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1.
Comput Intell Neurosci ; 2021: 6516722, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34671391

RESUMO

With the rapid development of modern China and the influx of capital, the number of companies has gradually increased. However, most companies cannot operate for a long time due to various reasons. Therefore, mergers and acquisitions have occurred. Large companies merge small companies to some extent. The number of employees can be guaranteed, and the market can be stabilized. However, mergers and acquisitions also have higher risks. As the pace of mergers and acquisitions accelerates, there are more and more cases of failed mergers and acquisitions. The synergy effect of mergers and acquisitions is an important indicator to judge the performance of mergers and acquisitions. This article measures the synergy obtained by the main enterprise from the perspective of performance changes, establishes an evaluation model through the rate of change of financial indicators and migration learning, estimates it through a neural network model, and conducts an empirical analysis on it. The transfer learning neural network has been studied in depth. The research of this article is to accurately assess the synergy effect obtained after mergers and acquisitions and to analyze whether the company can profit from mergers and acquisitions, so as to provide a reference for subsequent mergers and acquisitions between companies.


Assuntos
Instituições Associadas de Saúde , China , Aprendizado de Máquina , Redes Neurais de Computação
2.
Am J Manag Care ; 27(10): e343-e348, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34668676

RESUMO

OBJECTIVES: Hospital mergers and acquisitions are increasingly used as a strategy to facilitate value-based care. However, no studies have assessed health care utilization (HCU) and patient flow across merged institutions. We aim to evaluate patient population distribution, HCU, and patient flow across a recent hospital merger of an academic medical center (AMC), a primary and specialty care alliance (PSC), and a community-based medical center (CMC). STUDY DESIGN: This was a retrospective observational study. METHODS: The study used 2018 adult demographic and encounter data from electronic health records. Patients' parent health care institution was determined by the most frequently visited site of face-to-face visits. Differences in patient demographics and HCU (ie, emergency department [ED] visits, hospitalizations, primary care visits) were compared. Independent factors associated with utilization were identified using adjusted logistic regression models. RESULTS: A total of 406,303 adult patients were identified in the cohort. The PSC setting, compared with the AMC and the CMC, had significantly more female (62.7% vs 54.4% and 58.5%, respectively), older (mean [SD] age, 52.0 [18.1] vs 51.1 [17.8] and 49.2 [17.8] years), and privately insured (63.6% vs 51.3% and 56.0%) patients. A higher proportion of patients at the CMC (27.5%) visited the ED compared with patients at the AMC (10.8%). Approximately 1645 primary care patients (7%) at the CMC setting went to the AMC for specialized care such as oncology, surgery, and neurology. CONCLUSIONS: Hospital mergers are increasing across the United States, allowing AMCs to expand their reach. These findings suggest that patients mainly sought care at their parent health care institution, yet appropriately received specialized care at the AMC. These results provide insights for future mergers and guide resource allocation and opportunities for improving care delivery.


Assuntos
Instituições Associadas de Saúde , Centros Médicos Acadêmicos , Adulto , Serviço Hospitalar de Emergência , Feminino , Hospitalização , Humanos , Pessoa de Meia-Idade , Estudos Retrospectivos , Estados Unidos
3.
Health Aff (Millwood) ; 40(10): 1627-1636, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34606343

RESUMO

Despite rural hospitals' central role in their communities, they are increasingly in financial distress and may merge with other hospitals or health systems, potentially reducing service lines that are less profitable or duplicative of services that the acquirer also offers. Using hospital discharge data from thirty-two Healthcare Cost and Utilization Project State Inpatient Databases from the period 2007-18, we examined the influence of rural hospital mergers on changes to inpatient service lines at hospitals and within their catchment areas. We found that merged hospitals were more likely than independent hospitals to eliminate maternal/neonatal and surgical care. Whereas the number of mental/substance use disorder-related stays decreased or remained stable at merged hospitals and within their catchment areas, it increased for unaffiliated hospitals and their catchment areas, indicating a potential unmet need in the communities of rural hospitals postmerger. Although a merger could salvage a hospital's sustainability, it also could reduce service lines and responsiveness to community needs.


Assuntos
Instituições Associadas de Saúde , Custos de Cuidados de Saúde , Hospitais Rurais , Humanos , Recém-Nascido , Pacientes Internados , População Rural
4.
AORN J ; 114(3): 231-240, 2021 09.
Artigo em Inglês | MEDLINE | ID: mdl-34436772

RESUMO

Advocate Aurora Health, located in the north-central United States, is the result of a merger between two large health care organizations in April 2018. The health care system comprises 26 hospitals, offers more than 500 sites of care, and employs 75,000 team members. This article discusses the effects that coronavirus disease 2019 had on the perioperative services departments while directors and site leaders were still managing the complexities of the merger. Included are strategies used to address the challenges created by the pandemic, special considerations based on level-of-care capacity, the effect that the hold on elective surgeries had on staffing assignments, the reactivation process when elective surgery resumed, and the importance of keeping the perioperative team members informed and safe. It also illustrates how facing the challenges caused by the pandemic helped to solidify the merger of the two health care organizations.


Assuntos
COVID-19 , Atenção à Saúde/organização & administração , Instituições Associadas de Saúde , Humanos , Pandemias , Estados Unidos
5.
Int J Health Econ Manag ; 21(4): 427-455, 2021 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-33818694

RESUMO

I use a 2010 non-profit hospital merger in Ohio to study the effect of market concentration on market outcomes. Using the Synthetic Control Method and Truven MarketScan data, I document three findings. First, courts are lenient to non-profit mergers, and I cast doubt on this practice by showing that the studied merger led to a 123% increase in the payments for inpatient childbirth services. Second, I provide the first empirical evidence for the conjecture that mergers increase out-of-pocket payments and reduce the utilization of care. Last, I show that the effect of market power on market outcomes is asymmetric: the increase in payments and welfare loss created by a merger persist after the merger is rescinded. Thus, even successful FTC challenges may not revert the effect of harmful mergers, and it is essential to deny such mergers before they proceed.


Assuntos
Instituições Associadas de Saúde , Custos de Cuidados de Saúde , Ohio , Organizações sem Fins Lucrativos
6.
Artigo em Inglês | MEDLINE | ID: mdl-33921426

RESUMO

Merger processes between hospitals have high benefit potential for patients, staff and managers. This integration of health centres can improve the quality and safety in patient care. Additionally, cooperative processes enhance the sustainability of the health system, by increasing team spirit, giving innovative ideas and improving staff satisfaction. In this article, the critical factors for successful hospital mergers and acquisitions in the Public Health System were considered to develop a brief guide to help with the organisation of a merger process. Five sections were designed: Strategic administration and objectives, Staff management, New hospital complex structure, Processes and Results. This guide facilitates the communication between a variety of stakeholders, thus improving the engagement between all members of the new healthcare system. This could be particularly important for countries with large regional variance in the organisation of health care and resources.


Assuntos
Instituições Associadas de Saúde , Atenção à Saúde , Hospitais Públicos , Humanos , Cultura Organizacional , Inovação Organizacional
10.
Health Info Libr J ; 38(1): 32-38, 2021 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-32338420

RESUMO

BACKGROUND: Birmingham Women's and Children's NHS Foundation Trust was formed in February 2017 following an acquisition. The Library and Knowledge Services (LKS) merged while operating across two hospital sites. A priority for the merged Library and Knowledge Service was to integrate e-collections. A literature review identified six papers reporting health libraries that had merged and integrated e-collections. OBJECTIVES: A priority for the merged Library and Knowledge Service was to integrate e-collections. METHODS: To ensure equitable and cost-effective access to an extended collection, an audit of pre-existing e-collections was conducted. Electronic licence agreements enabling cross-site access were negotiated. A new OpenAthens ID was created. RESULTS: The integration of e-collections enabled Trust staff access to a greater number of e-journals and additional e-content, and an overall cost-saving was achieved. DISCUSSION: This case study supports existing literature stating that integrating collections increases the number of e-journals. It further identifies cost-difference in acquiring cross-site access to e-journals compared to databases providing full-text e-journals and additional e-content. CONCLUSION: Integrating e-collections enables equity of access and value. A national co-ordinated approach to procurement of e-collections will further support equity and best value throughout NHS LKS.


Assuntos
Instituições Associadas de Saúde/métodos , Centros de Informação/tendências , Bibliotecas Hospitalares/tendências , Instituições Associadas de Saúde/tendências , Humanos , Serviços de Biblioteca/tendências , Programas Nacionais de Saúde/organização & administração , Programas Nacionais de Saúde/estatística & dados numéricos
11.
Fertil Steril ; 115(2): 290-295, 2021 02.
Artigo em Inglês | MEDLINE | ID: mdl-33358019

RESUMO

To succeed in the assisted reproductive technology industry, physician owners of fertility practices have to develop a wide array of business skills and expertise. In today's business world, a natural next step for many assisted reproductive practices is exploring potential mergers, sales, or acquisitions. This article will explore what factors physician owners of fertility practices should consider before pursuing a potential sale or merger; how to prepare for such a transaction; and what to expect once a transaction is underway.


Assuntos
Comércio/legislação & jurisprudência , Clínicas de Fertilização/legislação & jurisprudência , Instituições Associadas de Saúde/legislação & jurisprudência , Médicos/legislação & jurisprudência , Técnicas de Reprodução Assistida/legislação & jurisprudência , Comércio/economia , Clínicas de Fertilização/economia , Instituições Associadas de Saúde/economia , Humanos , Médicos/economia , Técnicas de Reprodução Assistida/economia
12.
Health Serv Res ; 55 Suppl 3: 1049-1061, 2020 12.
Artigo em Inglês | MEDLINE | ID: mdl-33284525

RESUMO

OBJECTIVE: We explore if there are ways to characterize health systems-not already revealed by secondary data-that could provide new insights into differences in health system performance. We sought to collect rich qualitative data to reveal whether and to what extent health systems vary in important ways across dimensions of structural, functional, and clinical integration. DATA SOURCES: Interviews with 162 c-suite executives of 24 health systems in four states conducted through "virtual" site visits between 2017 and 2019. STUDY DESIGN: Exploratory study using thematic comparative analysis to describe factors that may lead to high performance. DATA COLLECTION: We used maximum variation sampling to achieve diversity in size and performance. We conducted, transcribed, coded, and analyzed in-depth, semi-structured interviews with system executives, covering such topics as market context, health system origin, organizational structure, governance features, and relationship of health system to affiliated hospitals and POs. PRINCIPAL FINDINGS: Health systems vary widely in size and ownership type, complexity of organization and governance arrangements, and ability to take on risk. Structural, functional, and clinical integration vary across systems, with considerable activity around centralizing business functions, aligning financial incentives with physicians, establishing enterprise-wide EHR, and moving toward single signatory contracting. Executives describe clinical integration as more difficult to achieve, but essential. Studies that treat "health system" as a binary variable may be inappropriately aggregating for analysis health systems of very different types, at different degrees of maturity, and at different stages of structural, functional, and clinical integration. As a result, a "signal" indicating performance may be distorted by the "noise." CONCLUSIONS: Developing ways to account for the complex structures of today's health systems can enhance future efforts to study systems as complex organizations, to assess their performance, and to better understand the effects of payment innovation, care redesign, and other reforms.


Assuntos
Prestação Integrada de Cuidados de Saúde/organização & administração , Continuidade da Assistência ao Paciente/organização & administração , Prestação Integrada de Cuidados de Saúde/normas , Competição Econômica , Eficiência Organizacional , Instituições Associadas de Saúde/organização & administração , Sistemas de Informação em Saúde/organização & administração , Pesquisa sobre Serviços de Saúde , Humanos , Relações Interinstitucionais , Entrevistas como Assunto , Modelos Organizacionais , Qualidade da Assistência à Saúde/normas , Estados Unidos
13.
Inquiry ; 57: 46958020976246, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-33233979

RESUMO

While most studies of health care industry consolidation focus on impacts on prices or quality, these are not its only potential impacts. This exploratory qualitative study describes industry and community stakeholder perceptions of the impacts of cumulative hospital, practice, and insurance mergers, acquisitions, and affiliations in Pittsburgh, Pennsylvania. Since the 1980s, Pittsburgh's health care landscape has been transformed and is now dominated by competition between 2 integrated payer-provider networks, health care system UPMC (and its insurance arm UPMC Health Plan) and insurer Highmark (and its health care system Allegheny Health Network). Semi-structured interviews with 20 boundary-spanning stakeholders revealed a mix of perceived impacts of consolidation: some positive, some neutral or ambiguous, and some negative. Stakeholders perceived consolidation's positive impacts on long-term viability of health care facilities and their ability to adopt new care models, enhanced competition in health insurance, creation of foundations, and pioneering medical research and innovation. Stakeholders also believed that consolidation changed geographic access to care, physician referral behaviors, how educated patients were about their health care, the health care advertising environment, and economies of surrounding neighborhoods. Interviewees noted that consolidation raised questions about what the responsibilities of non-profit organizations are to their communities. However, stakeholders also reported their perceptions of negative outcomes, including ways in which consolidation had potentially reduced patient access to care, accountability and transparency, systems' willingness to collaborate, and physician autonomy. As trends toward consolidation are not slowing, there will be many opportunities to experiment with policy levers to mitigate its potentially negative consequences.


Assuntos
Setor de Assistência à Saúde , Instituições Associadas de Saúde , Atenção à Saúde , Competição Econômica , Humanos , Pennsylvania
14.
J Healthc Manag ; 65(5): 330-343, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32925532

RESUMO

EXECUTIVE SUMMARY: The United States is experiencing another wave of hospital mergers. Whether patients benefit from these mergers, however, remains an open issue for many interested stakeholders. One measure of the potential benefit of hospital mergers is how they affect patient experience. This study used a quasi-experimental design to examine the relationship between hospital mergers and four different Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) ratings (i.e., overall, physician communication, nurse communication, and staff responsiveness). The study findings showed an association between hospitals that experienced a merger and slower growth in HCAHPS scores for two of the four HCAHPS domains (overall and nurse communication) when compared to matching hospitals that did not merge. Findings from this study can guide and inform hospital administrators, health system boards, state and federal government regulators and policymakers, and others across the spectrum of healthcare stakeholders.


Assuntos
Pesquisas sobre Serviços de Saúde/estatística & dados numéricos , Instituições Associadas de Saúde/organização & administração , Satisfação do Paciente/estatística & dados numéricos , Adulto , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estados Unidos
16.
J Healthc Manag ; 65(5): 346-364, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32925534

RESUMO

EXECUTIVE SUMMARY: The number of rural hospital mergers has increased substantially in recent years. A commonly reported reason for merging is to increase access to capital. However, no empirical evidence exists to show whether capital expenditures increased at rural hospitals after a merger. We used a difference-in-differences approach to determine whether total capital expenditures changed at rural hospitals after a merger. The comparison group (rural hospitals that did not merge during the 2012 through 2015 study period) was weighted using inverse probability of treatment weights. The key outcome measure was logged total capital expenditures.Merging resulted in a 26% increase in capital expenditures and also was associated with a significant improvement in plant age. The postmerger improvement in plant age may have been partially attributable to merger-related accounting changes and partially attributable to increased capital expenses, possibly on long-term asset renovations and replacement.These findings suggest that through mergers, rural hospital board members and executives who have accepted or are considering a merger may improve a hospital's ability to increase capital expenditures. Further, increased capital investments in rural hospitals may be an important signal to the community that the acquirer intends to keep the rural hospital open and continue providing some volume and level of services within the community. Future research should determine how capital is spent after a merger.


Assuntos
Gastos de Capital/estatística & dados numéricos , Gastos de Capital/tendências , Instituições Associadas de Saúde/economia , Instituições Associadas de Saúde/estatística & dados numéricos , Hospitais Rurais/economia , Hospitais Rurais/estatística & dados numéricos , Previsões , Humanos , Estados Unidos
17.
Rev. bras. ativ. fís. saúde ; 25: 1-9, set. 2020. fig
Artigo em Inglês | LILACS | ID: biblio-1129587

RESUMO

The Academia da Saúde programme has been considered an important health promotion strategy in the scope of primary health care in Brazil. However, there is little evidence on what and how professional practices have been developed as a means to enact health promotion processes in the programme. The study ́s purpose was to analyse the health promotion work in a Academia da Saúde programme ́s unit from Lajeado city, Brazil. The study employed a qualitative approach and grounded theory research method. Participants included a female Health and Physical Education professional (aged 32y), a female health centre coordinator (aged 41y) and eight users (2 men, 6 women, aged 30-69y). Data were collected through condensed fieldwork, involving interviews and non-participant observation of group sessions. Using salutonegesis theory, qualitative analysis generated key findings on the elements of the health promotion work, namely: holistic care, use of diversification into cognitive, psychosocial and physical activities, development of skills and capacities that served as health resources, and the occurrence of resistance and challenges in the programme. Furthermore, the findings offered practical examples of possibilities to enact health promotion process, which represents a significant contribution to knowledge on health work. The study may support both future interventions and professional education, indicating alternative pathways for practitioners and undergraduate students to widen the scope of health promotion actions beyond the biophysical dimension


O programa Academia da Saúde tem sido considerado uma importante estratégia de promoção da saúde no âmbito da atenção primária à saúde no Brasil. Entretanto, existem poucas evidências sobre quais e como práticas profissionais têm sido desenvolvidas como forma de operacionalizar processos de promoção da saúde no programa. O objetivo do estudo foi analisar o trabalho de promoção da saúde em uma unidade do programa Academia da Saúde de Lajeado, Brasil. O estudo empregou uma abordagem qualitativa e o método de pesquisa da teoria fundamentada nos dados. Os participantes incluíram uma profissional de Educação Física (32 anos), uma coordenadora de centro de saúde (41 anos) e oito usuários (2 homens, 6 mulheres, 30-69 anos). Os dados foram coletados por meio do trabalho de campo condensado, envolvendo entrevistas e observação não-participante das atividades coletivas. Utilizando a teoria da salutogênese, a análise qualitativa gerou os resultados sobre os elementos do trabalho de promoção da saúde, a saber: cuidado holístico, uso da diversificação em atividades cognitivas, psicossociais e físicas, desenvolvimento de habilidades e capacidades que serviram como recursos de saúde, e a ocorrência de resistências e desafios no programa. Além disso, os resultados ofereceram exemplos práticos de possibilidades para mobilizar o processo de promoção da saúde, o que representa uma contribuição significativa para o conhecimento sobre o trabalho em saúde. O estudo pode subsidiar intervenções futuras e a formação profissional, indicando caminhos alternativos para profissionais e estudantes de graduação ampliarem o escopo das ações de promoção da saúde para além da dimensão biofísica


Assuntos
Prática Profissional , Serviços Comunitários de Saúde Mental , Instituições Associadas de Saúde , Saúde Holística , Programas Nacionais de Saúde
18.
Healthc Q ; 23(2): 37-43, 2020 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-32762819

RESUMO

To capture the value of the Scarborough Health Network amalgamation, a value realization framework (VRF) was developed, based on three themes and nine goals. Each goal was mapped to key strategies and indicators that signalled our delivery of value to the community. Value was achieved when indicators moved in the desired direction. The VRF acknowledged that integration is a journey and identified value in the short, medium and long term. Four quarterly VRF progress reports were completed, illustrating a positive story of the post-merger period. The VRF provided a standardized framework for tracking and monitoring strategies for a successful organizational transition.


Assuntos
Instituições Associadas de Saúde , Hospitais Comunitários/organização & administração , Hospitais Comunitários/normas , Planejamento de Instituições de Saúde , Pessoal de Saúde , Humanos , Ontário , Satisfação do Paciente
19.
Inquiry ; 57: 46958020935666, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32684072

RESUMO

The objective of this study is to determine whether key hospital-level financial and market characteristics are associated with whether rural hospitals merge. Hospital merger status was derived from proprietary Irving Levin Associates data for 2005 through 2016 and hospital-level characteristics from HCRIS, CMS Impact File Hospital Inpatient Prospective Payment System, Hospital MSA file, AHRF, and U.S. Census data for 2004 through 2016. A discrete-time hazard analysis using generalized estimating equations was used to determine whether factors were associated with merging between 2005 and 2016. Factors included measures of profitability, operational efficiency, capital structure, utilization, and market competitiveness. Between 2005 and 2016, 11% (n = 326) of rural hospitals were involved in at least one merger. Rural hospital mergers have increased in recent years, with more than two-thirds (n = 261) occurring after 2011. The types of rural hospitals that merged during the sample period differed from nonmerged rural hospitals. Rural hospitals with higher odds of merging were less profitable, for-profit, larger, and were less likely to be able to cover current debt. Additional factors associated with higher odds of merging were reporting older plant age, not providing obstetrics, being closer to the nearest large hospital, and not being in the West region. By quantifying the hazard of characteristics associated with whether rural hospitals merged between 2005 and 2016, these findings suggest it is possible to determine leading indicators of rural mergers. This work may serve as a foundation for future research to determine the impact of mergers on rural hospitals.


Assuntos
Administração Financeira , Instituições Associadas de Saúde/economia , Hospitais Rurais , Administração Financeira/economia , Administração Financeira/estatística & dados numéricos , Hospitais Rurais/economia , Hospitais Rurais/estatística & dados numéricos , Humanos , Estados Unidos
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