Dominance Analysis of Bright and Dark Dispositional Predictors of Socially Desirable Responding.

Although the role of so-called dark traits in the prediction of maladaptive behavior has seen a large increase in interest by researchers, the Big Five still maintain their ubiquity in the prediction of most behaviors. This study uses measures of the Dark Tetrad and the Big Five personality traits to predict a very specific form of maladaptive behavior: the impression management form of socially desirable responding. In regression-based dominance analysis, results suggest that not all of the Big Five nor the Dark Tetrad provide statistically significant incremental validity but as a block, the Big Five dominate the Dark Tetrad in the prediction of the purposeful misrepresentation of one's self to others on self-report inventories. More specifically, four of the Big Five as well as the traits of Machiavellianism and sadism from the Dark Tetrad are significant predictors of impression management.

Strategic groups and outcomes in the US hospice care industry.

PURPOSE: As a result of a drastic increase in new patients, two major shifts are occurring in the US hospice care industry: an increase in the number of for-profit providers, and hospices are increasing in size through acquisitions and mergers. Hospices are trying to both increase the number of innovative programs they offer and decrease their operating expenses to improve their margins and attract more patients. This study seeks to investigate if strategic groups exist within the industry as hospices try to become more innovative and efficient, which grouping factors are most significant, and to determine whether there is a relationship between group membership and performance. DESIGN/METHODOLOGY/APPROACH: Cluster analysis and ANOVA are used to analyze data from 93 California hospices. FINDINGS: Three strategic groups exist within the market, innovative practices significantly affect group membership, and innovation-oriented groups outperform others in terms of quality of care. PRACTICAL IMPLICATIONS: Many hospices focus on innovation, and evidence suggests that continued pursuit of innovative practices is critical, whereas efficiency does not appear to have a significant impact on quality of care. Focus on such evidence-based practices is important for long-term success. ORIGINALITY/VALUE: This is the first study to investigate strategic group formation in the hospice care industry.

A study of the effects of innovative and efficient practices on the performance of hospice care organizations.

BACKGROUND: Due to changes in social norms, funding initiatives, and other environmental factors, the business of hospice care has significantly evolved over the past 40 years. There has been an influx of for-profit firms, increased consolidation, and significant funding changes. We have witnessed a growth in utilization rates, an increase in insurance coverage, and improved governmental funding. Hospice care organizations have responded to these pressures by pursuing more efficient and innovative business practices. PURPOSE: Drawing upon institutional theory, this study seeks to address whether quality of care provided to hospice patients is affected as organizations respond to environmental pressures for innovative and efficient business practices. METHODOLOGY/APPROACH: This study uses hierarchical regression to analyze data from 111 hospices in California. FINDINGS: Innovative practices are positively related to quality of care. However, efficient practices have no significant relationship with quality of care. PRACTICAL IMPLICATIONS: It appears that incorporating innovative practices is positively related to quality of care. Although cost containment may be necessary for continued survival, efficiency improvement efforts do not seem to lead to improved quality of care.

The impact of competition on the importance of conforming to social norms: strategies for managed care organizations.

PURPOSE: This study focuses around the central question of whether or not the relative importance of conformity to institutional norms varies as markets become more competitive. DESIGN/METHODOLOGY/APPROACH: Using data gathered for 187 managed health care plans in the U.S., this study uses hierarchical regression analysis involving blocked variables. FINDINGS: This study finds that conformity to technical environmental requirements has a significant impact on performance at all levels of competition. However, the importance of conformity to institutional norms increases as markets becomes more competitive. PRACTICAL IMPLICATIONS: From the perspective of MCOs, this means that managers need to carefully monitor the prevailing technical and institutional environmental forces and match their responses according to the competitiveness of their individual markets. From a societal perspective, this study suggests that improved health care delivery is likely to result from increased competition in the managed care market. ORIGINALITY/VALUE: Prior research has shown that conformity to social norms is important for MCO performance. However, this is the first study to examine the whether the importance of conformity to social norms varies as a function of market competition.

A comparative analysis of stakeholder power in the Mexican and U.S. health care systems.

The primary focus of this paper is to analyze the Mexican health care system and the forces driving its change. To facilitate this, the paper conducts an analysis of the key stakeholders in both the U.S. and Mexican health care systems. The Mexican system is dominated by an autocratic federal government that is gradually relinquishing its role as provider of health care in exchange for control of the reform efforts. The U.S. system is characterized by a relatively equal distribution of power among the key stakeholders, in which changes occur primarily through incrementalism. The results of the analysis indicate that the key differences lie in terms of relative stakeholder power and rate of change in the systems. Compared with the U.S.,Mexico is making rapid changes to its health care system and both countries are struggling with the same key issues: Cost, access, and quality.