Factors associated with seismic risk in California hospitals

California has required its hospitals to assess their vulnerability of collapse from earthquakes, and make the necessary facility upgrades and or replacement to become compliant with state regulation. However, little is known about the characteristics of the hospitals that have the greatest risk of structural collapse (e.g., SPC-1 hospitals). The purpose of this study is to determine the organizational and market factors associated with those hospitals rated as SPC-1 hospitals. We used the resource dependency perspective to examine these factors, and we reviewed prior literature to identify the key factors that may relate to non-compliance of California hospitals. To carry out our study, we used organizational, operational and financial data from the California Office of Health Planning and Development for fiscal years 2007 through 2009. Also, we used market data made available from the Area Resource File. After excluding hospitals in counties that do not have any SPC-1 facilities, and hospitals that are in the process of becoming compliant with the seismic building standards, we established a final sample of 258 acute care hospitals. We used logistic regression analysis to determine factors associated with the presence of SPC-1 hospitals. Our findings indicate that SPC-1 hospitals are located in more populated areas, have smaller market share, demonstrate a higher percentage of Medicaid patients and possess less liquidity. Implications for hospital executives and health policymakers are discussed.