Biomedical subjects
Publications and source records attributed to Shulamit Bernard.
We examined how five integrated delivery systems make decisions about and implement clinical information systems. Using case study methods, we identified general themes and explored how organizational context factors and information technology characteristics affect adoption and implementation processes.
In this paper we compare physician referral patterns, quality, patient satisfaction, and community benefits of physician-owned specialty versus peer competitor hospitals. Our results are based on evidence gathered from site visits to six markets, 2003 Medicare claims, patient focus groups, and Internal Revenue Service data. Although physician-owners are more likely than others to refer to their own facilities and treat a healthier population, there are rationales for these patterns aside from motives for profit. Specialty hospitals provide generally high-quality care to satisfied patients. Uncompensated care plus specialty hospitals' taxes represent a greater burden, in percentage terms, than community benefits provided by nonprofit providers.