This article reviews the art and practice of strategic management process in hospitals today, in order to help hospital administrators for managing strategic management system in their hospitals. The strategic management process model in this article is based on an integrated approach combining traditional environmental model with resource-based model of strategy. The components of the model are consisted of five steps: (1)formulating objectives, strategic assessment by external environmental analysis, internal capability analysis, TOWS analysis and marketing audit, (3)strategy choice considering context and criteria of choice, (4)program implementation through operational planning, resource allocation, and conversion, and (5)control by monitoring and evaluating hospital outputs. This article deals with many aspects of issues inherent in every step on this strategic management process.
This paper investigates the current feature of management strategy of hospitals in Korea, and examines the relationships between adoption of a particular strategic orientation and the hospitals environmental and organizational characteristics, strategic behaviors and management improvement activities, and financial performance. Data were collected from CEOs of 88 hospitals among 650 hospitals for a 13.5% response rate using the self-administered questionnaire by mail survey. The major findings that obtained are as follows: 1. Only 37.2% of response hospitals carried out strategic planning, Most of these hospitals established the first strategic planning in 1991(81.3%) and renovated strategic planning by 4 or 5 years(56.3%), and modified strategic planning with flexibility(59.4%). Most strategic plans were documented, but informalized(68.8%). And only 29.0% of these hospitals had independent planning division. 2. Hospital services that CEOs assessed rank ordered for their impact on profitability are as follows: i)diagnostic ultrasound facility, computerized tomography scanner, obstetric inpatient unit, therapeutic X-ray, and physical therapy at present. ii)diagnostic ultrasound facility, physical therapy, computerized tomography scanner, emergency department, and health screening at future. And the services rank ordered that CEOs hoped to introduce are as follows: emergency department, physical therapy, health screening, volunteer services, and computerized tomography scanner. 3. Using a typology developed by Miles and Snow(l978), the strategic orientation of response hospitals are shifting significantly from defenders in the past to analyzers in the present, and to prospectors in the future(p<.01). 4. With regard to hospital environmental and organizational characteristics such as ownership, physician training, location, bed size, and hospital management training career and specialty of CEOs, the four strategic orientation archetypes varied not significantly. But, hospitals with a analyser orientation in the present and a reactor orientation in the future perceived competition significantly higher than the other three archetypes(p<.05). 5. The four archetypes rank ordered in terms of appling strategic behaviors and management improvement activities are as follows: prospector, analyzer, reactor, and defender. 6. The four archetypes differed significantly in terms of their financial performance using revenue per bed(p<.05). Reactors and prospectors in terms of total revenue per bed, prospectors in terms of outpatient revenue per bed, and reactors and prospectors in terms of inpatient revenue per bed had the best performance.
The overall objective of this article is to identify the strategic type of Korean hospitals in terms of Porter's framework and to examine differences in performance of the hospitals across strategic types. A survey was conducted through structured questionnaire for 739 hospitals in Korea and the data from 120 hospitals were utilized in the final analysis. Study results indicate that the most frequently used strategy was 'stuck-in-the-middle strategy'(26.7%), followed by 'focused cost leadership strategy'(24.0%), 'focused differentiation strategy'(20.8%), 'cost leadership strategy'(15.8%), and 'differentiation strategy'(13.7%). Overall, 'focused differentiation strategy' showed superior performance in terms of profitability of services, ability to retain patients and growth in revenue, while 'differentiation strategy' produced relatively low performance in general. Implications of these findings are also discussed.
As healthcare environment being more complex and turbulent, strategic approach of hospitals became more important. This study was to investigate strategic orientation of Korean hospitals and their related characteristics. We surveyed managers of 360 hospitals randomly selected from all hospitals in Korea. For typology of strategic orientation, we used that developed by Miles and Snow, and results are as follows. Firstly, major types of organizational strategic orientation of Korean hospitals were analyzer(42.0%) and prospector(34.0%). Secondly, characteristics affecting to hospitals' strategic orientation significantly were hospital ownership and sex of managers. Medical corporation had a high tendency of prospector strategic orientation by 2.7 times compared to personal ownership. Female managers had a low tendency of prospector strategic orientation by 0.2, which was statistically significant. Though 60+ age group (compared to twenties and thirties) and middle managers (compared to CEO) had a tendency of being more prospector strategic orientation, but insignificant. The study result that majority of strategic orientation were prospector and analyzer reflects Korean hospital environment are complex and unstable. Hospital managers need to more focus on environment and boundary spanning function for maintenance and survival of their organizations.
The purpose of this study was to find out the differences and relationships among balanced strategy, coordinating and learning mechanism, and perceived performance of hospitals in Korea, and provide some directions to establish effective strategic management of hospital. Measure items on balanced strategy, coordinating and learning mechanism, and perceived performance were developed from previous studies. Questionnaire was sent and received through Internet site and e-mail during May, 2008. Data were collected from key informant in each institutions, and analyzed using frequency analysis, T-test, ANOVA, correlation and regression analysis. The major findings of this study were as follows: 1. The level of strategic selection and external learning mechanism of private hospital was lower than that of medical corporation, and others corporation hospital. 2. There was little difference between hospitals in metropolitan and those in small cities. 3. Hospitals that have under 100 beds were statistically lower level in strategic selection and external learning mechanism than hospitals has over 100 beds. 4. Formal coordinating and external learning mechanism, and foundation form(medical corporation) were significantly influenced on profitability from specialized field. 5. Strategic selection and adaptation mechanism were significantly affected on total profitability. 6. Strategic selection and external learning mechanism were significantly influenced on competitive power around its local market. Hospitals that are to be competitive by specialization should have to establish mechanism for management such as balanced strategy, coordinating and learning mechanism.
This study investigated contents of mission statements for Strategic Management of hospitals in Korea and Japan. For the study, 44 tertiary care hospitals in korea, which were accredited by the Ministry of Health and Welfare, were selected. And 83 special functioning hospitals in Japan, which were approved by the Minister of Health, Labour and Welfare, were included. Both quantitative and qualitative analyses were conducted by classifying 5 components of the mission statement; market, service, philosophy, image, contribution. Findings from this study are as follow. First, hospitals in Korea emphasized image(93.2%) and philosophy(81.8%) components in their mission statements, whereas hospitals in Japan highlighted components of service(89.2%) and market(72.3%). In detail, mission statements of Korean tertiary care hospitals describe the components of hospital's image (93.2%), philosophy(81.8%), contribution(56.8%), market(22.7%) and service (18.2%) in order. On the other hand, mission statements of Japanese special functioning hospitals describe hospital's service(89.2%), market(72.3%), contribution(61.4%), image (49.4%) and philosophy(34.9%), respectively. Second, as results of Content analysis, there were some differences in mission statements of hospitals between two countries, and it is mainly from the divergences of standards for recognition of medical institutions, environmental factors, and different ways of mission statement description. For strategic hospital management, carrying out innovative restructuring organization or promoting of research and training for medical development is considered as a desirable approach. However, clear description of mission statement is more important and it is required for effective control and managing organization. And then the mission should be communicated within an organization so all internal members understand it and put their efforts to achieve the mission of organization. In conclusion, it is recommended that a leader and senior managers should re-evaluate its mission statement whether it reflects characteristics of an organization. In addition, a mission statement should be created or improved based on critical decision, as well as it should be clearly shared within an organization in order to become a future oriented organizations.
This study purports to examine the current management and information technology related strategy of Korean hospitals and suggest the effective management strategy in the 21st century when is digital era. Specifically the study tries to analyze the changing trends of strategic orientation and investigate the general management and information technology strategy of Korean hospitals. Self-administered Questionnaires were distributed to 721 hospitals nationwide and finally 98 Questionnaires were analyzed for the study. The results of the study are as follows : 1) Half of the respondent hospitals reported that they have an analyzer orientation in 2000, whereas 19.4% were prospectors, reactors 16.4%, and defenders 14.3%. However, the respondent hospitals intended to have a prospector orientation in the future (2002), while 29.6% planned on being analyzers, 17.3% reactors, and 3.1% defenders. 2) Hospital services for improving patient satisfaction were the most common. strategy for the respondent hospitals, followed by cost containment, organizational restructuring, employee education, purchasing system change, specialization of clinical services, quality improvement of medical care, strengthening the networking with the stakeholders, public relations and marketing strategy, diversification, and installing the information system. However, the strategies of annual salary system, retrenchment of unprofitable services, merit payment based on performance were still not popular for the respondent hospitals. 3) As for the strategies related with information technology, most hospitals have not implemented actively, except for the establishment of home-pages, order communication systems, and insurance claims through electronic data interchange system. 4) There were significant differences in the level of strategy implementation in terms of the ownership, bed size, financial performance, and the top managers I knowledge of information technology. The larger bed size, the higher financial performance, the better knowledge of information technology the top managers have, the more strategies the respondent hospitals implemented. The managerial and political implications for Korean hospitals in digital era were also discussed.
The purpose of this study is to analyze the influence of external environment, organizational characteristics on informatization level in hospital settings, and to provide suggestions to improve the informatizaiton level of strategic information system of hospitals. In order to achieve study purpose, causal model was developed and empirically tested. Data were collected from 716 managers of 89 hospitals keeping information system in Busan and KyungNam Province using self-administered structured questionnaire. Major results of this study were as follows; First, among hospitals which had information training programs, informatization capacity was significantly higher. Moreover, informatization capacity was significantly varied by ownership type, institutional level, and number of beds of hospitals. Second, environmental uncertainty, intra-industry competition intensity, decision-making concentration, work standardization variables and perceived benefits were found to be significant affecting factors on informatization capacity as a result of path analysis. Third, support of top-management and perceived benefits were found to be significant affecting factors on informatization capability as a result of path analysis. Especially, informatization capability was positively affected by informatization capacity. Finally, perceived benefits was found to be significant affecting factors on informatization competency as a result of path analysis. Especially, informatization competency was positively affected by informatization capability.
The purpose of this study is to make managerial information regarding outsourcing more concrete by identifying and evaluating how outsourcing as an useful strategic tool for hospitals influences organizational effectiveness. The survey was performed to 311 general hospitals and tertiary hospitals, and 63 questionnaires were recovered and analyzed. As the result of measuring organizational effectiveness after introduction of outsourcing, non-financial performance(3.34) was higher than financial performance(3.25) and satisfaction(3.08). According to the characteristics of organizational structure, financial performance showed statistically significant difference when categorizing the hospitals. It was higher in the general hospitals than in the tertiary hospitals. In addition, the hospitals that outsource the logistic and patient affairs parts have higher financial performances than non-financial ones. Especially, there was statistically significant difference depending on the sub-parts of the logistics, which means the hospitals outsourcing the logistic part have higher financial performance than the hospitals without outsourcing the logistics.
PHAM, Cuong Duc;VU, Sen Thi;PHAM, Yen Thi Kim;VU, Nam Thi
The Journal of Asian Finance, Economics and Business
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제7권6호
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pp.339-349
/
2020
The study evaluates the performance of public hospitals in Vietnam by applying the Balanced Scorecard (BSC). The authors first review the literature to find the research gap of performance in public hospitals. Then, we built Likert questionnaires to collect data from more than 200 managers of public hospitals in the Northwestern provinces of Vietnam. The research uses correlation regression to evaluate the performance based on the influence of factors in the BSC model, including Strategic planning, Internal process, Finance, Mission, Customer, and Employee learning and growth. The results show that the performance of public hospitals in the research sample is influenced by the factors in the BSC model in descending order based on the regression coefficient as follows: Internal process, Finance, Mission, Strategic planning, Customer, Employee learning and growth. Based on the quantitative research findings, we continue by conducting some deep interviews with specialty to propose intensive recommendations about how to implement Mission, Internal process, Financial policies, etc. to managers in public hospitals with an aim to improve the performance of public hospitals in the Northwestern mountainous region of Vietnam. The lessons could be applied for other public hospitals in Vietnam and other jurisdictions that have similar conditions.
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