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R M Mullner

Publications and source records attributed to R M Mullner.

22 records · Page 2Linked to original sources
PubMed1982

Closure among U.S. community hospitals, 1976-1980: a description and a predictive model.

Closure of U.S. community hospitals during the years 1976-1980 is analyzed by describing the distributional patterns of closings among hospitals classified by certain institutional characteristics: bed size, number of facilities and services, ownership, teaching status, location in a Standard Metropolitan Statistical Area (SMSA) or in a non-SMSA, and location in one of the nine United States Census Divisions. The method of Cox regression analysis is used to show that each of these institutional characteristics is independently, and significantly, associated with closure, and to estimate the strength of the association. On the basis of this analysis, a theoretic model is constructed for estimating the relative probability of closure for any community hospital with a given set of these institutional characteristics.

Health Facilities↗
PubMedDate not supplied

Rural community hospitals and factors correlated with their risk of closing.

The issue of rural hospital closings in the United States in recent years has become of increasing concern to health care policy analysts. Rural communities face unique health needs, necessitating access to local health care. Much has been written about the social, economic, legislative, and technological changes that have increased the stress on rural hospitals in the 1980s. However, quantifiable models have been lacking with which to examine in detail factors associated with rural hospitals and to correlate such factors with individual hospitals' risks of closing. In this study, we identify variables correlated with rural community hospital closures in the period 1980-87. Using epidemiologic case-control methods, 161 closed rural hospitals were matched 1 to 3 with a control group of 483 rural hospitals which remained open during the same period. A series of hospital performance indicators and demographic, economic, and social community variables were entered into a multiple logistic regression model. Four variables were found to be positively correlated with risk of closure. They are for-profit ownership; nongovernment, not-for-profit ownership; presence of a skilled nursing or other longterm care unit; and the number of other hospitals in the county. Variables negatively correlated with risk of closure were accreditation by the Joint Commission on the Accreditation of Healthcare Organizations, the number of facilities and services, and membership in a multihospital system. Policy and research implications at the Federal, State, and local levels are discussed.

Accreditation↗
PubMedDate not supplied

Effects of characteristics of the survey instrument on response rates to a mail survey of community hospitals.

A 4-factor, 16-cell experimental design was used to investigate the relationship between response rates of community hospitals to a survey conducted by the American Hospital Association (AHA) and 4 characteristics of the survey instrument, each varied dichotomously: the perceived length of the questionnaire, the order of questions, the orientation of the appeal made in the cover letter, and the presence or absence of a promise to share the results of the study with respondents. Response rate variations between the various cells were examined and multiple logistic regression was used to analyze the significance of the association between response rates and each of the four survey instrument variables while controlling for the effect of the others. At the same time, control was also maintained for the effects of five institutional characteristics of hospitals which a previous study had shown to have a significant relationship to response: bed size, location within or outside a standard metropolitan statistical area, AHA membership status, type of ownership, and form of control. The perceived length of the questionnaire and the order of questions were found to have a significant effect on response rates, but the orientation of the cover letter and a promise to share the results of the study with the respondents were found to be insignificant.

American Hospital Association↗