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Article
Publication date: 1 June 2006

Xiao‐yun Chen, Kazunobu Yamauchi, Ken Kato, Akio Nishimura and Katuski Ito

The objective of the paper is to confirm the feasibility and value of using the balanced scorecard (BSC) to measure performance in two hospitals in different countries.

Abstract

Purpose

The objective of the paper is to confirm the feasibility and value of using the balanced scorecard (BSC) to measure performance in two hospitals in different countries.

Design/methodology/approach

One hospital from China and another from Japan were chosen and key indicators were selected according to the BSC framework. A comparative hospital performance measurement model was set up using the BSC framework to comprehensively compare hospital performance in two countries.

Findings

The BSC was found to be effective for underlining existing problems and identifying opportunities for improvements. The BSC also revealed the hospitals' contribution to performance improvement of each country's total health system.

Research limitations/implications

Hospital performance comparisons between countries using the BSC depend on the selection of feasible and appropriate key performance indicators, which is occasionally limited by data collection problems.

Originality/value

The first use of the BSC to compare hospital performance between China and Japan shows benefits that not only suggests performance improvements in individual hospitals but also reveals effective health factors allowing implementation of valid national health policies.

Details

International Journal of Health Care Quality Assurance, vol. 19 no. 4
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 5 May 2021

Assadej Vanichchinchai

The purpose of this research is to explore the differences across hospital characteristics (i.e. lean maturity, hospital size, hospital type and ISO 9001) on lean…

Abstract

Purpose

The purpose of this research is to explore the differences across hospital characteristics (i.e. lean maturity, hospital size, hospital type and ISO 9001) on lean expectation, lean performance, service quality expectation and service quality performance.

Design/methodology/approach

The survey instruments were developed from an extensive literature review, validated by experts and tested by statistical techniques. Data was collected from the perspective of care providers in 220 outpatient departments of Thai hospitals with multiple respondents to improve reliability of data. Analysis of variance and independent sample t test were applied for analysis.

Findings

It was found that there are significant differences across lean maturity and hospital size on overall lean expectation and overall lean performance, and across ISO 9001 on overall service quality performance. Overall, service quality expectation and performance have higher mean scores than overall lean expectation and performance.

Originality/value

To the best of author’s knowledge, this is one of the first studies to present insights into the links between Thai hospital characteristics, expected lean and service quality and performance from the care provider viewpoint. Findings form this study can be used to improve individual hospitals or develop healthcare system at national level.

Details

International Journal of Lean Six Sigma, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 2040-4166

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Book part
Publication date: 7 October 2011

Harry D. Holt, Jonathan Clark, Jami DelliFraine and Diane Brannon

This chapter reviews and integrates the empirical literature on the influence of organizational factors on hospital financial performance. Five categories of…

Abstract

This chapter reviews and integrates the empirical literature on the influence of organizational factors on hospital financial performance. Five categories of organizational characteristics that research has addressed are identified and examined as part of the review: ownership, governance, integration, management strategy, and quality. With some exceptions, our review reveals a general lack of consistency and conclusiveness across studies in each area. Exceptions were found in the areas of governance (e.g., physician participation and board processes) and integration (e.g., horizontal system centralization). Despite the lack of conclusive findings across studies, our review suggests substantial opportunities for future work, including opportunities for qualitative and exploratory work. Additional implications for theory and management are discussed.

Details

Biennial Review of Health Care Management
Type: Book
ISBN: 978-0-85724-714-8

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Article
Publication date: 3 April 2017

Ayman Bahjat Abdallah, Mais Issam Abdullah and Firas Izzat Mahmoud Saleh

The purpose of this paper is to investigate the effect of trust with suppliers on hospital-supplier integration (SI) and hospital supply chain (SC) performance

Abstract

Purpose

The purpose of this paper is to investigate the effect of trust with suppliers on hospital-supplier integration (SI) and hospital supply chain (SC) performance. Additionally, the mediating effect of SI on trust-hospital SC performance is investigated.

Design/methodology/approach

A research model and hypotheses were developed based on literature review. The study is based on survey data collected from 152 respondents in 55 private hospitals in Jordan. The proposed hypotheses were tested using structural equation modeling.

Findings

The paper finds that trust with suppliers has a positive impact on hospital-SI and hospital SC performance. Hospital-SI partially mediates the relationship between trust and hospital SC performance.

Practical implications

The findings of this research provide useful insights into the role of trust in boosting SC performance in the healthcare sector. High levels of SI not only improve hospital SC performance but also enhance the transformation of trust benefits into SC performance.

Originality/value

This research is one of the limited studies that investigated the effect of trust on hospital-SI and hospital SC performance in the healthcare sector. To the best of the authors’ knowledge, this is the first study to investigate those relationships in the Middle East in general and in Jordan in particular.

Details

Benchmarking: An International Journal, vol. 24 no. 3
Type: Research Article
ISSN: 1463-5771

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Article
Publication date: 19 November 2018

Claudia Affonso Silva Araujo, Peter Wanke and Marina Martins Siqueira

The purpose of this paper is to estimate the performance of Brazilian hospitals’ services and to examine contextual variables in the socioeconomic, demographic and…

Abstract

Purpose

The purpose of this paper is to estimate the performance of Brazilian hospitals’ services and to examine contextual variables in the socioeconomic, demographic and institutional domains as predictors of the performance levels attained.

Design/methodology/approach

The paper applied a two-stage approach of the technique for order preference by similarity to the ideal solution (TOPSIS) in public hospitals in 92 Rio de Janeiro municipalities, covering the 2008–2013 period. First, TOPSIS is used to estimate the relative performance of hospitals in each municipality. Next, TOPSIS results are combined with neural networks in an effort to originate a performance model with predictive ability. Data refer to hospitals’ outpatient and inpatient services, based on frequent indicators adopted by the healthcare literature.

Findings

Despite a slight performance increase over the period, substantial room for improvement is observed. The most important performance predictors were related to the demographic and socioeconomic status (area in square feet and GDP per capita) and to the juridical nature and type of ownership of the healthcare facilities (number of federal and private hospitals).

Practical implications

The results provide managerial insights regarding the performance of public hospitals and opportunities for better resource allocation in the healthcare sector. The paper also considers the impact of external socioeconomic, demographic and institutional factors on hospitalsperformance, indicating the importance of integrative public health policies.

Originality/value

This study displays an innovative context for applying the two-stage TOPSIS technique, with similar efforts not having been identified in the healthcare literature.

Details

International Journal of Productivity and Performance Management, vol. 67 no. 9
Type: Research Article
ISSN: 1741-0401

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Article
Publication date: 9 March 2015

Patience Aseweh Abor

– The purpose of this study is to examine the effects of health-care governance and ownership structure on the performance of hospitals in Ghana.

Abstract

Purpose

The purpose of this study is to examine the effects of health-care governance and ownership structure on the performance of hospitals in Ghana.

Design/methodology/approach

The study uses multiple regression models based on a sample of 132 hospitals in Ghana.

Findings

The results of the study indicate that hospitals with a governing board perform better than those without a governing board. The results of this study also suggest that board characteristics and ownership structure are important in explaining the performance of hospitals in Ghana. The results further indicate that mission-based and private hospitals with effective board governance structures exhibit better performance than public hospitals.

Originality/value

This study makes a number of new and meaningful contributions to the extant literature and the findings support managerialism, stakeholder and resource dependency theories. The findings also have important implications for the effective governance of hospitals.

Details

International Journal of Law and Management, vol. 57 no. 2
Type: Research Article
ISSN: 1754-243X

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Article
Publication date: 1 August 2000

Ling X. Li and David A. Collier

The stimulus for this research is that as US hospitals and health care organizations become more competitive, wise investments in technology and quality improvement are…

Abstract

The stimulus for this research is that as US hospitals and health care organizations become more competitive, wise investments in technology and quality improvement are keys to financial success and survival. A structural equation model is hypothesized using the following five constructs: clinical technology; information technology; clinical quality; process quality; and hospital financial performance. No research to date has examined the relationships between the type of technology, the type of quality, and hospital financial performance. The general research hypothesis tested is that hospital technology directly drives (affects) quality and hospital financial performance. The results indicate that the type of hospital technology (clinical or information) drives different types of quality‐related performance (clinical or process), and directly and indirectly affects hospital financial performance. The simple recursive model documented here is an important first step to defining more complete models that accurately predict hospital financial performance as a function of technology and quality investments and initiatives. The article concludes by summarizing results, discussing their implications, and proposing future research ideas.

Details

International Journal of Service Industry Management, vol. 11 no. 3
Type: Research Article
ISSN: 0956-4233

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Article
Publication date: 12 February 2018

Saad Alshahrani, Shams Rahman and Caroline Chan

The purpose of this paper is to develop a comprehensive conceptual model for the impact of hospital-supplier integration on the overall performance of healthcare…

Abstract

Purpose

The purpose of this paper is to develop a comprehensive conceptual model for the impact of hospital-supplier integration on the overall performance of healthcare organisations. It also investigates the moderating role of lean practices between hospital-supplier integration and hospital performance.

Design/methodology/approach

Data were collected from 498 public and private hospitals in Saudi Arabia using a survey. Structural equation modelling was used for data analysis.

Findings

The results indicate that hospital-supplier integration has a positive impact on the hospital performance. These effects are even more notable when adopting lean practices in the hospitals.

Research limitations/implications

The data were collected from one developing country, namely Saudi Arabia. Thus, the findings may be relevant to the Saudi context but not those of other developing countries. Second, the data were collected from the hospitals’ end but not from the suppliers, so the latter’s perspectives on the themes covered here are not known. Future research may investigate the validity of the model in various developing countries whose healthcare systems have different characteristics, and the relationships between hospitals and their suppliers may follow different governance models.

Practical implications

The developed model and results will help hospitals in the Saudi health system to make better decisions on managing their logistics and supply partners.

Originality/value

This study extends the current research by developing a model that highlights the impact of hospital-supplier integration on the overall performance of healthcare organisations and tests this model to confirm its validity. To the authors’ knowledge, this study would be one of the first that uses both lean thinking and relational view of competitive advantage theory combined to examine the moderating role of lean practices on the inter-organisational relationships in Saudi Arabia.

Details

The International Journal of Logistics Management, vol. 29 no. 1
Type: Research Article
ISSN: 0957-4093

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Article
Publication date: 14 August 2007

Christopher McDermott and Gregory N. Stock

As hospital costs continue to rise, increasing attention is being paid to the way these organizations are and should be managed. This attention typically comes in the form…

Abstract

Purpose

As hospital costs continue to rise, increasing attention is being paid to the way these organizations are and should be managed. This attention typically comes in the form of focus on costs of services, quality (often measured through mortality rates) and length of stay. Hospital management has a broad array of choices at their disposal to address these challenges. As service operations, hospitals present a significant opportunity to apply the many tools and techniques from the field of operations strategy to this important industry. The objective of this paper is to use the operations strategy framework to assess the relationship between a set of operational elements and hospital performance in terms of average length of stay (ALOS), so that hospital managers improve the effectiveness and efficiency of patient care of their hospitals.

Design/methodology/approach

Using the structural and infrastructural operations strategy framework, this study examines the relationship between several strategic variables and hospital performance. To analyze these relationships the paper employs data from the population of hospitals in New York State. The performance measure is the ALOS for patients, adjusted for the mix and severity of cases in each hospital.

Findings

The paper finds that a direct relationship exists between the dependent variable and location, capacity, and teaching status, and failed to find a direct relationship for capital expenditures, salary, and staffing levels. However, the paper did find significant interaction effects between capital expenses and both salary and staffing levels.

Practical implications

There appear to be trade‐offs between capital expenditures and workforce decisions that have significant implications in light of current and expected hospital staffing shortages. The findings indicate that reductions in staff may not be perfectly replaced by corresponding increases in capital expenditures.

Originality/value

This paper further expands the body of research that addresses the important challenges hospitals face from an operations management perspective.

Details

International Journal of Operations & Production Management, vol. 27 no. 9
Type: Research Article
ISSN: 0144-3577

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Article
Publication date: 11 June 2021

Huilan Zhang

There has been little empirical research focused on the effect of lean on hospital performance in the form of a consolidated methodology. This paper aims to apply a more…

Abstract

Purpose

There has been little empirical research focused on the effect of lean on hospital performance in the form of a consolidated methodology. This paper aims to apply a more sophisticated approach to examine whether hospitals’ decision for lean implementation is endogenous and test the effects of lean on hospital performance.

Design/methodology/approach

This study uses a publicly available data set of hospitals across the USA from 2002 to 2019 and performs two-stage least squares (2SLS) analysis. In the first stage, a probit model is used to estimate hospitals’ decision to implement lean. The fitted probability values from the first stage are used in the second stage to test the relationship between lean and hospital performance. Ordinary least squares (OLS) regression results are compared with those of the 2SLS approach.

Findings

The decision to implement lean is significantly associated with hospital-specific characteristics (the complexity of care, size and cost-to-charge ratio), indicating hospitals’ decision for lean implementation is endogenous. Moreover, there is strong evidence that lean implementation is positively associated with hospital financial and operational performance. The Hausman F-tests confirm the presence of endogeneity and this, in turn, suggests that OLS regressions result in unreliable estimates.

Practical implications

The findings of this study can help hospital managers benchmark performance and explore opportunities for profit and efficiency improvement. The findings are also relevant to policymakers who strive to lower health-care spending.

Originality/value

This study is motivated by the challenges facing the health-care industry. This study is among the first to investigate endogeneity in lean implementation and the association between lean and hospital performance using large-scale archival panel data. The use of the 2SLS approach provides more confidence in statistical findings.

Details

Journal of Accounting & Organizational Change, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1832-5912

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