tive, the hospital aligns its internal systems with the delivery system outside of the hospital in order to better manage the health care of the community.
Other hospitals respond in different ways. Among these alternative approaches are initiatives by hospitals to advertise their services to the end user. Advertising to the end user by hospitals is intended to partially circumvent the institution's dependency upon physician referrals by causing potential patients to ask for a specific hospital. This study will examine the effects of the use of advertising by one hospital.
Changes in the health care system, financial responsibility shifts, technical medical advances, and medical care rationing are among the factors that are driving health care providers of all stripes toward affiliations that in turn become health care systems (Tong, 1995, p. 165). When hospitals engage in such transformations, one of the managerial innovations introduced is the use of advertising.
Changes in reimbursement, medical practice, demographics and lifestyles are altering profoundly the way physicians relate to hospitals (Hagland, 1991, p. 20). As a consequence, hospitals need to form much closer relationships with physician group practices and managed care groups to ensure strong referral bases in all specialties, particularly in primary care. Although collaboration among hospitals and physicians is not a new concept, some experts now believe such partnering will evolve into an integrated health care delivery system of the future. Some of these experts contend that the survival of hospitals in the United States will depend on such relationships.
Hospitals are aware of these changes, particularly in regard to the growing dominance of managed care (Hagland, 1991, p. 20). The growth of managed care threatens the continued existence of the health care indemnity insurance industry because of the shift in focus from retrospective to prospectiv...