Author ORCID Identifier


Defense Date


Document Type


Degree Name

Doctor of Philosophy


Health Related Sciences

First Advisor

Dr. Suzanne Wright

Second Advisor

Dr. Michael Fallacaro

Third Advisor

Dr. Robert Graboyes

Fourth Advisor

Dr. Lorraine Jordan


Hospital administrators are being held accountable by patients, insurers, and other stakeholders in evaluating their overall hospital performance to reduce costs and improve efficiency. With the move to alternative payment models and value-based purchasing, hospital administrators must understand the economic viability and value that their specialty services bring to their facility.

The purpose of this study was to identify the determinants New England acute care hospital administrators’ utilize in making the choice of anesthesia practice model for their facility.

A quantitative, exploratory study of factors hospital administrators use when choosing an anesthesia practice model utilizing a non-experimental, correlational research design was completed. The research was descriptive in nature to determine the factors that influenced a hospital administrator when making decisions about the type of anesthesia practice model that would be the best for their hospital. This research examined seventeen independent variables that were hypothesized to determine hospital administrators’ choice of anesthesia practice model. After the final logistic regression analysis, it was determined that the presence of a hospital being located in a medically underserved area (MUA) alone was a predictor of type of anesthesia practice model utilized. In light of the study limitations and prior literature on the CRNA-only model being present in almost 100% of rural facilities, more exploration is necessary to come to more robust conclusions on predictors of choice of anesthesia practice model determined by hospital administrators.

This study showed that there are definitive areas that hospital administrators identify as high importance to the healthy functioning of their facility. By addressing these needs, an anesthesia department could contribute to the overall stability of the hospital, while at the same time, making themselves a more valuable asset overall. Value-driven services offered by anesthesia departments may be the determining factor in choice of anesthesia practice model. By measuring and analyzing anesthesia provider and hospital demographics and hospital administrators’ perceptions of anesthesia services, the objective data collected may assist in defining the most appropriate practice model for a hospital.


© Maribeth L. Massie 2017

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VCU University Archives

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VCU Theses and Dissertations

Date of Submission



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