Borje O. Saxberg

An Empirical Test of the Configurational Theory of Organizations

The configurational theory of organizations was used to analyze the relationships among organization environment, structure, and performance in proprietary nursing homes. This theory extends previous contingency theory research and conceptualization by including performance as the main focus behind organization design activities. Thirty proprietary nursing homes in the state of Washington responded to comprehensive interviews and survey questionnaires designed to measure variables specified in the configurational theory. The results of this study suggest partial support for the configurational theory; most notably in explaining differences in efficiency among nursing homes operating in low intensity environments.

Does prospective payment encourage nursing home efficiency

The health-care field is increasingly sensitive to the effect of third-party reimbursement policies on health-care organization performance. The ability to attain low costs and high net income, for example, is particularly affected by prospective reimbursement. Theoretically, prospective payments should provide an incentive to health-care organizations to implement better control overperformance. These ideas are examined in a study of nursing homes. Results of this analysis indicate that management controlpractices contribute to efficient performance. The association of thisfinding with prospective reimbursement is discussedfrom theperspective of implicationsfor health-care organizations.

Administration: the critical long-term care variable.

Administrators and managers are crucial variables in the provision of long-term services. Their potential contribution to efficient and effective long-term care can be successfully shaped for maximum results.

Public Incentives for Effective Health Care Administration

The issue of providing public incentives for effective health care administration is explored in nursing homes. Measures of performance are analyzed in relation to management control activities. The results suggest these activities are associated with higher net revenues and a lower intensity of care. The implications for health care are discussed.