Focus as emphasis: Conceptual and performance implications for hospitals

Focus in hospitals has been heralded as the next frontier in improving its efficiency and efficacy (Herzlinger, 2004). However, there is scarce empirical work examining its effects in this setting. Focus in hospitals can take several different forms, ranging from standalone specialty centers to a hospital that chooses to emphasize in some operational way a particular specialty while still offering a full range of services. Although standalone facilities can be found in many locations, the vast majority of hospitals must follow the latter route to achieve focus. Current conceptualizations and measures of focus struggle to capture this construct in a way that does not assume a narrowing of range of offerings. In contrast to the traditional view of focus as narrowing, in this paper, we address the perspective of focus as emphasis. We select cardiology as the specialty and use secondary data for more than 264,000 patients in New York State to examine the relationship between focus as emphasis and hospital cost performance. Our results support the notion that such focus is associated with lower costs. Moreover, our results also show that focus in hospitals can be operationalized as a disproportionate emphasis on one line of service, without necessarily narrowing the overall range of services provided.