Hospital response variation to the demands of preadmission certification

This paper reports findings from a study of the impact of preadmission certification programs from the perspective of the hospital--a deeply affected party. A series of field studies was undertaken to explore and delineate the range of hospital responses to the challenges posed by this third-party payer mandate and to identify factors associated with variation in responses. The evidence presented suggests wide variation in how hospitals chose to share responsibility for pre-certification with physicians and patients. The findings are broadly consistent with a proposed model that hospital response is determined by both external and internal considerations, but a larger scale hospital survey is necessary to test the hypotheses that can be derived from this study.