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Contracting Out in a Complex Network: An Effectiveness Analysis of EPC Program I
Moussa, Edie A.
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While government contracting out its work continues to proliferate and studies about this phenomenon have increased during the past two decades, still little is known about how effective government sponsored networks are at managing broad and complex networks of primarily non-governmental entities. This dissertation reports the results of one such investigation, which examined a U.S. federal agency's contracting experiences in evidence-based health care. The Agency for Healthcare Research and Quality (AHRQ) is a unit of the U.S. Department of Health and Human Services (HHS). Among other tasks, AHRQ supports the development and dissemination of evidence about current best practices in health services delivery through its Evidence-based Practice Center (EPC) programs that contract out its work and operate in broad and complex network. The purpose of this study was to examine the extent to which AHRQ's EPC Program I was effective in supporting the translation of evidence reports and disseminating the products to the public by contracting with public and non-profit entities to do the work. This dissertation also sought to examine the extent to which the evidence reports and derivative products were publicly accessible by operationalizing the objectives articulated in AHRQ's authorizing legislation in a manner consistent with theories of representative democracy and exploring Program I's effectiveness using William T. Gormley's ideas (1989; Gormley & Balla 2003) of bureaucratic control. The results from this dissertation suggest that a decentralized network was related to overall higher translation and dissemination network effectiveness. Specifically, the findings from this study suggest that a decentralized network was related to overall higher translation and dissemination network effectiveness. Also, weak ties among the network actors when transferring complex knowledge was associated with higher translation and dissemination network effectiveness on the whole. The findings from this dissertation also contribute to network theory by extending Gormley's bureaucratic control typology (1989; Gormley & Balla 2003) to the network level, and also to the type of control that was available to the Agency over the network. Finally, the results contribute to better understanding of the dynamics that can be associated with the effectiveness of similar programs.
- Doctoral Dissertations