Refine
Year of publication
- 2022 (2) (remove)
Document Type
- Article (2)
Language
- English (2)
Has Fulltext
- yes (2)
Is part of the Bibliography
- no (2)
Keywords
- Management (2) (remove)
Catholic Ownership, Physician Leadership and Operational Strategies: Evidence from German Hospitals
(2022)
Previous research has revealed that Catholic hospitals are more likely follow a strategy of horizontal diversification and maximization of the number of patients treated, whereas Protestant hospitals follow a strategy of horizontal specialization and focus on vertical differentiation. However, there is no empirical evidence pertaining to this mechanism. We conduct an empirical study in a German setting and argue that physician leadership mediates the relationship between ownership and operational strategies. The study includes the construction of a model combining data from a survey and publicly available information derived from the annual quality reports of German hospitals. Our results show that Catholic hospitals opt for leadership structures that ensure operational strategies in line with their general values, i.e., operational strategies of maximizing volume throughout the overall hospital. They prefer part-time positions for chief medical officers, as chief medical officers are identified to foster strategies of maximizing the overall number of patients treated. Hospital owners should be aware that the implementation of part-time and full-time leadership roles can help to support their strategies. Thus, our results provide insights into the relationship between leadership structures at the top of an organization, on the one hand, and strategic choices, on the other.
In a cross-sectional study, impact of management in dairy farms on calf mortality rates and prevalence of rotavirus and Cryptosporidium parvum in feces of calves was investigated. Sixty-two commercial dairy herds in Mecklenburg-Western Pomerania, Germany, were stratified selected in 2019. We performed in-person interviews and fecal specimens in samples of all-female calves of age 7 up to 21 days. Management data were documented on farm level. A Multiscreen Ag-ELISA was performed to determine rotavirus and Cryptosporidium parvum. Associations between two calf mortality rates, detection of C. parvum and rotavirus, and predictors were examined with GLM models. In farms with routine vaccination against respiratory diseases, 31-days mortality rate was 4.2% +/-1.26 compared to 7.6% +/-0.97 (p = 0.040) on non-vaccinating farms. Six-months mortality was lower in farms that continued feeding milk to calves during periods of diarrhea compared to farms that did not (6.9% +/-0.8 vs. 12.4% +/-2.3). In case of a routine shifting of calves from the calving box into calf boxes less C. parvum was detected compared to an individual moving of calves (33.3% +/-2.6 vs. 19.6% +/-5.3; p = 0.024). Our model confirms a positive association between occurrence of aqueous feces and frequency of detection of C. parvum (45.4% +/-23.6 vs. 21.4% +/-18.7; p < 0.001). Frequency of detection of rotavirus was lower in farms that reported a defined amount of applicated colostrum per calf than in farms that presented a range of colostrum instead of a defined amount. This study indicates the potential for mitigation of risk factors for mortality in calves.