PurposeThis research paper comparatively reviews online accountability practices in public, private and nonprofit organizations, using the hospital industry as a case of analysis.Design/methodology/approachThe authors conducted a quantitative content analysis of 240 US hospital websites, sampled from the 2016 American Hospital Association (AHA) database. Online Accountability Practices (OAP) instrument was utilized, and it included five dimensions as follows: accessibility, engagement, performance, governance and mission.FindingsThere were statistically significant differences in online accountability practices among the three sectors. Nonprofit organizations were leading the way in their overall online accountability practices. They were more likely to score higher on engagement, performance and mission dimensions. We explain this finding through the prism of multiple accountabilities, guided by the stakeholder theory. Private organizations had the lowest scores on every online accountability dimension, except for accessibility. Consistent with previous literature, private organizations were more likely to make information accessible in the online sphere, but not necessarily meaningful or reliable for evaluating organizational performance. Public organizations had the strongest scores within the governance dimension, placing importance on disclosing organizational leadership and sharing information on their governance structures.Research limitations/implicationsThis project contributes to theory building on accountability in the online environment. It argues that the distinction between two forms of accountability (functional and holistic) is applicable in the online environment, while accessibility and performance dimensions of online accountability closely align with the functional (hierarchical) form of accountability, and a more holistic approach to accountability includes dimensions like engagement, governance and mission. In addition, this project is the first of its kind to apply the stakeholder theory to accountability practices in three sectors of the economy and how the stakeholder theory provides guidance as a basis of understanding the forms of accountability (functional and holistic) that are most likely aligned with organizations in three sectors of the economy.Practical implicationsThe results of this study point to a number of implications for hospital patients, families, hospital administration, healthcare professionals and policymakers. These implications can be broadly divided into two groups as follows: policy implications and management implications. Policy implications pertain to the national dialog and interorganizational deliberations of sector-wide policy to enrich accountability practices; while management implications are concerned with local, intraorganizational discussions among administrators and organizational leaders on formulating specific strategies and tactics.Originality/valueThis research paper contributes to empirical studies on organizational accountability in the online environment. It enriches our understanding of how organizations in different sectors present themselves to the public.

Most certainly, this thesis would not have been possible without the love, encouragement and support of my family. I would like to thank my mom for listening to me, in good times and in bad times, providing me with love, nurturing me, and caring about my well-being. I would like to thank my sister, my closest friend from the day I was born. You were amazing coding and coding and never complaining. I would like to thank my dad, my "rock" when times were turbulent. Most importantly, I would like to greatly thank Chance Cooley, my companion, my inspiration, and my love. This journey through the school would not be the same without you. You made it exciting and stimulating by challenging me in every class, by holding our long discussions, by giving me advice, by reading my papers, and by being my Junto buddy. I am giving you a credit for defending your thesis first, but I am not giving you superiority in iceskating and ping-pong. Remember, I will always love and challenge you in our journey together.

35:e178-e wileyonlinelibrary.com/journal/hpm e195. e K E Y W O R D S disclosure, hospitals, online accountability, website | INTRODUCTIONUS health care is one of the fastest-growing areas of the economy that is extensive, highly institutionalized, adheres to multiple regulatory forces, and is marked by high levels of professionalism. 1 Parties involved in health care (regulatory agencies, legislature, hospitals, insurance companies, medical providers, etc.) are faced with ever-growing pressures to provide health services more effectively, efficiently, and equitably. Previous solutions to providing better health care included reforms that focus on downsizing, privatization, performance measurements, competition in service delivery, and citizen participation. 2 All these approaches have one thing in common: a strong emphasis on accountability in improving health care performance.Health care accountability has several purposes. It helps to reduce fraud and abuse, 2 which is estimated at $60 billion per year by the National Health Care Anti-Fraud Association. 3 It also assists in ensuring compliance with procedures and standards as well as revealing gaps requiring policy attention. 2 Also, accountability contributes to improving performance and learning (such as generating a system-wide perspective on health sector reforms). 2 Hospitals play the most extensive role in the US health care industry, accounting roughly for a third of health care expenditures. 4 Being on the forefront of medical development and innovation, US hospitals (regardless of ownership) are at the forefront of improving public health. 5 When reviewing the literature on hospital accountability, we find a rather narrow focus of studies, mostly on health care delivery outcomes, such as readmission rates 6,7 and quality-of-care. 8 Some studies move beyond health care delivery outcomes and look at hospital financial outcomes 9 in terms of hospital accountability. Others focus on one particular type of hospital-nonprofit hospitals-while researching accountability practices. 10-12 While these are all important topics, they rarely address how hospitals meet the demands of a broader group of stakeholders-the public at large (patients, families, community members, etc.). For many, an organizational website is a first and most trusted resource they turn to when in need of information about a hospital. Online accountability (OA) practices are how hospitals address these expectations. OA is one of the critical dimensions of overall accountability efforts in hospitals, and not much research is available on this subject. Thus, hospital OA is a topic of this research paper.The existing empirical evidence sheds light on variations in online accountability practices (OAP) within the nonprofit sector 13-17 but not within health care organizations. This study aims to fill these research gaps by exploring variations in OAP in the US hospitals and identifying key determinants of robust OAP. The particular contribution of this research project to the scholarly community...

No abstract

No abstract