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University of Houston

Does Similarity Produce Synergy in Horizontal Hospital Acquisitions? Linking Operations Characteristics to Operations Strategy

Abstract

dc:description.abstract

The efficiency gains of hospital mergers and acquisitions (M&As) are derived not only from the market, financial, and managerial synergies, but also from operational synergies in economies of scale, clinical standardizations, service line optimizations, and so forth. To understand the roles that operations characteristics, and operations strategy play in hospital acquisitions, this dissertation examines the direct effects of geographic proximity and the service overlap on an acquired hospital’s post-acquisition operational performance (i.e., cost and quality) and its post-acquisition service-mix changes. The dissertation presents the findings from two essays. The first essay examines whether acquisitions benefit hospitals in terms of cost and quality. In addition, we try to determine the extent to which these benefits stem from similarities in two operational characteristics (i.e., service lines and geographical location). In the second essay, we test the effects of geographic proximity and market competition on an acquired hospital’s operations strategy (i.e., the service-mix changes). Analyzing four years (2010-2013) of data from 218 acquired hospitals in the U.S. (i.e., target hospitals), we find that hospital acquisitions result in lower readmission rates and operating expenses for the acquired hospitals. Also, the degree of geographic proximity is positively related to the post-acquisition quality improvements of the acquired hospitals. More important, there is an inverted U-shaped relationship between the pre-acquisition degree of service line similarity between the acquired and the acquirer hospitals and the post-acquisition quality improvements of the acquired hospital. Moreover, the relationship between the degree of service similarity and an acquired hospital’s post-acquisition quality performance is moderated by the degree of geographic proximity between the acquired and the acquirer hospitals. Finally, geographic proximity and market competition have some effects on an acquired hospital’s post-acquisition service-mix changes.

Degree

thesis:*
Name thesis:degree_name
Doctor of Philosophy
Level thesis:degree_level
Doctoral
Discipline thesis:degree_discipline
Supply Chain and Logistics Technology
Grantor
University of Houston
Year dc:date.issued
2019

Author and committee

dc:creator, dc:contributor.*
Author dc:creator
  • Cheng, Yuqiao
Advisor dc:contributor.advisor
  • Peng, David Xiaosong
Committee members dc:contributor.committeemember
  • Robinson, Powell
  • Sahin, Funda
  • Kirk, Terry D.

Subjects

dc:subject × 2

Rights

dc:rights
Statement dc:rights
  • The author of this work is the copyright owner. UH Libraries and the Texas Digital Library have their permission to store and provide access to this work. Further transmission, reproduction, or presentation of this work is prohibited except with permission of the author(s).
Language dc:language.iso
eng

Identifiers

dc:identifier.*
Handle dc:identifier.uri
https://hdl.handle.net/10657/4711
OAI identifier oai:identifier
oai:uh-ir.tdl.org:10657/4711

Chain of custody

source
Harvested from
University of Houston
Base URL
uh-ir.tdl.org/server/oai/request
Last updated
2026-07-24
Source record
OAI-PMH GetRecord
citation

Cheng, Yuqiao. Does Similarity Produce Synergy in Horizontal Hospital Acquisitions? Linking Operations Characteristics to Operations Strategy. Doctoral thesis, University of Houston, 2019. https://hdl.handle.net/10657/4711