Theses and Dissertations - UTB/UTPA

Date of Award


Document Type


Degree Name

Doctor of Philosophy (PhD)


Business Administration

First Advisor

Dr. Cynthia J. Brown

Second Advisor

Dr. Damian Damianov

Third Advisor

Dr. Jose A. Pagan


Research in the area of financing and investment decisions made by firms focuses on maximization of shareholder wealth in an open corporation with clear separation of ownership and management. The inherent profit motive leaves no ambiguity in investment decision-making. On the other hand, several other factors come into play when the organization making the investment decision is non-profit. This dissertation investigates the influence that community uninsurance may have on investment decisions in hospitals, most of which operate as non-profit ventures. Unlike other types of non-profit organizations, hospitals do not focus on a target consumer base to generate revenues. Instead, every resident in the community potentially uses its services. For hospitals to break even on large investments, they need to operate in a market with a higher propensity to reimburse them for providing these services. Extant research shows that the uninsured exhibit reduced demand for high-priced hospital services. This dissertation primarily analyzes the influence of the degree of uninsurance in local health care markets on the availability of essential and high-cost technology and community service investments in hospitals. Results suggest that uninsurance in a community significantly and negatively influences the availability of three out of the six investments analyzed. Moreover, in areas with high uninsurance, there exists a statistically significant probability of hospitals choosing not to provide the investment through any of five channels of availability that were analyzed. This result is true for all of the six investments.


Copyright 2010 Lakshmi Balasubramanian. All Rights Reserved.

Granting Institution

University of Texas-Pan American