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Resource dependence and institutional elements in nursing home TQM adoption.

机译：采用养老院全面质量管理过程中的资源依赖和体制因素。

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OBJECTIVE: To examine the contextual attributes that influence nursing home TQM adoption, as informed by resource dependence and institutional theories. DATA SOURCES: A survey of licensed nursing home administrators in the Commonwealth of Pennsylvania during 1994-1995, the Medicare and Medicaid Annual Certification Survey (MMACS) data file, and the Area Resource File (ARF). STUDY DESIGN: Because the dependent variable (TQM adoption vs. non-adoption) is dichotomous, the model was estimated using logistic regression. DATA COLLECTION: Of the 615 facilities that were mailed surveys, 241 (39.2%) returned completed questionnaires. No significant differences were observed between respondents and nonrespondents in size, for-profit status, system membership, registered nurse staffing, cited licensure deficiencies, Medicare census, or Medicaid census. PRINCIPAL FINDINGS: Perceived competition, Medicare's share of total hospital discharges in the market, and facility Medicare census were significant predictors of TQM adoption. CONCLUSIONS: Our results provide limited support for the association between some rational adaptive and institutional factors and TQM adoption in nursing homes. Perceived competition and the influence of the Medicare program both at the facility and the market level are associated with TQM adoption. However, other factors associated with TQM adoption in other industries, such as size, are not associated with TQM adoption in the nursing homes in this study.
机译：目的：根据资源依赖和制度理论，研究影响养老院全面质量管理采用的背景属性。数据来源：对1994-1995年间宾夕法尼亚州特许护理院管理人员的调查，Medicare和Medicaid年度认证调查（MMACS）数据文件以及区域资源文件（ARF）。研究设计：由于因变量（采用TQM与不采用TQM）是二分法的，因此该模型使用对数回归进行估计。数据收集：在通过邮寄方式进行调查的615个设施中，有241个（39.2％）返回了已完成的调查问卷。在受访者和非受访者之间，在规模，营利性状态，系统成员资格，注册护士人员配备，引证执照缺陷，医疗保险普查或医疗补助普查方面均未观察到显着差异。主要发现：感知的竞争，医疗保险在市场上总出院率中所占的份额以及医疗保险机构的人口普查是采用全面质量管理的重要预测指标。结论：我们的结果为某些合理的适应性和制度性因素与疗养院中全面质量管理的采用之间的关联提供了有限的支持。 TQM的采用与在设施和市场层面的感知竞争和Medicare计划的影响有关。但是，在这项研究中，与其他行业采用TQM相关的其他因素（例如规模）与护理院采用TQM无关。

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