ORGANIZATIONAL AND ADMINISTRATIVE FACTORS INFLUENCING THE ADOPTION OFCONSORTIA PROGRAMS BY RURAL HOSPITALS

This study was designed to assess the effects of various hospital and environmental characteristics on the involvement of rural hospitals in forming and governing consortia and adopting consortia programs. The study focused on the 127 hospitals that are members of the nine rural consortia developed by grants from the Robert Wood Johnson Foundation during 1989 under its Hospital-Based Rural Hospital Consortia Program. Hospital involvement in the formation and governance of the consortia was found to be far less than expected for these grass-roots organiza tions. Only 38 percent of the administrators said that their hospitals were involved in developing the consortia, and 44 percent said that t hey played a role in determining the program menu. Governing board and medical staff involvement was even more limited. Program adoption rat es were found to be related to both the types of programs offered by t he consortia and the characteristics of the hospitals. In general, gre ater involvement of physicians and governing board members in hospital decisions was found to enhance program adoption rates, but the influe nce varied by type of involvement in the hospital and program content.