Increasing global supply chains' resilience after the COVID-19 pandemic: Empirical results from a Delphi study.

COVID-19 has revealed global supply chains' vulnerability and sparked debate about increasing supply chain resilience (SCRES). Previous SCRES research has primarily focused on near-term responses to large-scale disruptions, neglecting long-term resilience approaches. We address this research gap by presenting empirical evidence from a Delphi study. Based on the resource dependence theory, we developed 10 projections for 2025 on promising supply chain adaptations, which were assessed by 94 international supply chain experts from academia and industry. The results reveal that companies prioritize bridging over buffering approaches as long-term responses for increasing SCRES. Promising measures include increasing risk criteria importance in supplier selection, supply chain collaboration, and supply chain mapping. In contrast, experts ascribe less priority to safety stocks and coopetition. Moreover, we present a stakeholder analysis confirming one of the resource dependence theory's central propositions for the future of global supply chains: companies differently affected by externalities will choose different countermeasures.

Balancing finances, politics, and public health: international student enrollment and reopening plans at US higher education institutions amid the COVID-19 pandemic.

Drawing from resource dependence theory, this study explores the extent to which international student enrollment related to institutional decisions to shift to in-person instructional strategies during the COVID-19 pandemic. We focus our study particularly on July 2020, a time during which tensions around international students' legal status in the US were especially high. Our results suggest that leaders at private not-for-profit institutions were significantly more likely to shift instructional strategies to include more in-person instruction, thus allowing more international students to enroll but also placing at risk the health of individuals on their campuses and in their local communities. A similar result was not found for public institutions. These results speak to the extent to which private institutions in the US have become financially dependent on international students' tuition and have clear implications for the financial futures of US higher education institutions. Supplementary Information: The online version contains supplementary material available at 10.1007/s10734-021-00768-7.

The Role of Nonprofit-Private Collaboration for Nonprofits' Organizational Resilience.

Growing social, political, and economic uncertainties have shown that organizational resilience is becoming increasingly important for nonprofit organizations (NPOs). To ensure their long-term survival, NPOs need to respond to extreme events and adapt their services and processes. The theoretical premise of resource dependence theory assumes that interactions between an organization and its environment are crucial for the long-term adaptation to adversities. The present study investigates the contributions of nonprofit-private collaborations to organizational resilience of NPOs in light of the refugee crisis in Germany in 2015. Findings from a multiple holistic case study design indicate that collaborations of nonprofits with for-profit organizations support NPOs with stability, resources, expertise, and compassion to overcome resource-based, conceptual, and emotional challenges.

Market characteristics associated with community health assessments by local health departments.

OBJECTIVES: Community health assessments (CHAs) have been promoted as a strategy for population health. This study uses the resource dependence theory (RDT) to examine how external market characteristics are associated with CHAs conducted by local health departments (LHDs) and subsequent partnering with hospitals for CHAs in the United States. STUDY DESIGN: The RDT was used to guide the conceptualization of the market in the context of local public health. RDT emphasizes that organizations are not in control of all the resources they need and, to some extent, must rely on the external environment to provide those necessary resources. Binary measures were used to examine whether LHDs conducted CHAs and whether they did so in partnership with a local hospital. Independent variables were identified to measure the RDT constructs of munificence (resource availability in the environment), complexity (level of heterogeneity), and dynamism (level of environmental turbulence). METHODS: Bivariate (Chi-squared and t-tests) and multivariate (logistic regression) cross-sectional analyses were conducted using secondary data from the National Association of County and City Health Officials 2013 Profile Survey, the 2013 County Health Rankings data set, and the Health Resources and Services Administration's Area Health Resource File. RESULTS: Two of three variables measuring munificence were positively associated with having conducted a CHA; one variable was also related to doing so in conjunction with a local hospital. One measure of market complexity was negatively associated with having conducted a CHA. No measure of dynamism was related to the dependent variables. CONCLUSIONS: Study results provide partial support for the use of RDT in understanding the relationship between market factors and LHDs' activities around CHAs. Local hospitals as partners and other market factors should be considered by LHDs when conducting CHAs. Findings from this work will be of interest to public health practitioners, policy-makers, and researchers interested in public health and population health improvement.

Decoding the trends and the emerging research directions of E-commerce and tourism in the light of Resource Dependence Theory: A bibliometric analysis.

E-commerce and tourism have all seen a lot of growth and development recently in both business and academia. The tourism sector has significantly changed because of the growth of e-commerce platforms, as more and more consumers buy their rooms and tickets online. The academics conducted further research to understand the impact of e-commerce platforms on the tourism industry, leading to the development of these two specific fields' body of literature. A bibliometric review was carried out to draw the trends of the research conducted to date in the field of e-commerce and tourism. Thus, it is possible to have a general overview of the literature for academics to intent to conducting future research. Employing bibliometric analysis with Biblimetrix software on 456 publications from the Web of Science database covering the years from 2000 to 2022, this study identifies predominant themes and research trends in the field. The terms "e-commerce" and "tourism" were used as keywords. During the analysis, six research questions were answered and results were combined with Resource Dependence Theory. Australia and China which are the first two countries in terms of citations. China is the outstanding country for author collaborations. Co-citation network analysis identified four clusters, namely management, model, satisfaction, and quality. Publications with keyword "communication", "enterprises", "application" and "rural" are in a decrease after 2015. Finally, future research directions were proposed.

Market Factors Associated with Comprehensive Behavioral Health Crisis Care Availability: A Resource Dependence Theory Study.

Behavioral health crisis care (BHCC) is a care delivery model for individuals experiencing acute distress related to a mental health or substance use disorder. We examined market factors associated with comprehensive BHCC availability using 2022 data on mental health treatment facilities (n = 9385) obtained from the Substance Abuse and Mental Health Services Administration. We aggregated facility-level data by county (n = 3142) and merged with county-level market factors. Logistic regression models were used to examine the adjusted associations between market factors and BHCC availability. We found that 468 (14.9%) counties had at least one mental health treatment facility offering comprehensive BHCC services. Specifically, counties with more mental health providers (Adjusted Odds Ratio = 2.26, Confidence Interval = 1.32-3.86) and metropolitan counties (AOR = 3.26, CI = 1.95-5.43) had higher odds of having a comprehensive BHCC facility. Our findings highlight the importance of developing the mental health workforce to increase BHCC availability and a need to address disparities in rural counties.

Can environmental information disclosure spur corporate green innovation?

How can the disclosure of environmental information (EID) stimulate corporate green innovation (CGI)? This research challenges the prevailing assumption that environmental regulations impact CGI by influencing corporate compliance costs. Instead, it offers a fresh theoretical framework to explain how EID affects CGI. This study combines signal theory and resource dependence theory to develop a moderated mediation model, illustrating how EID reduces information asymmetry and alleviates corporate financial constraints (CFC). To test these hypotheses, this study utilized data from A-share listed companies spanning the period 2004 to 2017. This study considered the year 2009 as a crucial point of analysis, marking the period before and after the implementation of China's first EID policy in 2008. This study employed a Difference-in-Differences (DID) model. The results reveal that EID has a positive impact on CGI by mitigating CFC, with non-state-owned enterprises (non-SOEs) exhibiting a more pronounced mediating effect. These findings remain robust even when the parallel trend assumption was tested to eliminate interference from other factors. This study unveils the mechanism through which voluntary environmental regulation, represented by EID, influences CGI by mitigating information asymmetry and alleviating CFC. These results deviate from the predictions of compliance cost theory and Porter's hypothesis regarding the impact of traditional environmental regulations on CGI, providing a fresh perspective on the role of voluntary environmental regulation in driving CGI.

Contextual factors and business strategy choice: The case of us hospitals.

US hospitals are struggling with how to compete and remain viable in an increasingly turbulent and competitive environment. Using Porter's generic strategies and resource dependence theory, this study examined the relationship between environmental factors and business strategy choice among U.S. hospitals. The study used longitudinal data from 2006 to 2016 of US urban, general acute care hospitals from the American Hospital Association Annual Survey, Medicare cost reports, and Area Health Resource File. Multinomial regression was used to analyze the data. and Discussion: Our findings showed four types of hospital strategy: cost-leadership, differentiation, hybrid, and stuck-in-the-middle. A greater number of physicians (county-level) increases the likelihood of pursuing differentiation and hybrid strategy. On the other hand, a higher older adult population (65 years+) increases the likelihood of pursuing a cost-leadership strategy. Similarly, lower competition and higher Medicare Advantage penetration increases the likelihood of pursuing cost-leadership over hybrid strategy. An increase in the unemployment rate decreases the likelihood of pursuing differentiation and cost-leadership strategies versus the hybrid strategy. Finally, hospitals pursuing a differentiation strategy tended to be larger, teaching, and not-for-profit. The results showed the importance of environmental and organizational factors in predicting the strategy choice of hospitals.

Why can't children with autism integrate into society in China? Study based on the perspective of NGO classification.

Introduction: In the field of protecting children with autism, NGOs have become a major force that cannot be ignored. Although NGOs for children with autism have expanded the number and improved the quality of the services they provide, a large number of autistic children still cannot achieve the goal of social inclusion in China. The existing literature has mostly tried to explain the reason from the perspective of the common characteristics of NGOs and has paid insufficient attention to the huge differences between these NGOs, so it is impossible to identify the obstacles that children with autism encounter accurately. Methods: From the perspective of NGO classification, this study conducted an in-depth investigation of 4 NGO cases in City N, China, to show the impact of the difference of NGOs on the obstacles to the social inclusion of autistic children. Results: The research has found that under the authoritarian regime, NGOs for children with autism that rely heavily on external funds include three common groups: government-oriented NGOs, foundation-supported NGOs, and individual-financed NGOs. The structural characteristics of the funders and their interaction with the NGOs for children with autism shape their different action logics, as the result that the desire of children with autism to integrate into society cannot be achieved as expected. Discussion: The results of this study give more accurate insights into the barriers in social service provision for children with autism that impede their social inclusion and provide a reference for those seeking a solution to this problem.

Finding the key to the black box of board diversity and firm performance: A mediating effect analysis of technological innovation.

A growing body of research has focused on the relationship between board diversity and firm performance. A series of empirical literatures have also examined a significant positive correlation between the two. But these results only demonstrate the relationship between the input of 'diversity' and the output of 'firm performance'. Such research is more of a black box because board diversity must act on certain strategies or decisions to affect firm performance. Some scholars try theoretical analysis with the purpose of opening the black box. In order to verify the relevant theoretical analysis results, this study uses the mediating effect analysis model in the field of psychology, through multiple regression, impulse analysis, variance decomposition and other methods, to thus empirically test the mediating effect of technological innovation in the process of board diversification promoting corporate performance. We found that board diversity can improve firm performance by enhancing the level of technological innovation. Among them, technological innovation has played a complete mediating role in the diversity of board members' functional and occupational background, and played a partial mediating role in the diversification of directors' part-time jobs. Technological innovation is a key indicator bridging board diversity and firm performance. This study can explore and explain the inner workings of the significant relationship between board diversity and firm performance, and link research findings on similar phenomena. The research results may make the existing board governance theories more systematic, expand the extension of theoretical research, and provide some empirical research references for academics and practitioners.

Impact of External Environmental Dimensions on Financial Performance of Major Teaching Hospitals in the U.S.

Teaching hospitals have a unique mission to not only deliver graduate medical education but to also provide both inpatient and ambulatory care and to conduct clinical medical research; therefore, they are under constant financial pressure, and it is important to explore what types of external environmental components affect their financial performance. This study examined if there is an association between the short-term and long-term financial performance of major teaching hospitals in the United States and the external environmental dimensions, as measured by the Resource Dependence Theory. Data for 226 major teaching hospitals spanning 46 states were analyzed. The dependent variable for short-term financial performance was days cash on hand, and dependent variable for long-term financial performance was return on assets, both an average of most recently available 4-year data (2014-2017). Utilizing linear regression model, results showed significance between outpatient revenue and days cash on hand as well as significant relationship between population of the metropolitan statistical area, unemployment rate of the metropolitan statistical area, and teaching hospital's return on assets. Additionally, system membership, type of ownership/control, and teaching intensity also showed significant association with return on assets. By comprehensively examining all major teaching hospitals in the U.S. and analyzing the association between their short-term and long-term financial performance and external environmental dimensions, based upon Resource Dependence Theory, we found that by offering diverse outpatient services and novel delivery options, administrators of teaching hospitals may be able to increase organizational liquidity.

Inter-organizational information sharing and bundled payment reimbursement: Do hospitals in the US use health information exchange to collaborate?

OBJECTIVE: The purpose of this study is to examine the relationship between the greater need for information generated by bundled payment reimbursement and the use of Health Information Exchange (HIE). METHODS: The study is based on a secondary data analysis using theAmerican Hospital Association (AHA) Healthcare IT Database and the AHA Annual Survey. A logistic regression was used to test the likelihood of hospitals participating in HIE if they were involved in bundled payment reimbursement. Negative binomial, ordered logistic and Poisson regression models were used to determine the associations between bundled payment reimbursement and health information sharing in terms of breadth, volume, and diversity, respectively. RESULTS: Hospitals in bundled payment programs were more likely to send and receive information through HIE and tosend information to different types of health providers but not to receive. They were also more likely to exchange different types of health information and to use HIE more often. CONCLUSIONS: The greater need for collaboration of hospitals participating in bundled payment programs was associated with greater information sharing among organizations through HIE, but different providers involved in the episode of care play different roles in HIE.

Hospitalists, two decades later: Which US hospitals utilize them?

Hospitalists, or specialists of hospital medicine, have long been practicing in Canada and Europe. However, it was not until the mid-1990s, when hospitals in the U.S. started widespread adoption of hospitalists. Since then, the number of hospitalists has grown exponentially in the U.S. from a few hundred to over 50,000 in 2016. Prior studies on hospitalists have well documented benefits hospitals gain from adopting this innovative staffing strategy. However, there is a dearth of research documenting predictors of hospitals' adoption of hospitalists. To fill this gap, this longitudinal study (2003-2015) purposes to determine organizational and market characteristics of U.S. hospitals that utilize hospitalists. Our findings indicate that private not-for-profit, system affiliated, teaching, and urban hospitals, and those located in higher per capita income markets have a higher probability of utilizing hospitalists. Additionally, large or medium, profitable hospitals, and those that treat sicker patients have a higher probability of adoption. Finally, hospitals with a high proportion of Medicaid patients have a lower probability of utilizing hospitalists. Our results suggest that hospitals with greater slack resources and those located in munificent counties are more likely to use hospitalists, while their under-resourced counterparts may experience more barriers in adopting this innovative staffing strategy.

High Medicaid Nursing Homes: Organizational and Market Factors Associated With Financial Performance.

High Medicaid nursing homes (85% and higher of Medicaid residents) operate in resource-constrained environments. High Medicaid nursing homes (on average) have lower quality and poorer financial performance. However, there is significant variation in performance among high Medicaid nursing homes. The purpose of this study is to examine the organizational and market factors that may be associated with better financial performance among high Medicaid nursing homes. Data sources included Long-Term Care Focus (LTCFocus), Centers for Medicare and Medicaid Services' (CMS) Medicare Cost Reports, CMS Nursing Home Compare, and the Area Health Resource File (AHRF) for 2009-2015. There were approximately 1108 facilities with high Medicaid per year. The dependent variables are nursing homes operating and total margin. The independent variables included size, chain affiliation, occupancy rate, percent Medicare, market competition, and county socioeconomic status. Control variables included staffing variables, resident quality, for-profit status, acuity index, percent minorities in the facility, percent Medicaid residents, metropolitan area, and Medicare Advantage penetration. Data were analyzed using generalized estimating equations with state and year fixed effects. Results suggest that organizational and market slack resources are associated with performance differentials among high Medicaid nursing homes. Higher financial performing facilities are characterized as having nurse practitioners/physician assistants, more beds, higher occupancy rate, higher Medicare and Medicaid census, and being for-profit and located in less competitive markets. Higher levels of Registered Nurse (RN) skill mix result in lower financial performance in high Medicaid nursing homes. Policy and managerial implications of the study are discussed.

The influence of institutional pressures on hospital electronic health record presence.

Electronic health records (EHR) are a promising form of health information technology that could help US hospitals improve on their quality of care and costs. During the study period explored (2005-2009), high expectations for EHR diffused across institutional stakeholders in the healthcare environment, which may have pressured hospitals to have EHR capabilities even in the presence of weak technical rationale for the technology. Using an extensive set of organizational theory-specific predictors, this study explored whether five factors - cause, constituents, content, context, and control - that reflect the nature of institutional pressures for EHR capabilities motivated hospitals to comply with these pressures. Using information from several national data bases, an ordered probit regression model was estimated. The resulting predicted probabilities of EHR capabilities from the empirical model's estimates were used to test the study's five hypotheses, of which three were supported. When the underlying cause, dependence on constituents, or influence of control were high and potential countervailing forces were low, hospitals were more likely to employ strategic responses that were compliant with the institutional pressures for EHR capabilities. In light of these pressures, hospitals may have acquiesced, by having comprehensive EHR capabilities, or compromised, by having intermediate EHR capabilities, in order to maintain legitimacy in their environment. The study underscores the importance of our assessment for theory and policy development, and provides suggestions for future research.

Prevalence of obesity in new york nursing homes: associations with facility characteristics.

PURPOSE OF THE STUDY: With the growing obesity epidemic, the proportion of obese U.S. nursing home (NH) residents has increased. Little is known about the characteristics of facilities that serve obese residents. We identified facility characteristics associated with risk-adjusted obesity prevalence, based on resource dependence theory. DESIGN AND METHODS: Information on residents' admission records from the Minimum Data Set for New York State was linked with the NH Compare and the Online Survey, Certification, and Reporting databases for CY2005-2007. Three facility-level outcome variables were rates of risk-adjusted obesity (body mass index [BMI] ≥ 30), mild-to-moderate obesity (30 ≤ BMI < 40), and morbid obesity (BMI ≥ 40). Facility characteristics included financial resources, staff resources, quality of care, operational efficiency, and other resources. Individual-level factors were used to calculate risk-adjusted obesity rates. Multivariate regression models were employed. RESULTS: Higher staffing was positively related to obesity rates. Every 0.1 increase in the staffing ratio was related to higher obesity (3.9%) prevalence, mild-to-moderate obesity rate (2.6%), and morbid obesity prevalence (4.6%). Facilities with poorer quality had higher obesity rates. Presence of any quality of life (QL) deficiency was associated with higher obesity (3.2%), mild-to-moderate obesity (2.5%), and morbid obesity (3.6%). IMPLICATIONS: Facilities more likely to provide care to obese residents appear to be characterized by higher resource use and poorer quality. Policymakers may need to pay closer attention to the financial implications that the growing population of obese residents may have on NHs, as well as the extent to which this trend may affect facilities' resources and the quality of care they provide.