All ETDs from UAB

Advisory Committee Chair

Stephen J O'Connor

Advisory Committee Members

Nir Menachemi

Haiyan Qu

Richard M Shewchuk

Rodney Tucker

Document Type

Dissertation

Date of Award

2016

Degree Name by School

Executive Doctor of Science (DSc) School of Health Professions

Abstract

The purpose of this dissertation is to explore hospice performance using a three paper format. Based on Structure-Conduct-Performance (SCP) and Structure-Process-Outcome (SPO) models, paper 1 conducts a systematic literature review to identify gaps in hospice performance research. Paper 2 explores the relationship between hospice market structure and inpatient services provision (Structure-Conduct). Market munificence is related to hospice inpatient services offering. Organizational factors such as hospice chain-affiliation, age, and ownership also play roles in predicting hospices’ probability in providing inpatient services. Paper 3 examines the impact of hospice inpatient service provision on service utilization and financial performance (Structure-Process-Outcome). Hospices that not offering inpatient services have longer average length of stay (LOS) and better financial performance than hospices offering inpatient services. Average LOS partially mediates the relationship between inpatient services provision and financial performance.

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