Correlates of Resource Availability in Hospital Emergency Units.

Abstract

Despite the fact that hospital emergency units (EUs) are the major source of emergency medical care in the United States, we underst and relatively little about factors that contribute to their effective performance. To begin to fill this gap, the present study drew on the data, measures, and conceptual framework of previous research by Georgopoulos and his associates (1978, 1980) and addressed questions concerning key correlates of the availability of resources in EUs (e.g., funds, personnel). The study hypothesized that resource availability in EUs would depend on their ability to conduct efficient transactions with other organizations (Williamson, 1981) and the extent to which parent hospitals depended on EUs for funds and patients (Pfeffer and Salancik, 1978). In addition, it hypothesized that resource availability in EUs would be related to both the adequacy of EU problem solving and organizational effectiveness (e.g., clinical performance, economic efficiency). Data used in this study were collected by Georgopoulos and his associates (1980) from 30 r and omly selected hospitals in six midwestern states. Nearly 1500 individuals, including administrators, physicians, and patients, participated in the study. Data also were gathered from organizational records. Results from multiple regression analyses provided modest support for the proposed hypotheses. Variance accounted for in measures of resource availability by the hypothesized predictors ranged from 12 percent to 52 percent, depending on the resource considered; these results were not substantially altered after introducing control variables (e.g., EU size, hospital size) into the analyses. The measures of resource availability accounted for 7 percent to 67 percent of the variance in measures of the adequacy of organizational problem solving and 8 to 28 percent of the variance in measures of EU effectiveness. Alternative explanations for the obtained results were discussed along with the need for further conceptual work on the resource dependence and transaction cost perspectives.