Competitive strategic grouping for hospitals

Contextual factors and business strategy choice: The case of us hospitals

US hospitals are struggling with how to compete and remain viable in an increasingly turbulent and competitive environment. Using Porter’s generic strategies and resource dependence theory, this study examined the relationship between environmental factors and business strategy choice among U.S. hospitals. The study used longitudinal data from 2006 to 2016 of US urban, general acute care hospitals from the American Hospital Association Annual Survey, Medicare cost reports, and Area Health Resource File. Multinomial regression was used to analyze the data. and Discussion: Our findings showed four types of hospital strategy: cost-leadership, differentiation, hybrid, and stuck-in-the-middle. A greater number of physicians (county-level) increases the likelihood of pursuing differentiation and hybrid strategy. On the other hand, a higher older adult population (65 years+) increases the likelihood of pursuing a cost-leadership strategy. Similarly, lower competition and higher Medicare Advantage penetration increases the likelihood of pursuing cost-leadership over hybrid strategy. An increase in the unemployment rate decreases the likelihood of pursuing differentiation and cost-leadership strategies versus the hybrid strategy. Finally, hospitals pursuing a differentiation strategy tended to be larger, teaching, and not-for-profit. The results showed the importance of environmental and organizational factors in predicting the strategy choice of hospitals.

Finding the niche towards performance excellence

Purpose

This paper aims to address the often fragmented approach to performance issues to maximise services quality and returns. With the increased emphasis on corporate reforms, the research presents a model framework as logic to strategy viability and competitive advantage for better outsourcing services delivery and excellence. The global change requires models with logic and variability to practically see the reality and challenges of all times.

Design/methodology/approach

Based on comprehensive literature search on performance research, nine influence factors were deduced as models for performance measure. This model is used to evaluate the performance of outsourcing firms in Malaysia. Over 200 questionnaires were sent out to outsourcing services delivery firms in Malaysia by post or personal visits; 68 of them responded. The study applied multivariate analysis to ascertain strategy capability and perception about factors that influence performance in the firms.

Findings

The outsourcing strategy performance revealed by the principal component analysis has given the strategy capability of the firms to be above-average, however not in a state to guarantee achievement of sustaining quality and excellence in services delivery. Conversely, to remain at the edge requires strategy that is flexible, integrated and sustainable, which most firms do not have. The results have also shown that more than half of the sampled population opted for a high-performance delivery goal; however, this vision was not supported adequately by a viable strategy. This inflexibility in strategy by most firms gives rise to usurpation and sub-optimality, which failed to take the facilities management (FM) profession beyond the reactive maintenance culture of the past century.

Research limitations/implications

This research paper is one of the few strategic models from Malaysia that holistically evaluates performance in outsourcing firms.

Practical implications

The paper provides a model that can integrate and sustain the workplace which is a valuable insight to the FM and research world.

Originality/value

This study introduced a paradigm using influence factors (timeless practice) to ensure excellency in outsourcing services delivery. Today savvy customers are looking for reliability and quality services with cost certainty, which is partly the reason for the expanding interests on outsourcing. The workplaces require strategic reforms to foster better facilities performance and value.

An Investigation of Service Quality—Willingness to Recommend Relationship across Patient and Hospital Characteristics

This study investigates onto which dimensions of service quality have more impact on patients’ overall quality perceptions of a hospital and seeks to determine the nature of relationship between service quality and patients’ willingness to recommend a hospital to their friends and family. The study also uncovers if the levels of service quality and recommendation behaviours and the relationship between service quality and recommendation behaviour exhibit similar patterns among male versus female, black versus white patients and small/medium versus large hospitals. Data gathered via mail questionnaires and phone interviews from a large sample of the patients of a hospital system in the Southern United States serve as the study setting. Results are presented and their implications are discussed. Avenues for future research are offered.