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California hospitals, capital projects, financial factors, market factors



  1. McCue, Michael J.


Background: Prior literature provides only a descriptive view of the types and numbers of capital expenditures made by hospitals.


Purposes: This study conducted an empirical analysis to assess simultaneously what market, organizational, and financial factors relate to the number of capital projects as well as the specific types: medical equipment, expansion, and maintenance projects.


Methodology/Approach: Sampling California hospital capital expenditure data from 2002 to 2007, this study aggregated the number of capital projects by each type of capital investment decision: medical equipment, expansion, and maintenance/renovation per hospital. Using ordinary least squares regression, this study evaluated the association of these factors with these types of capital investment projects.


Findings: This study found that hospitals capturing a greater share of the market, maintaining high levels of liquidity, and operating with more than 350 beds invested in a greater number of capital projects per hospital as well as medical equipment and expansionary projects per hospital.


Practical Implications: Within the state of California, the demand for health care services within a hospital market as well as cash and investment reserves were key drivers in the hospital CEOs and boards' decision to increase their capital purchases. The types of purchases included capital outlays related to medical equipment, such as CT scanners, MRIs, and surgical systems, and revenue-generating expansionary projects, such as new bed towers, hospitals wings, operating and emergency rooms, and replacement hospitals from 2002 to 2007.