دانلود رایگان مقاله لاتین کسب و کار فناوری در بیمارستان دبی از سایت الزویر


عنوان فارسی مقاله:

کسب و کار فناوری در بیمارستان های دبی


عنوان انگلیسی مقاله:

Technology acquisition and efficiency in Dubai hospitals


سال انتشار : 2016



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بخشی از مقاله انگلیسی:


2. Background and hypotheses development

 2.1. Technology and efficiency in hospitals Numerous scholars have called for more robust empirical evidence on the relationship between the acquisition of technology and hospital performance (Agarwal et al., 2010). In fact, although several studies have examined the impact of health and information technology on hospital performance, results are mixed (Dobrzykowski and Tarafdar, 2016). Some authors find either marginal improvements (McCullough et al., 2010) or a negative impact on hospital performance (Koppel et al., 2005; Smelcer et al., 2009), at least in the short-term (Zhivan and Diana, 2012). Kazley and Ozcan (2009), examining the relationship between hospital electronic medical record (EMR) and efficiency change over time by comparing hospitals with and without EMR, find no improvement in efficiency over time. However, other studies report a positive impact (Devaraj and Kohli, 2003; Aron et al., 2011). In particular, examining the role of IT on patient flow and its consequences for improved hospital production efficiency and performance, Devaraj and Kohli (2003) suggest that IT is associated with improved revenues, and that this is not at the expense of quality. In another study, Menon and Kohli (2013) investigate the impact of past IT spending on the malpractice insurance premium and find that past IT expenditure is negatively associated with malpractice insurance premium and positively associated with quality of patient care. Other studies have indicated that use of new medical technology in the form of capital equipment is associated with higher service quality in healthcare (Dranove and Satterthwaite, 2000; Picone et al., 2003). In the US, Acemoglu and Finkelstein (2008) find that the increase in the capitallabour ratio and the acquisition of a range of new health care technologies brought about by the introduction of prospective payment systems has led to a significant decrease in the hospital length of stay. In turn, this reduction has led to a de facto higher hospital capacity and an increase in production efficiency. These findings suggest that health technology is not necessarily beneficial only to healthcare quality but also to operational efficiency. Based on above discussion we propose the following two hypotheses: H1. Hospital wards benefiting from the acquisition of new health technology (medical equipment) exhibit higher levels of production efficiency. H2. Hospital wards benefiting from the acquisition of higher levels of IT exhibit higher levels of production efficiency. 2.2. Moderating effects at the organizational and sub-organizational levels A relevant theoretical support to our analysis can be found in the upper echelons theory (Carpenter et al., 2004; Finkelstein et al., 2009; Hambrick and Mason, 1984), which posits that the organization is a reflection of its top managers. The theory acknowledges that managers heavily influence organizational outcomes through the choices they make, which, in turn, are affected by the managers' characteristics. Hambrick and Mason (1984) further postulate that the strategic choices of the upper echelons help to explain an organization's performance. Hambrick (2007) suggests that the relationship between top management characteristics and organizational performance is strongly related to managerial discretion, referring to the latitude of action top managers enjoy in making strategic choices (Hambrick and Finkelstein, 1987; Carpenter et al., 2004). A second factor is identified by the challenges top managers face (Hambrick et al., 2005), the tougher the challenges, less time managers will have to contemplate decisions, leading them to rely more on their personal backgrounds. Thus, Hambrick (2007) predicts that the relationship between managerial characteristics and organizational outcomes will be stronger when the level of managerial challenges is high.



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