Date of Award

Summer 1994

Document Type


Degree Name

Doctor of Philosophy (PhD)


Urban Services--Health Services

Committee Director

Gregory H. Frazer

Committee Member

C. Thomas Somma

Committee Member

Brenda S. Nichols

Committee Member

Lindsay L. Rettie

Committee Member

Clare Houseman


The 1990's will see dramatic changes for the health care industry. At no previous time have both public and private health care institutions faced a more turbulent, confusing and threatening environment. Changes in health care arena will come from Federal, State and local governments; international as well as domestic economic and market forces; demographic shifts and life style changes; and structural evolution of the health care industry including mergers, integrations and competition.

The health care industry faces increasing financial pressures due to fundamentally new forces that affect the very viability of many health care organizations. Such pressures include prospective payment, increased competition, diminished Federal monies, new technological development, the increased growth and bargaining power of preferred provider organizations (PPO's), and growing employer and consumer demands for more cost-effective care.

Faced with all these problems, health care executives have chosen different management strategies as a way to pilot their organizations from acquisitions, closures and liquidations to more profitable and viable facilities.

In order to assess the likely impact the various management systems may have on Virginia acute care hospitals profitability, market share, market growth potential and personnel (staff), turnover rates, the survey method with appropriate questions addressing these areas of concern was used.

In order to investigate the possible differences among the various management systems in regard to their likely impact on the profitability, market share, market growth potential and staff turnover rates, the analysis of variance techniques was explored. Analysis of variance often abbreviated with the acronym ANOVA... is a broad class of techniques for identifying and measuring the various sources of variation within a collection of data.

The different management systems were found not to have any significant difference regarding the institutions profitability, market share, market growth potential or personnel turnover rates. However, it was found that hospitals which are classified as diversified not-for-profit had greater market of general inpatient care (SI) than the hospitals which have different diversification classification.

In conclusion, the results of the data analysis did not support earlier findings in which differences in management systems were responsible for hospital performance variations.