Predictors of online accountability practices in US hospitals: An exploratory investigation

Abstract

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...

Impact of the global pandemic on online accountability practices in INGOs

“…Accountability in a time of crisis may be impaired as the power of stakeholders with the greatest need, such as beneficiaries to demand accountability may be weakened (Agyenim-Boateng and Oduro-Boateng, 2019). Online accountability is especially important during a crisis as online accountability should maintain reputation and assure stakeholders that the organisation is open and not hiding information (Yang et al ., 2010; Cooley, 2020a). As discussed in Section 7, the reaction of the INGOs' online accountability to the pandemic was limited.…”

“…However, the statistically significant change in the accessibility dimension also suggests that the INGOs needed to change their accountability as they felt obliged to respond to the Covid-19 pandemic. The statistically significant change in the engagement dimension shows that INGOs want to engage with their stakeholders and to enhance a two-way communication with them (Cooley, 2020a). This may be because the INGOs are experiencing reductions in funding as a consequence of the crisis and are trying to increase income from existing and new stakeholders (Agostino et al ., 2021).…”

“…The performance dimension assesses the disclosure of performance measures. While the governance of an organisation is assessed through the governance dimension, mission-related disclosure is examined through the mission dimension (Dumont, 2013;Cooley, 2020aCooley, , 2020b.…”

“…Online accountability is a branch of accountability practices which focusses on the online environment (Cooley, 2020a; Dumont, 2013). Various concepts used to define online accountability such as virtual, digital and web-based accountability, all refer to the same concept (Tremblay-Boire and Prakash, 2015; Saxton and Guo, 2011).…”

“…Cooley (2020a) used the NPVAI in performing content analysis of 240 US hospital websites. She found that public and not-for-profit hospitals were inclined to disclose more in terms of online accountability than private hospitals.…”