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New ownership types in health care of welfare states raise concerns regarding psychosocial work conditions including different control dimensions. The purpose of this paper is to investigate how job demands, control over work and control within work (CWW) were related to job satisfaction in publicly administered, private non-profit and private for-profit hospitals.

Questionnaire data came from employees at three hospitals; a publicly administered (n=774), a private non-profit (n=1,481) and a private for-profit (n=694) hospital. Mean-level analyses and hierarchical regressions with multiple group tests were conducted.

Demands including workload were significantly lower at the publicly administered hospital while the control dimension CWW was significantly higher. Background factors and their associations with job satisfaction differed slightly between ownership types. Attitudes to privatization were not associated with job satisfaction within any ownership type. Overall, psychosocial work characteristics, including job demands and control, were significantly associated with job satisfaction while their interactions showed no consistent associations with job satisfaction. As for the strength of the associations, no consistent differences emerged between ownership types.

Using self-reports only, the associations between psychosocial work characteristics and job satisfaction seemed comparable across ownership types.

Associations between psychosocial work characteristics and job satisfaction seem comparable across ownership types. This may relate to societal demands on the structuring of costs, work and production efficiency being similar for all.

Contributions include researching different occupations and their attitudes to privatization and two control dimensions considered important for different ownership types.

Change in ownership among U.S. community hospitals has been frequent and, not surprisingly, remains an important issue for both researchers and public policy makers. In the past, investor-owned hospitals were long suspected of pursuing financial over other goals, culminating in several reviews that found few differences between for-profit and nonprofit forms (Gray, 1986; Sloan, 2000; Sloan, Picone, Taylor, & Chou, 2001). Nevertheless, continuing to the present day, several states prohibit investor-ownership of community hospitals. Conversions to investor-ownership are only one of six types of ownership change, however, with relatively less attention paid to the other types (e.g., for-profit to nonprofit, public to nonprofit). This study has two parts. We first review the literature on the various types of ownership conversion among community hospitals. This review includes the rate at which conversions occur over time, the relative frequency in conversions between specific ownership categories and the observed effects of conversion on hospital operations (e.g., strategic direction and decision-making processes) and performance (e.g., access, quality, and cost). Overall, we find that the impact of ownership conversion on the different measures is mixed, with slightly greater evidence for positive effects on hospital efficiency. As one explanation for these findings, we suggest that the impact of ownership conversion on hospital performance may be mediated by changes in the hospital's strategic content and process. Such a hypothesis has not been proposed or examined in the literature. To address this gap, we next study the role of strategic reorientation following hospital conversion in a field study. We conceptualize ownership conversion within a strategic adaptation framework, and then analyze the changes in strategy content and process across sixteen hospitals that have undergone ownership conversions from nonprofit to for-profit, public to for-profit, public to nonprofit, and for-profit to nonprofit. The field study findings delineate the strategic paths and processes implemented by new owners post-conversion. We find remarkable similarity in the content of strategies undertaken but differences in the process of strategic decision making associated with different types of ownership changes. We also find three main performance effects: hospitals change ownership for financial reasons, experience increases in revenues and capital investment post-conversion, and pursue labor force reductions post-conversion. Membership in a multi-hospital system, however, may be a major determinant of both strategy content and decision-making process that is confounded with ownership change. That is, ownership conversion may mask the impact of system membership on a hospital's strategic actions. These findings may explain the pattern of performance effects observed in the literature on ownership conversions.

Sharing patient health information (PHI) among hospitals has been much slower than the adoption of health record systems. This paper aims to investigate if privacy regulation (PR) or security measures (SMs) influence hospitals’ use of health information exchange (HIE) to share PHI with other providers (e.g. physicians, labs, hospitals). The study specifically focuses on how multiple PRs can impede and a strong national security infrastructure (NSI) can support HIE.

The study uses secondary data from a multi-national and multi-hospital survey administered by the European Union. The multi-level structure of the cross-sectional panel data is used to test the influence of both hospital-level (e.g. PR) and national-level variables (e.g. NSI) on HIE. A total of nine types of HIE, three types of PRs, nine SMs and other relevant control variables are considered. This study uses a two-level random intercept generalized linear model to test the hypothesis proposed in the study.

The study finds that national-level PRs (NLPR) have the strongest positive influence on HIE in comparison to regional (RLPR) and hospital-level (HLPR) PRs. Moreover, the study finds evidence that the presence of RLPR and HLPR, on average, decreases the positive impact of NLPR by 264%. The SMs also have a significant and positive impact on HIE. Adoption of an additional SM can increase the odds of engaging in a certain type of HIE between 21% and 61%. On the other hand, a strong NSI can also amplify the positive impact of SM on certain types of HIE.

This study extends prior research on the role of PRs in enabling HIE by considering the complexities brought up by adopting multiple PRs. NLPRs have the strongest impact on HIE in comparison to RLPRs or HLPRs. Moreover, public infrastructure initiatives such as those related to secure communications can also complement SMs adopted by the providers by encouraging HIE.

The purpose of this study is to investigate how two types of drivers, namely, executive compensation and market competition, can affect hospital quality in the USA. Recently, patients, insurers and regulators have increasingly focused on hospital quality. Understanding the interplay of incentives in this industry is important because in 2019, hospital treatment contributed $1.161bn to health-care costs in the USA. This study answers the call for more studies in the so-called “mixed” industry, where ownership differences can affect organizational objectives and operating constraints.

This study explores the roles of hospital executive compensation and industry competition as determinants of health-care quality. Specifically, the study probes the heterogeneity in the factors that influence quality across hospital types in the USA.

Using California hospital data from 2006 through 2020, the findings show that the effects of compensation and competition on hospital quality differ by ownership type. Executive compensation is positively associated with quality in for-profit hospitals but is not associated with that of nonprofit hospitals, suggesting for-profit hospitals are more likely to use higher levels of compensation to attract managers with higher ability, whereas the utility function for nonprofit managers may be multidimensional. Within the nonprofit hospital group, competition is more positively associated with quality for religious nonprofits relative to secular nonprofits, suggesting that competition provides more monitoring for religious hospitals.

Taken together, the findings provide evidence that the drivers of quality vary across hospitals in ways consistent with differences in constraints and objectives across ownership types. The findings are important for regulators seeking to incentivize higher quality. For example, Medicare in the USA has incorporated quality measures into its new hospital reimbursement scheme (value-based purchasing) to incentivize quality. This study proposes that regulators should consider differences across ownership types when evaluating the best ways to incentivize hospital quality.

This study aims to examine the performance implications of an information governance (IG) framework for managing, controlling access to and securing information, focusing on (1) the performance benefits of an organization's IG orientation and (2) how the configuration of IG orientation and supply chain (SC) strategy type relate to performance outcomes.

This study leverages multiple secondary sources for US hospitals, serving as the context for the study. It also employs cluster analysis to develop an SC strategy taxonomy, namely sophisticated and delivery-focused SC strategies. The proposed research model is tested using a robust regression to mitigate the influence of outliers and produce more accurate estimates.

IG orientation is positively associated with financial performance and patient experience, and IG-oriented hospitals with a sophisticated SC strategy realize more financial benefits and achieve better patient care experiences compared to other configurations. Regardless of SC strategy type, IG-oriented hospitals offer better care experiences than non-IG-oriented hospitals.

This paper offers empirical evidence that a hospital's IG orientation and SC strategy jointly affect financial outcomes and patient experience. For hospitals, an organization-wide framework for governing information streamlines both intra- and inter-organizational information flows and improves care delivery throughout a patient's care experience.

This is one of a few studies that empirically examine the performance implications of governance of information in the domain of supply chain management (SCM). This study also develops an SC strategy taxonomy for the healthcare context and offers a springboard for research in service SC strategy.

This study aims to compare nurses’ authentic leadership and perceptions of the safety climate and concepts association according to different areas of work and types of hospitals.

A cross-sectional design was used to conduct this comparative study on 314 Jordanian nurses. The Authentic Leadership Questionnaire (ALQ) and the Safety Climate Survey (SCS) were used.

Nurses in private hospitals were more educated. True leadership was mild. Unit nurses had higher ALQ and subscale mean scores. Armed forces hospitals had the highest ALQ subscales, while governmental hospitals had the lowest. The ALQ mean scores favored military hospitals. Governmental hospitals have a negative safety climate. Unit nurses had a higher SCS mean than ward nurses. Military, governmental and private hospitals are rated the safest. Nurses benefited from higher SCS scores in military hospitals. Nurses’ ALQ and safety climate perceptions were moderately positive.

A larger, randomized and equal-sized sample is recommended in future studies to conclude different areas of work and hospitals. It is also recommended to report the confidence interval in further studies using different statistical methods, increasing confidence when interpreting statistical significance variables. Other mediating, moderating and predicting variables could be studied and compared across different areas of work and types of hospitals. Sample characteristics should be handled as confounding variables in the next planned study using various ways to control confounding variables such as randomization, restriction, matching, regression and statistical control. The authors plan to statistically control for the confounding variables by entering them into the regression model. Future studies could investigate safety culture; both safety culture and safety climate are formative and inclusive terms (Experts Insight, 2017).

This paper fills in the gap in the literature and practice. Authentic leadership is associated with safety climate perceptions and varies across different areas of work and hospitals. Interventions are required to improve safety climate perceptions and promote authentic leadership in all settings and hospitals. Military hospitals ranked the highest in nurses’ perceptions of authentic leadership and safety climate.

The current study’s favorable association between authentic leadership and safety climate measurement would apply to many high-risk institutions, including public and private hospitals. It becomes necessary to include the impacts of authentic leadership on the safe climate within the nursing curriculum and continuing education courses. This may be put into action by executing a hands-on activity, followed by information and reflection conversations that highlight the link between authentic leadership and safety climate measurement. According to the findings of this study, authentic leadership appears to be a basic block in making a difference in nurses’ views of safety climate.

Authentic leadership style is a relatively new concept in the health-care sector, and its link to safety climate security still needs empirical evidence. It is still unclear how leadership resulted in more effective outcomes (Maziero et al., 2020). Few studies investigated both the concepts of authentic leadership and the nursing safety climate (Dirik and Intepeler, 2017; Lee et al., 2019a; Woo and Han, 2018). Aside from the scarcity of studies, no study has compared “working area,” “department” or “hospital type” concepts. Few comparative studies have been conducted using concepts of interest. For example, authentic leadership was linked to empowerment and burnout (Laschinger et al., 2013) and nurses’ satisfaction with safety climates (Vatani et al., 2021). No research has examined authentic leadership in Jordan’s nursing and health-care context. Few studies focused on the safety climate other than authentic leadership (Abualrub et al., 2012) or the safety culture in Jordan rather than the safety climate (Khater et al., 2015).

The purpose of this paper is twofold: first, to examine whether workers in various hospital job groups differ in their perceptions of the provision of managerial support, and of their up-to-date expertise (UDE), willingness to change (WTC) and employment opportunities (EO). Second, to examine whether and how the relationships between managerial support, workers’ UDE, WTC and their EO are moderated by hospital job type.

Survey data were collected from 1,764 employees of three Dutch hospitals. ANOVAs and structural equation modeling were used to test the hypotheses.

The research findings indicate significant differences between the hospital job groups with regard to UDE, WTC and EO. No support was found for differences on managerial support nor for a moderating effect of hospital job type. The latter means that the relationships of managerial support with workers’ UDE, WTC and EO are independent of job type.

Based on the findings, a classification system is constructed that shows how hospital workers’ UDE, WTC and EO can be explained by the combination of the educational level required by a job and its degree of specialization.

Lean Six Sigma in public and private healthcare organisations has received considerable attention over the last decade. Nevertheless, such process improvement methodologies are not generalizable, and their effective implementation relies on contextual variables. The purpose of this study is to explore the readiness of Italian hospitals for Lean Six Sigma and Quality Performance Improvement (LSS&QPI), with a focus on gender differences.

A survey comprising 441 healthcare professionals from public and private hospitals was conducted. Multivariate analysis of variance was used to determine the mean scores on the LSS&QPI dimensions based on hospital type, gender and their interaction.

The results showed that public healthcare professional are more aware of quality performance improvement initiatives than private healthcare professionals. Moreover, gender differences emerged according to the type of hospital, with higher awareness for men than women in public hospitals, whereas for private hospitals the opposite was true.

This study contributes to the Lean Six Sigma literature by focusing on the holistic assessment of LSS&QPI implementation.

This study informs healthcare managers about the revolution within healthcare organisations, especially public ones. Healthcare managers should spend time understanding Lean Six Sigma as a strategic orientation to promote the “lean hospital”, improving processes and fostering patient-centredness.

This is a preliminary study focussing on analysing inter-relationship between perceived importance of soft readiness factors such as gender dynamics as a missing jigsaw in the current literature. In addition, the research advances a holistic assessment of LSS&QPI, which sets it apart from the studies on single initiatives that have been documented to date.

The purpose of this study is to analyze how to improve the satisfaction and loyalty of Badan Penyelenggara Jaminan Sosial Kesehatan (BPJS) health patients in Indonesia based on services in Islamic hospitals, where the service quality was analyzed from a Sharīʿah perspective.

The sample for this study was 470 Muslim patients from BPJS health, 248 from large Islamic hospitals and 232 from small Islamic hospitals in Central Java, Indonesia. Overall, the respondents were from five large hospitals and five small hospitals. The study used eight service quality variables that were modified from the SERVQUAL, PAKSERV and CARTER models. All the variables used indicators of Sharīʿah principles and tested their effects on satisfaction and loyalty.

The results of the study showed that the insurance system has been proven to significantly increase the satisfaction and loyalty of BPJS health patients. This means that the efforts of the Indonesian Government to improve the level of health by establishing BPJS can benefit the community. Satisfaction can also be increased through the variables of reliability, empathy and responsiveness, while the loyalty of BPJS Health patients is strongly influenced by satisfaction. The sincerity variable can increase the satisfaction and loyalty of BPJS health patients in small hospitals, but not in large hospitals. On the other hand, the variable of compliance can increase the satisfaction and loyalty of BPJS health patients in large hospitals, but not in small hospitals.

The insurance system implemented in Indonesia can influence the improvement of satisfaction and loyalty. Also, hospitals that are fair in serving patients and that apply amanah (trust), tabligh (responsiveness) and are fast in handling BPJS health patients’ complaints are important indicators that need attention from BPJS health and hospitals. These indicators can form variables that can increase satisfaction and loyalty.

The aim of the study was to examine the use of Porter’s generic strategies and their effect on performance in the context of the Slovak hospital industry. Using mail survey the study first identified the natural taxonomy of four strategic types of Slovak hospitals, based on their use of Porter’s generic strategies in pure form and in combination. Next the study examined whether different strategic types were associated with different levels of organisational performance, while controlling for such variables as size and location, which have been argued to influence the hospital performance. The findings indicate that hospitals which follow a “stuck‐in‐the‐middle” strategy, in general, have superior performance on all used performance measures, while hospitals that place only low emphasis on cost leadership, differentiation and focus, labelled “wait and see” in this study, perform the poorest. The study concludes that the research provided body of knowledge relevant for the Slovak hospital industry, that may be used by hospital managers in the strategy formulation process as well as by the researches in exploring the influence of different contingencies on hospitals’ strategic orientation.