All ETDs from UAB

Advisory Committee Chair

S Robert Hernandez

Advisory Committee Members

Nancy Borkowski

William Opoku-Agyeman

Robert Weech-Maldonado

Document Type


Date of Award


Degree Name by School

Executive Doctor of Science (DSc) School of Health Professions


While past studies have examined the relationship between accreditation and hospital performance, no previous studies have evaluated the relationship between Joint Commission accreditation and Federal Qualified Health Center (FQHC) performance. Multiple regression analyses were used to evaluate the relationship between Joint Commission accreditation and variables of interest. Joint Commission accreditation was utilized as the dependent variable in the evaluation of organizational and environmental market factors, and utilized as the independent variable in the evaluation of clinical and non-clinical performance outcomes. This study applies a novel approach to determine the relationship between Joint Commission accreditation and adoption among FQHCs, and organizational performance outcomes after accreditation is obtained. Data from secondary sources for 1,355 FQHCs in 2016 were analyzed using hierarchical and multivariable regressions in order to evaluate the association between Joint Commission accreditation and organizational and environmental market factors and clinical and non-clinical performance outcome measures. The policy implications for study results may influence long-term financial support from federal and statutory levels for FQHCs. The practice implication for study results should create organizational performance metrics that serve as the mysteries for high performing FQHCs. The research implication from study results should lead to further analysis of the adoption of accreditation as a leadership priority. This study clearly demonstrates the positive relationship between Joint Commission accreditation and certain organizational factors (patients at 200% of federal poverty level, uninsured patients, patients with Medicaid and/or CHIP coverage, and FQHC size) and environmental market factor (target population), and a number of performance measures (adolescent weight screening, adult weight screening, cholesterol treatment, and total grant expenditure). Furthermore, study results support the assumption that FQHCs in more competitive markets are more likely to adopt Joint Commission accreditation, and FQHCs that adopt Joint Commission accreditation are associated with better organizational performance compared to non-adopters.



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