According to W. Edwards Deming, American companies require nothing less than a transformation of management style and of governmental relations with industry. In Out of the Crisis, originally published in 1982, Deming offers a theory of management based on his famous 14 Points for Management. Management's failure to plan for the future, he claims, brings about loss of market, which brings about loss of jobs. Management must be judged not only by the quarterly dividend, but by innovative plans to stay in business, protect investment, ensure future dividends, and provide more jobs through improved product and service. In simple, direct language, he explains the principles of management transformation and how to apply them.

Out of the Crisis

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The Theory of Industrial Organization

Resource-based theories of competitive advantage: A ten-year retrospective on the resource-based view

Typologies are an important way of organizing the complex cause-effect relationships that are key building blocks of the strategy and organization literatures. Here, I develop a novel theoretical perspective on causal core and periphery, which is based on how elements of a configuration are connected to outcomes. Using data on hightechnology firms, I empirically investigate configurations based on the Miles and Snow typology using fuzzy set qualitative comparative analysis (fsQCA). My findings show how the theoretical perspective developed here allows for a detailed analysis of causal core, periphery, and asymmetry, shifting the focus to midrange theories of causal processes.

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Building Better Causal Theories: A Fuzzy Set Approach to Typologies in Organization Research

Mixed methods research offers powerful tools for investigating complex processes and systems in health and health care. This article describes integration principles and practices at three levels in mixed methods research and provides illustrative examples. Integration at the study design level occurs through three basic mixed method designs—exploratory sequential, explanatory sequential, and convergent—and through four advanced frameworks—multistage, intervention, case study, and participatory. Integration at the methods level occurs through four approaches. In connecting, one database links to the other through sampling. With building, one database informs the data collection approach of the other. When merging, the two databases are brought together for analysis. With embedding, data collection and analysis link at multiple points. Integration at the interpretation and reporting level occurs through narrative, data transformation, and joint display. The fit of integration describes the extent the qualitative and quantitative findings cohere. Understanding these principles and practices of integration can help health services researchers leverage the strengths of mixed methods.

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Achieving Integration in Mixed Methods Designs—Principles and Practices

Preferred provider organizations (PPOs) and other discount health care purchasers are injecting price competition into the hospital market, which has hitherto been insulated from price competition by comprehensive and generous insurance coverage. Providing the discounts demanded by PPOs thus poses unaccustomed and difficult problems for hospitals. We constructed a model to study the choices forced by PPOs on the hospital market. We predict that prices will fall, excess capacity will be reduced, and some hospitals may develop financial problems. In the extreme case, prices will fall substantially, some hospitals will go bankrupt, excess capacity will be eliminated, and an unprecedented price volatility will be introduced into the market.

The effect of injecting price competition into the hospital market: the case of preferred provider organizations.

The theory of cost-shifting posits that nonprofit hospitals respond to negative financial shocks by raising prices for privately insured patients. We examine how hospitals responded to the sharp reductions in their endowments caused by the 2008 stock market collapse. We find that the average hospital did not engage in cost-shifting, but average hospitals that likely have substantial market power did cost-shift. Investigating further how hospitals responded to the financial setback, we found no evidence of reductions in treatment costs. However, hospitals with large endowment losses delayed purchases of health information technology and curtailed the offering of unprofitable services.

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How do Hospitals Respond to Negative Financial Shocks? The Impact of the 2008 Stock Market Crash

Is there underinvestment in R & D about prevention?

A note on the relational aspects of hospital market definitions.

We compare four datasets that researchers might use to study competition in the health insurance industry. We show that the two datasets most commonly used to estimate market concentration differ considerably from each other (both in levels and in changes over time), and reflect implausibly high volatility in market shares. By comparison, market share volatility is much lower in a private dataset gathered by a leading investment bank, and in state-level hospital discharge data. We also demonstrate that the outcome of regressions using these data vary considerably by the source used. We conclude that researchers should be cautious about using available data and recommend a new source be developed for public use.

David Dranove

Papers

The effect of injecting price competition into the hospital market: the case of preferred provider organizations.

How do Hospitals Respond to Negative Financial Shocks? The Impact of the 2008 Stock Market Crash

Is there underinvestment in R & D about prevention?

A note on the relational aspects of hospital market definitions.

Data impediments to empirical work on health insurance markets