All ETDs from UAB

Advisory Committee Chair

Amy Y Landry

Advisory Committee Members

Eric W Ford

S Robert Hernandez

William Opoku-Agyeman

Document Type


Date of Award


Degree Name by School

Executive Doctor of Science (DSc) School of Health Professions


INTERORGANIZATIONAL RELATIONSHIPS AND HOSPITAL ADOPTION OF SURGICAL ROBOTS STEPHEN G. CULLEN EXECUTIVE DOCTORIAL PROGRAM IN HEALTHCARE LEADERSHIP ABSTRACT The study investigates the relationship between interorganizational relationships (IORs) and hospital adoption of robotic surgery in the United States over a ten-year period. As a competitive strategy for hospitals, IORs should matter in a hospital’s decision to adopt a surgical robot given associated costs and risks. While literature exists on IORs and technical innovation, there is a gap in the literature on IORs and hospital adoption of surgical robots. This study explores four types of IORs (i.e., networks, systems, contract management, and joint ventures), hospitals with more than one IOR, and hospitals with surgical robots. To evaluate the effect of IORs on hospital adoption of surgical robots over a ten-year period, the study employs generalized estimating equations to allow for analysis of repeated measurements of categorical response data. Data for this study was drawn from the American Hospital Association (AHA) Annual Survey of Hospitals, starting with the 2005 survey when AHA started collecting data on surgical robots. Over 27,625 observations from acute care hospitals are used in the study. Findings revealed hospitals engaged in certain types of IORs or in more than one IOR are more likely to adopt a surgical robot than hospitals not in such an arrangement. The findings will be of value to hospitals considering strategies to adopt surgical robots. They also afford opportunities to explore further IORs and hospitals having or adopting technology innovations. Keyword: interorganizational relationship, hospital, adoption, robot, innovation



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