Organizational Fragmentation and Care Quality in the U.S. Healthcare System
- (pp. 93-113)
AbstractMany goods and services can be readily provided through a series of unconnected transactions, but in health care, close coordination over time and within care episodes improves both health outcomes and efficiency. Close coordination is problematic in the U.S. healthcare system because the financing and delivery of care is distributed across a variety of distinct and often competing entities, each with its own objectives, obligations, and capabilities. These fragmented organizational structures lead to disrupted relationships, poor information flows, and misaligned incentives that combine to degrade care quality and increase costs. We illustrate our argument with examples taken from the insurance and hospital industries, and discuss possible responses to the problems resulting from organizational fragmentation.
CitationCebul, Randall D., James B. Rebitzer, Lowell J. Taylor, and Mark E. Votruba. 2008. "Organizational Fragmentation and Care Quality in the U.S. Healthcare System." Journal of Economic Perspectives, 22 (4): 93-113. DOI: 10.1257/jep.22.4.93
- H51 National Government Expenditures and Health
- H75 State and Local Government: Health, Education, and Welfare
- I11 Analysis of Health Care Markets
- I18 Health: Government Policy; Regulation; Public Health