Article

Innovation in nursing homes: Which facilities are the early adopters?

Institute for Health, Health Care Policy and Aging Research, New Brunswick, NJ 08901, USA.
The Gerontologist (Impact Factor: 3.21). 05/2001; 41(2):161-72. DOI: 10.1093/geront/41.2.161
Source: PubMed

ABSTRACT This study examined organizational and market factors associated with nursing homes that are most likely to be early adopters of innovations. Early adopter institutions, defined as the first 20% of facilities to adopt an innovation, are important because they subsequently facilitate the diffusion of innovations to others in the industry.
Two groups of innovations were examined, special care units and subacute care services. I used discrete-time logistic regression analysis and nationally representative data from 13,162 facilities at risk of being early adopters of innovations during twelve 6-month intervals from 1992 to 1997.
Organizational factors that increase the likelihood of early innovation adoption are larger bed size, chain membership, and high levels of private-pay residents. Four market factors that increase the likelihood of early innovation adoption are: a retrospective Medicaid reimbursement methodology, a more competitive environment, higher average income in the county, and a higher number of hospital beds in the county.
This analysis shows that organizational and market characteristics of nursing homes affect their propensity toward early adoption of innovations. Some of the results may be useful for nursing home administrators and policy makers attempting to promote innovation.

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    • "Castle (2001) examines nursing homes that are pioneer users of new processes and technology since " identifying characteristics associated with this early adoption process could be useful in further facilitating the diffusion of innovations " (Castle 2001, 161). From a sample of more than 13,000 US facilities between 1992 and 1997, the author identifies the first 20 percent of firms to adopt any of 13 innovations, including for example special care units for Alzheimer's disease, AIDS, head trauma or Huntingdon's disease as well as subacute care for physical therapy, cardiac treatment, and dialysis. "
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    • "The presence of repeated success among innovation adopters prompts other organizations to innovate; this pattern is particularly prominent in competitive environments (Kimberly & Evanisko, 1981). Organizations share a limited pool of resources (such as potential clients) in competitive private-sector environments, and thus may seek out innovation adoption to distinguish their services and improve their market image (Castle, 2001). Market competition has been noted in the literature as a driving force towards isomorphism, and the resulting legitimacy pressures may provide an additional impetus towards innovation adoption (Abrahamson & Rosenkopf, 1993). "
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