volunt Int J Volunt Nonprofit Organ. 2015; 26(2): 693-719.
- 28DiMaggio PJ, Powell WW. The iron cage revisited: institutional isomorphism and collective rationality in organizational fields. Am Sociol Rev. 1983; 48(2): 147-160. https://doi.org/10.1016/S0742-3322(00)17011-1
- 29Meyer JW, Rowan B. Institutionalized organizations: formal structure as myth and ceremony. Am J Sociol. 1977; 83(2): 340-363. https://doi.org/10.1086/226550
- 30Yang C. Implementing hospital innovation in Taiwan: the perspectives of institutional theory and social capital. Int J Health Plann Manage. 2015; 30(4): 403-425.
- 31Yang CW, Fang SC, Huang WM. Isomorphic pressures, institutional strategies, and knowledge creation in the health care sector. Health Care Manage Rev. 2007; 32(3): 263-270. https://doi.org/10.1097/01.HMR.0000281627.22526.ee
- 32Haraldsson M. Transparency and accountability lost?: full cost accounting reporting in the Swedish municipal solid waste business. J Account Organ Chang. 2016; 12(3): 254-280. https://doi.org/10.1108/JAOC-01-2015-0006
- 33Rodríguez Bolívar MP, Alcaide Muñoz L, López Hernández AM. Determinants of financial transparency in government. Int Public Manag J. 2013; 16(4): 557-602. https://doi.org/10.1080/10967494.2013.849169
- 34Kazley AS, Ozcan YA. Organizational and environmental determinants of hospital EMR adoption: a national study. J Med Syst. 2007; 31(5): 375-384. https://doi.org/10.1007/s10916-007-9079-7
- 35Lucas JA, Avi-Itzhak T, Robinson JP, Morris CG, Koren MJ, Reinhard SC. Continuous quality improvement as an innovation: which nursing facilities adopt it? Gerontologist. 2005; 45(1): 68-77. https://doi.org/10.1093/geront/45.1.68
- 36Zinn JS, Proenca J, Rosko MD. Organizational and environmental factors in hospital alliance membership and contract management: a resource-dependence perspective. Hosp Health Serv Adm. 1997; 42(1): 67-86. http://www.ncbi.nlm.nih.gov/pubmed/10164899. Accessed July 19, 2018
- 37Chang IC, Hwang HG, Hung MC, Lin MH, Yen DC. Factors affecting the adoption of electronic signature: executives' perspective of hospital information department. Decis Support Syst. 2007; 44(1): 350-359. https://doi.org/10.1016/j.dss.2007.04.006
- 38Hung SY, Hung WH, Tsai CA, Jiang SC. Critical factors of hospital adoption on CRM system: organizational and information system perspectives. Decis Support Syst. 2010; 48(4): 592-603. https://doi.org/10.1016/j.dss.2009.11.009
- 39Kahn JM, Ten Have TR, Iwashyna TJ. The relationship between hospital volume and mortality in mechanical ventilation: an instrumental variable analysis. Health Serv Res. 2009; 44(3): 862-879. https://doi.org/10.1111/j.1475-6773.2009.00959.x
- 40Needham DM, Bronskill SE, Rothwell DM, et al. Hospital volume and mortality for mechanical ventilation of medical and surgical patients: a population-based analysis using administrative data. Crit Care Med. 2006; 34(9): 2349-2354. https://doi.org/10.1097/01.CCM.0000233858.85802.5C
- 41 Health Research & Educational Trust. The Role of Small and Rural Hospitals and Care Systems in Effective Population Health Partnerships; 2013. http://www.hpoe.org/Reports-HPOE/The_Role_Small_Rural_Hospital_Effective_Population_Health_Partnership.pdf. Accessed November 27, 2017.
- 42 American Hospital Association. AHA Hospital Statistics, 2017 Edition; 2017. http://www.aha.org/products-services/aha-hospital-statistics.shtml. Accessed November 27, 2017.
- 43Menachemi N, Shin DY, Ford EW, Yu F. Environmental factors and health information technology management strategy. Health Care Manage Rev. 2011; 36(3): 275-285. https://doi.org/10.1097/HMR.0b013e3182048e7e
- 44Yeager VA, Zhang Y, Diana ML. Analyzing determinants of hospitals' accountable care organizations participation. Med Care Res Rev. 2015; 72(6): 687-706. https://doi.org/10.1177/1077558715592295
- 45 Rural Health Research Center. Policy Brief Key HIT Applications in Critical Access Hospitals and Other Rural Hospitals; 2009. http://rhrc.umn.edu/wp-content/files_mf/mcculloughhitpolicy.pdf. Accessed November 27, 2017.
- 46 American Hospital Association. The opportunities and challenges for rural hospitals in an era of health reform. 2011;(April):1-16. http://www.aha.org/research/reports/tw/11apr-tw-rural.pdf. Accessed November 27, 2017.
- 47Shen Y-C, Eggleston K, Lau J, Schmid C. Hospital Ownership and Financial Performance: A Quantitative Research Review. Cambridge, Mass; 2005. http://www.nber.org/papers/w11662. Accessed July 19, 2018.
- 48Iacovou CL, Benbasat I, Dexter AS. Electronic data interchange and small organizations: adoption and impact of technology. MIS Q. 1995; 19(4): 465. https://doi.org/10.2307/249629
- 49Lian JW, Yen DC, Wang YT. An exploratory study to understand the critical factors affecting the decision to adopt cloud computing in Taiwan hospital. Int J Inf Manage. 2014; 34(1): 28-36. https://doi.org/10.1016/j.ijinfomgt.2013.09.004
- 50Chong AY-L, Chan FT. Structural equation modeling for multi-stage analysis on radio frequency identification (RFID) diffusion in the healthcare industry. Expert Syst Appl. 2012; 39(10): 8645-8654.
- 51Deering P, Tatnall A, Burgess S. Adoption of ICT in rural medical general practices in Australia: an actor-network study. In: Social Influences on Information and Communication Technology Innovations. Hershey, Pennsylvania: IGI Global; 2012: 40.
10.4018/978-1-4666-1559-5.ch003 Google Scholar
- 52Chabotar KJ. Financial ratio analysis comes to nonprofits. J Higher Educ. 1989; 60(2): 188-208. https://doi.org/10.1080/00221546.1989.11775021
- 53Pinto I, Picoto WN. Configurational analysis of firms' performance: understanding the role of Internet financial reporting. J Bus Res. 2016; 69(11): 5360-5365.
- 54 Fast Facts on U.S. Hospitals, 2018|AHA. In: 2018 AHA Hospital Statistics; 2018. https://www.aha.org/statistics/fast-facts-us-hospitals. Accessed March 21, 2018.
- 55Bazzoli GJ, Shortell SM, Dubbs N, Chan CL, Kralovec P. A taxonomy of health networks and systems: bringing order out of chaos. Health Serv Res. 1999; 33(6): 1683-1717. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070343/pdf/hsresearch00032-0131.pdf. Accessed July 19, 2018
- 56Luke RD. Taxonomy of health networks and systems: a reassessment. Health Serv Res. 2006; 41(3 I): 618-628. https://doi.org/10.1111/j.1475-6773.2006.00524.x
- 57Holmgren AJ, Ford EW. Assessing the impact of health system organizational structure on hospital electronic data sharing. J Am Med Inform Assoc. 2018; 25(9): 1147-1152. https://doi.org/10.1093/jamia/ocy084
- 58Lesser CS, Ginsburg PB. Update on the nation's health care system: 1997-1998. Health Aff. 2000; 19(6): 206-216.
- 59Cuellar AE, Gertler PJ. Trends in hospital consolidation: the formation of local systems. Health Aff (Millwood). 2003; 22(6): 77-87. https://doi.org/10.1377/hlthaff.22.6.77
- 60Cutler DM, Scott MF. Hospitals, market share, and consolidation. JAMA. 2013; 310(18): 1964-1970. https://doi.org/10.1001/jama.2013.281675
- 61Hillman AJ, Withers MC, Collins BJ. Resource dependence theory: a review. J Manage. 2009; 35(6): 1404-1427. https://doi.org/10.1177/0149206309343469
- 62Pfeffer J, Salancik GR. The External Control of Organizations: A Resource Dependence Perspective. New York: Harper & Row; 1978.
- 63Hübner U, Ammenwerth E, Flemming D, Schaubmayr C, Sellemann B. IT adoption of clinical information systems in Austrian and German hospitals: results of a comparative survey with a focus on nursing. BMC Med Inform Decis Mak. 2010; 10(1): 8. https://doi.org/10.1186/1472-6947-10-8
- 64Henke RM, Karaca Z, Moore B, et al. Impact of health system affiliation on hospital resource use intensity and quality of care. Health Serv Res. 2018; 53(1): 63-86. https://doi.org/10.1111/1475-6773.12631
- 65Lee S-YD, Alexander JA, Bazzoli GJ. Whom do they serve?: community responsiveness among hospitals affiliated with health systems and networks. Med Care. 2003; 41(1): 165-179.
- 66Lütkepohl H, Xu F. The role of the log transformation in forecasting economic variables. Empir Econ. 2012; 42(3): 619-638. https://doi.org/10.1007/s00181-010-0440-1
- 67Henson RK. Understanding internal consistency reliability estimates: a conceptual primer on coefficient alpha. Meas Eval Couns Dev. 2001; 34(3): 177-189.
- 68Field A. Discovering Statistics Using SPSS. Sage Publications; 2009. https://books.google.com/books/about/Discovering_Statistics_Using_SPSS.html?id=5253SAL5nDgC. Accessed July 20, 2018.
- 69Behn B, DeVries D, Lin J. Voluntary Disclosure in nonprofit organizations: an exploratory study. SSRN Electron J. February 2007. doi:10.2139/ssrn.727363
- 70Gordon T, Fischer M, Malone D, Tower G. A comparative empirical examination of extent of disclosure by private and public colleges and universities in the United States. J Account Public Policy. 2002; 21(3): 235-275. https://doi.org/10.1016/S0278-4254(02)00051-0
10.1016/S0278-4254(02)00051-0 Google Scholar
- 71Foster G. Financial Statement Analysis. Englewood Cliffs, N.J.: Prentice-Hall; 1986.
- 72Carson EM. Do Performance appraisals of registered nurses reflect a relationship between hospital size and caring? Nurs Forum. 2004; 39(1): 5-13.
- 73Manojlovich M, Antonakos CL, Ronis DL. The relationship between hospital size and ICU type on select adverse patient outcomes. Hosp Top. 2010; 88(2): 33-42.
- 74Hooghiemstra R. Corporate communication and impression management—new perspectives why companies engage in corporate social reporting. J Bus Ethics. 2000; 27(1): 55-68.
- 75Patten DM. Intra-industry environmental disclosures in response to the Alaskan oil spill: a note on legitimacy theory. Accounting, Organ Soc. 1992; 17(5): 471-475. https://doi.org/10.1016/0361-3682(92)90042-Q
- 76Fox J. The uncertain relationship between transparency and accountability. Dev Pract. 2011; 17(4): 663-671. https://doi.org/10.2307/25548267
- 77 Hospital Accountability Project|Community Catalyst. https://www.communitycatalyst.org/initiatives-and-issues/initiatives/hospital-accountability-project/full-description. Accessed August 15, 2018.
