THE ORGANIZATION CHARACTERISTICS AND PRACTICE OUTCOMES OF HOSPITAL-BASED AND FREESTANDING BIRTH CENTER NURSE-MIDWIFERY PRACTICES.
Contributors: Case Western Reserve University.
Published: 1993
Number of pages: 304
Subjects: Health Sciences, Nursing.; Health Sciences, Obstetrics and Gynecology.
Description: The purpose of this exploratory descriptive study was to determine the organization characteristics and performance outcomes of hospital-based and freestanding birth center nurse-midwifery practices. In addition, the differences between the two types of practices, based on the organizational and performance variables, were determined. The investigation was based on an organization theory functionalist paradigm.

The sample was determined by a two step cluster sampling technique. Sixty-two hospital-based and 23 freestanding birth center nurse-midwifery practices were randomly selected. Using the Dillman Total Design Method for conducting a mail survey, the practice directors were requested to complete a questionnaire developed by this investigator. The two-part questionnaire, based on the Aston Programme, assessed the organization and performance characteristics of the nurse-midwifery practices. Major variables assessed were the context and structure characteristics and productivity and profitability characteristics during the initial full year in business and the immediate preceding full year of business.

Descriptive statistics were used to describe the organization characteristics and performance characteristics of the practices by group. Chi-Square and t-test (for nominal categories) were applied to the date to determine the contingency relationships between organizational characteristics and the type of practice. Performance outcomes were based on the Growth Rate determined by the difference between the first year of practice and the immediate last of the practice. T-values were determined to establish the significance of the growth rate between the performance characteristics and the type of practice.

Nurse-midwifery practices are more likely to be located in an urban area with hospital-based practices receiving more than 50% income primarily from Medicaid, while the freestanding birth center practices receive more than 50% of their income from private insurance. There is a significant difference between the two types of practices less than one-half of the organization characteristics (p $<$.05), thus, it is not possible to determine the type of practice by context and structure as suggested by the Aston Programme. Based on Growth Rate, the two types of practices differed only in the number of births and the number of full-time certified nurse-midwives.
Notes: Source: Dissertation Abstracts International, Volume: 54-07, Section: B, page: 3552.

Thesis (PH.D.)--CASE WESTERN RESERVE UNIVERSITY (HEALTH SCIENCES), 1993.

School code: 0499.