All ETDs from UAB

Advisory Committee Chair

Nancy M Borkowski

Advisory Committee Members

Andrew Brickman

Darrell E Burke

Haiyan Qu

Janet M Brostein

Document Type

Dissertation

Date of Award

2018

Degree Name by School

Doctor of Philosophy (PhD) School of Health Professions

Abstract

This dissertation studied the role of Health Information Technology (HIT) adoption on clinical performance; the effects of clinical performance on chief executive officer (CEO) compensation; and the association between CHC’s financial and clinical performances in Community Health Centers (CHC). Data from the Uniform Data System (UDS) and the Internal Revenue System (IRS) 990 Forms were extracted for the period 2011-2016. Generalized estimating equations models with state and year fixed effects were performed. To test the relationship between the age and extent of HIT adoption and clinical performance, Resource-Based View of the Firm constructs were used. The age of HIT adoption was found to be positively associated with clinical performance. Further, the full adoption of HIT was correlated with better clinical performance compared to CHCs that had not adopted HIT. Using the constructs of Agency, Social Comparison, and Managerial Power theories, the association between clinical performance and CEO compensation was studied. Clinical performance was not associated with CEO compensation in CHCs. However, the highest paid employees’ compensation was significantly related to CEO compensation. Moreover, CEO characteristics were all predictive of higher executive compensation. Contrasting previous studies, non-White CEOs earned more than White CEOs in CHCs. Based on the Deming Chain Reaction model, the mediating effect of patient visits per patient per disease on the association between clinical and financial performances of CHC was explored. Specifically, two common disease types, hypertension and diabetes, were selected to study this association. While the proposed mediator was found to be inadequate, the study found a positive correlation between clinical and financial performance.

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