Background
Perspective of awareness-motivation-capability (AMC)
Characteristics of competitor actions
Implementation requirement of an action
Strategic orientation of action
Action complexity
Methods
Sample
Data collection
Measures
Number of competitive action types adopted by hospitals
Names of hospitals | 2006 | 2007 | 2008 | ||||||
---|---|---|---|---|---|---|---|---|---|
Type of actiona
| Number of actionsb
| Objective performancec
| Type of action | Number of actions | Objective performance | Type of action | Number of actions | Objective performance | |
Medical center A | 17 | 96 | 6266 | 17 | 96 | 6314 | 17 | 100 | 6606 |
Medical center B | 18 | 106 | 6656 | 18 | 115 | 7014 | 18 | 114 | 8096 |
Medical center C | 19 | 116 | 3308 | 18 | 113 | 3512 | 18 | 117 | 3574 |
Medical center D | 16 | 75 | 6606 | 16 | 77 | 6745 | 18 | 93 | 6977 |
Regional hospital E | 16 | 75 | 1025 | 17 | 85 | 1110 | 18 | 91 | 1232 |
Regional hospital F | 14 | 97 | 3141 | 15 | 94 | 3197 | 16 | 99 | 3215 |
Regional hospital G | 20 | 102 | 1410 | 20 | 110 | 1364 | 20 | 109 | 1395 |
Regional hospital H | 18 | 90 | 1617 | 18 | 94 | 1642 | 19 | 96 | 1657 |
Regional hospital Id
| 0 | 0 | 0 | 12 | 50 | 720 | 10 | 41 | 1107 |
Regional hospital J | 16 | 92 | 3251 | 17 | 98 | 3383 | 18 | 107 | 3403 |
Regional hospital K | 19 | 81 | 2831 | 19 | 100 | 2932 | 19 | 111 | 2951 |
Regional hospital L | 13 | 56 | 1574 | 14 | 62 | 1591 | 15 | 65 | 1688 |
Regional hospital M | 12 | 47 | 555 | 13 | 49 | 554 | 14 | 57 | 592 |
Regional hospital N | 16 | 69 | 989 | 17 | 98 | 1011 | 18 | 108 | 1013 |
Regional hospital O | 15 | 58 | 979 | 17 | 70 | 1219 | 18 | 78 | 1341 |
Regional hospital P | 17 | 82 | 2824 | 17 | 82 | 2773 | 18 | 84 | 3059 |
Regional hospital Q | 14 | 53 | 637 | 14 | 58 | 621 | 16 | 68 | 634 |
Regional hospital R | 13 | 57 | 302 | 15 | 103 | 1064 | 19 | 133 | 1424 |
Regional hospital S | 15 | 49 | 726 | 16 | 60 | 752 | 20 | 82 | 810 |
Regional hospital T | 11 | 36 | 535 | 15 | 53 | 540 | 15 | 56 | 567 |
Total of year | – | 1437 | – | 1667 | – | 1809 |
Competitive actions
Implementation requirements of action
Strategic orientation of action
Action complexity
Hospital performance
Control variables
Results
Competitive actions | Implementation requirements of actions (mean)a
| implementation requirements of actions dimensions |
---|---|---|
Procurement of new medical equipment | 3.9000 | ● High capital should be invested when executing the action. ● The management should make significant efforts when executing the action. ● Personnel, system or process should be reconfigured when executing the action. ● The support of external stakeholders is required when executing the action. ● Senior supervisors should announce the execution of the action. ● The action should be significantly reported in the internal journals. ● Main stakeholders are the targets for responsibility and duty in the execution of the action. ● The equipment should be reorganized when executing the action. ● High level of cross-department integration is not required when executing the action. ● After the execution of the action, the levels of the organizations and authority should have high level of commitment. ● Senior supervisors should approve the execution of the action. ● Once the action is not executed, the related resources cannot be transferred to other actions. |
Enhancement of medical quality | 3.9000 | |
Merger and acquisition | 3.8625 | |
Development of featured medical service | 3.8417 | |
Development of innovative medical service | 3.8250 | |
Expansion of service areas | 3.7875 | |
Development of medical items upon customers’ expenditure | 3.7333 | |
Service improvement/enhancement | 3.6875 | |
Change of organizational structure | 3.6292 | |
Participation in community service | 3.6125 | |
Alliance | 3.5917 | |
Acquisition of fair payment of medical cost | 3.4958 | |
Share of financial responsibility | 3.4792 | |
Different industry cooperation | 3.4375 | |
Change of cost structure | 3.4208 | |
Delegation affairs unrelated to NHI | 3.3917 | |
Medical business outsourcing | 3.3542 | |
Price cutting/promotion | 3.3083 | |
Non-medical business outsourcing | 3.2958 | |
Same industry cooperation | 3.2125 | |
Bargaining of procurement | 3.1917 |
The number of competitive action | Medical centers | Medical centers 3 years accumulation | Regional hospitals | Regional hospitals 3 years accumulation | ||||
---|---|---|---|---|---|---|---|---|
Competitive actions type | 2006 | 2007 | 2008 | 2006 | 2007 | 2008 | ||
Procurement of new medical equipment | 7 | 6 | 6 | 19 | 3 | 13 | 22 | 38 |
Enhancement of medical quality | 21 | 21 | 22 | 64 | 63 | 72 | 71 | 206 |
Merger and acquisition | 0 | 0 | 0 | 0 | 1 | 0 | 2 | 3 |
Development of featured medical service | 17 | 17 | 21 | 55 | 41 | 48 | 61 | 150 |
Development of innovative medical service | 30 | 32 | 38 | 100 | 51 | 87 | 100 | 238 |
Expansion of service areas | 5 | 5 | 7 | 17 | 9 | 10 | 13 | 32 |
Development of medical items upon customers’ expenditure | 36 | 37 | 40 | 113 | 78 | 92 | 105 | 275 |
Service improvement/enhancement | 55 | 58 | 59 | 172 | 182 | 219 | 223 | 624 |
Change of organizational structure | 5 | 5 | 5 | 15 | 14 | 14 | 16 | 44 |
Participation in community service | 17 | 17 | 17 | 51 | 57 | 67 | 69 | 193 |
Alliance | 0 | 0 | 0 | 0 | 30 | 33 | 36 | 99 |
Acquisition of fair payment of medical cost | 20 | 20 | 20 | 60 | 58 | 65 | 70 | 193 |
Share of financial responsibility | 7 | 7 | 6 | 20 | 19 | 19 | 21 | 59 |
Different industry cooperation | 4 | 4 | 8 | 16 | 11 | 18 | 34 | 63 |
Change of cost structure | 32 | 32 | 32 | 96 | 59 | 64 | 83 | 206 |
Delegation affairs unrelated to NHI | 42 | 42 | 42 | 126 | 100 | 127 | 127 | 354 |
Medical business outsourcing | 4 | 4 | 4 | 12 | 12 | 13 | 14 | 39 |
Price cutting/promotion | 16 | 20 | 21 | 57 | 40 | 59 | 68 | 167 |
Non-medical business outsourcing | 17 | 16 | 17 | 50 | 52 | 59 | 60 | 171 |
Same industry cooperation | 38 | 38 | 38 | 114 | 101 | 119 | 122 | 342 |
Bargaining of procurement | 20 | 20 | 21 | 61 | 63 | 68 | 68 | 199 |
Total | 393 | 401 | 424 | 1218 | 1044 | 1266 | 1385 | 3695 |
Name of variables | 1 | 2 | 3 | 4 | 5 | 6 | 7 | 8 |
---|---|---|---|---|---|---|---|---|
1 Private non-profit hospital | ||||||||
2 Private for-profit hospitals | −0.535** | |||||||
3 Regional hospital | −0.357** | 0.327* | ||||||
4 Organizational size | −0.049 | −0.050 | −0.654** | |||||
5 Implementation requirements | 0.188 | −0.220 | −0.378** | 0.489** | ||||
6 Strategic orientation | −0.347** | 0.248 | −0.003 | 0.351** | 0.295* | |||
7 Action complexity | −0.140 | 0.089 | −0.386** | 0.560** | 0.497** | 0.593** | ||
8 Perception performance | −0.420** | 0.135 | −0.101 | 0.351** | 0.625** | 0.592** | 0.088 | |
9 Objective performance | 0.041 | 0.097 | −0.721** | 0.803** | 0.253 | 0.647** | 0.242 | 0.377** |
Results of regression analysis using generalized estimating equation models
Dependent variables: management performance | ||||||||||||
---|---|---|---|---|---|---|---|---|---|---|---|---|
Model 1 interviewee perception performance | Model 2 interviewee perception performance | Model 3 Objective performance | Model 4 Objective performance | |||||||||
Variables | B1 | Std.Error1 | Sig. | B2 | Std.Error2 | Sig. | B3 | Std.Error3 | Sig. | B4 | Std.Error4 | Sig. |
Independent variables | ||||||||||||
Implementation requirements | −20.281 | 13.9198 | −20.920 | 15.8432 | −0.121 | 0.2733 | −0.417 | 0.1372 | *** | |||
Strategic orientation | 24.126 | 4.7518 | *** | 20.745 | 5.9890 | *** | −0.145 | 0.2885 | −0.009 | 0.2018 | ||
Action complexity | 0.086 | 0.0273 | *** | 0.079 | 0.0272 | *** | 0.003 | 0.0005 | *** | 0.002 | 0.0004 | *** |
Control variables | ||||||||||||
Private non-profit hospital | −9.751 | 6.3849 | 0.043 | 0.0673 | ||||||||
Private for-profit hospitals | −7.451 | 5.9564 | 0.169 | 0.0757 | ** | |||||||
Regional hospital | 1.257 | 8.8418 | −0.317 | 0.1262 | ** | |||||||
Organizational size | 0.005 | 0.0074 | 0.000 | 8.5350 | *** |