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The ties that bind: an integrative framework of physician-hospital alignment

Jeroen Trybou UGent, Paul Gemmel UGent and Lieven Annemans UGent (2011) BMC HEALTH SERVICES RESEARCH. 11(36). p.1-15
abstract
Background Alignment between physicians and hospitals is of major importance to the health care sector. Two distinct approaches to align the medical staff with the hospital have characterized previous research. The first approach, economic integration, is rooted in the economic literature, in which alignment is realized by financial means. The second approach, noneconomic integration, represents a sociological perspective emphasizing the cooperative nature of their relationship. Discussion Empirical studies and management theory (agency theory and social exchange theory) are used to increase holistic understanding of physician hospital alignment. On the one hand, noneconomic integration is identified as a means to realize a cooperative relationship. On the other hand, economic integration is studied as a way to align financial incentives. The framework is developed around two key antecedent factors which play an important role in aligning the medical staff. First, provider financial risk bearing is identified as a driving force towards closer integration. Second, organizational trust is believed to be important in explaining the causal relation between noneconomic and economic integration. Summary Hospital financial risk bearing creates a greater need for closer cooperation with the medical staff and alignment of financial incentives. Noneconomic integration lies at the very basis of alignment. It contributes directly to alignment through the norm of reciprocity and indirectly by building trust with the medical staff, laying the foundation for alignment of financial incentives.
Please use this url to cite or link to this publication:
author
organization
year
type
journalArticle (original)
publication status
published
subject
keyword
FINANCIAL INCENTIVES, HEALTH-CARE ORGANIZATIONS, SYSTEM ALIGNMENT, AGENCY THEORY, PERFORMANCE, IMPACT, PERSPECTIVE, MODEL, TRUST, COST
journal title
BMC HEALTH SERVICES RESEARCH
BMC Health Serv. Res.
volume
11
issue
36
article_number
36
pages
1 - 15
Web of Science type
Article
Web of Science id
000288030100001
JCR category
HEALTH CARE SCIENCES & SERVICES
JCR impact factor
1.66 (2011)
JCR rank
37/75 (2011)
JCR quartile
2 (2011)
ISSN
1472-6963
language
English
UGent publication?
yes
classification
A1
copyright statement
I have transferred the copyright for this publication to the publisher
id
1152005
handle
http://hdl.handle.net/1854/LU-1152005
date created
2011-02-15 15:34:27
date last changed
2015-06-17 09:26:04
@article{1152005,
  abstract     = {Background
Alignment between physicians and hospitals is of major importance to the health care sector. Two distinct approaches to align the medical staff with the hospital have characterized previous research. The first approach, economic integration, is rooted in the economic literature, in which alignment is realized by financial means. The second approach, noneconomic integration, represents a sociological perspective emphasizing the cooperative nature of their relationship.
Discussion
Empirical studies and management theory (agency theory and social exchange theory) are used to increase holistic understanding of physician hospital alignment. On the one hand, noneconomic integration is identified as a means to realize a cooperative relationship. On the other hand, economic integration is studied as a way to align financial incentives. The framework is developed around two key antecedent factors which play an important role in aligning the medical staff. First, provider financial risk bearing is identified as a driving force towards closer integration. Second, organizational trust is believed to be important in explaining the causal relation between noneconomic and economic integration. 
Summary
Hospital financial risk bearing creates a greater need for closer cooperation with the medical staff and alignment of financial incentives. Noneconomic integration lies at the very basis of alignment. It contributes directly to alignment through the norm of reciprocity and indirectly by building trust with the medical staff, laying the foundation for alignment of financial incentives.},
  articleno    = {36},
  author       = {Trybou, Jeroen and Gemmel, Paul and Annemans, Lieven},
  issn         = {1472-6963},
  journal      = {BMC HEALTH SERVICES RESEARCH},
  keyword      = {FINANCIAL INCENTIVES,HEALTH-CARE ORGANIZATIONS,SYSTEM ALIGNMENT,AGENCY THEORY,PERFORMANCE,IMPACT,PERSPECTIVE,MODEL,TRUST,COST},
  language     = {eng},
  number       = {36},
  pages        = {36:1--36:15},
  title        = {The ties that bind: an integrative framework of physician-hospital alignment},
  volume       = {11},
  year         = {2011},
}

Chicago
Trybou, Jeroen, Paul Gemmel, and Lieven Annemans. 2011. “The Ties That Bind: An Integrative Framework of Physician-hospital Alignment.” Bmc Health Services Research 11 (36): 1–15.
APA
Trybou, J., Gemmel, P., & Annemans, L. (2011). The ties that bind: an integrative framework of physician-hospital alignment. BMC HEALTH SERVICES RESEARCH, 11(36), 1–15.
Vancouver
1.
Trybou J, Gemmel P, Annemans L. The ties that bind: an integrative framework of physician-hospital alignment. BMC HEALTH SERVICES RESEARCH. 2011;11(36):1–15.
MLA
Trybou, Jeroen, Paul Gemmel, and Lieven Annemans. “The Ties That Bind: An Integrative Framework of Physician-hospital Alignment.” BMC HEALTH SERVICES RESEARCH 11.36 (2011): 1–15. Print.