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

Background. Virtually all hospitals in the United States report that they engage in efforts to improve quality, such as continuous quality improvement (CQI). Little is known about the costs of these efforts and whether they are associated with improved outcomes or lower patient-care costs. Objectives. The principal objective of this study was to provide benchmark data on the costs of efforts to improve quality. The authors also attempted to determine if quality improvement expenditures are correlated with outcomes and/or condition-specific hospital costs. Methods. Detailed information on the cost of quality improvement was obtained from hospitals participating in a broad study of CQI activities. These data were correlated with patient outcomes and condition-specific costs. The subjects were medium to large hospitals throughout the United States. Senior managers provided budgetary information on direct costs of quality improvement, and details about meetings associated with quality improvement. They also provided summary medical bills for all patients undergoing total hip replacement and coronary artery bypass graft surgery. The billing information was combined with data provided by the Health Care Finance Administration to estimate condition-specific costs. Patients were directly surveyed to obtain information about satisfaction and outcomes. Results. There is a wide range of expenditures on quality improvement activities. Meeting costs are a substantial percentage of total costs. Neither total costs nor meeting costs are correlated with condition-specific costs. Discussion. Hospital managers can be expected to insist on evidence that quality improvement expenditures produce tangible benefits. This article provides benchmark estimates of those benefits and a methodology for further research.

The cost of efforts to improve quality.

The Trillion Dollar Conundrum

In April 1997, a consortium of hardware manufacturers and movie studios launched the DVD format. By that fall, electronics retailing giant Circuit City announced its intentions to launch a partially incompatible format known as DIVX. This Paper assesses Circuit City's strategy to establish the dominant standard for digital video technology. We identify several key principles that any firm must consider when deciding how to compete in a market with evolving standards. We argue that virtually all of these factors weighed in against Circuit City, so that its effort was destined to fail.

Surviving a Standards War: Lessons Learned from the Life and Death of DIVX

Hospitals employ an increasing number of physicians and bill for a growing share of outpatient procedures. We exploit a plausibly exogenous increase in Medicare prices for hospital-employed physicians relative to Medicare prices for other physicians to show that payer reimbursement rules explain part of this trend. The shock we study explains 20 percent of the increase in physician employment and 75 percent of the increase in hospital-billed outpatient procedures between 2009 and 2013.

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Employed for Higher Pay? How Medicare Payment Rules Affect Hospital Employment of Physicians

DURING the early 1970s several states enacted hospital rate-setting programs. These programs effectively reduced the growth of hospital expenditures over the ensuing decade.' In this paper we develop and test an economic theory of regulation that explains the passage of rate-setting laws. We consider and reject the hypothesis that states enacted the laws in response to large general increases in hospital expenses. We conclude instead that states passed these laws in order to reduce expenditures for hospitalized Medicaid patients. Rate-setting programs differ along several dimensions, including the unit of review (the unit of output for which the rate is set), whether participation and compliance is mandatory, and the number of patients for whom the rates apply. There are only eight states in which participation and compliance is mandatory and in which the rates have applied to 50 percent or more of the patients. Table 1 lists these states and the years in which they enacted rate setting. When enacted, the rates in all these states applied to Medicaid recipients and Blue Cross enrollees. In some states rates have also applied to other privately insured patients and those without insurance.2 For our purposes we will refer to all eight states as the

David Dranove

Papers

The cost of efforts to improve quality.

The Trillion Dollar Conundrum

Surviving a Standards War: Lessons Learned from the Life and Death of DIVX

Employed for Higher Pay? How Medicare Payment Rules Affect Hospital Employment of Physicians

Why did states enact hospital rate-setting laws?