Defining hospital's internal boundaries. An organisational complexity criterion

Area of Science:

• Healthcare Management
• Organizational Design
• Health Services Research

Background:

• Defining effective hospital ward boundaries is crucial for organizational design.
• Existing models often lack empirical evidence for service aggregation criteria.
• Organizational complexity is a key factor influencing ward performance.

Purpose of the Study:

• To provide empirical evidence for defining hospital ward boundaries.
• To suggest service aggregation criteria based on organizational complexity.
• To inform organizational designing processes in healthcare settings.

Main Methods:

• Panel data analysis was conducted on hospitals in Lombardy, Italy.
• Data were aggregated at the in-patient ward level from administrative records and registry offices.
• Research hypotheses were tested using statistical methods.

Main Results:

• Wards offering integrated services outperformed more specialized wards.
• Increasing levels of within-ward complexity reduced the positive impact of formal integration.
• Empirical findings support specific service aggregation criteria.

Conclusions:

• Integrated service delivery enhances hospital ward performance.
• Organizational complexity moderates the benefits of ward integration.
• Findings offer practical guidelines for designing hospital organizational structures.