Regulatory change, constraints on adaptation and organizational failure: An empirical analysis of acute care hospitals
研究了1983年Medicare预付费制度实施后，医院因收入结构、规模经济和范围经济等约束而无法适应新环境，导致组织失败（倒闭）的现象，基于芝加哥地区医院数据。
Abstract The advent of the Medicare prospective payment system (PPS) in 1983 affected individual general hospitals in varying degrees based on their revenue and cost structures. These same factors served to constrain a hospital's ability to adapt to the post‐PPS environment. The three constraints are based on the proportion of the hospital's private‐pay (non‐Medicare/Medicaid) patients, economies of scale and economies of scope among medical services. We test the relationship between these constraints and organizational failure in the Chicago area. Hospitals selected out of the new environment (1986‐91) were at a significant relative disadvantage with respect to the proposed constraints.