Last modified: 2019-09-30
Abstract
As a result of government-imposed regulations, the U.S. hospital industry has undergone substantial structural changes. The Emergency Medical Treatment and Active Labor Act (EMTALA) of 1986 requires hospitals with an emergency room to provide services to patients regardless of their insured status or ability to pay. This regulatory act has incentivized a change in hospitals’ organizational structures. Specialist hospitals, which lack emergency rooms and are not under the jurisdiction of the EMTALA, have multiplied, while general hospitals, which have emergency rooms and fall under the EMTALA, have suffered. Therefore, the EMTALA has contributed to the formation of a new niche in the hospital industry. An examination of the birth of specialist hospitals and the mortality of general hospitals provides an insightful approach to teaching organizational ecology and niche formation. This investigation provides useful direction to educators at the undergraduate level.