| During the past quarter century, efforts have been made to control rising hospital costs, which are the largest component of U.S. health care expenditures. The purpose of this research is to examine the relationship among five community characteristics and hospital ownership types; determine whether there are differences in operational performance (cost and efficiency) between private nonprofit and private for-profit hospitals; and propose an answer to the question---Why do local governments contract-manage their hospital operation? Using a mixed-method research design, the findings are: (1) there are mixed results in the relationship between community characteristics and hospital ownership types; (2) there are no significant differences in operational performance of private nonprofit and private for-profit hospitals; and (3) hospitals pursue contract management services to gain hospital management expertise, financial management, medical and information technology, and human resource management and recruitment. The implications of this study calls for a broader examination of operational performance among hospital ownership types and policy direction on the goals and mission of a public private venture such as contract management. |
