| Summary: | 碩士 === 國立中山大學 === 人力資源管理研究所 === 89 === Strategic management and hospital performances in small and medium hospitals
---- From the viewpoint of Balanced Scorecard----
Abstract: ----------------------------------------------------------------------------------------------
The new era of National Health Insurance has impacted the management of
the small and medium hospitals significantly. For the purpose of survival and
maintaining good performance, the small and medium hospitals need to adopt a
suitable strategic manage ment. The published literatures in the hospital performance
are numerous but with more focus in the field of public and larger hospitals, very few
of them discussed about the smaller hospitals. Previously ,the measurement of
hospital performance has been mainly based on the financial guideline. In this work ,
we investigated the relationship between strategic management and hospital
performance in the different scaled small and medium hospitals using the viewpoint
of Balanced Scorecard(BSC). The purposes of this study are (1) to classify hospital
strategies using the Miles & Snow’s typology, (2) to investigate the effects of the
hospital size on hospital strategies, and (3) to examine the relationships between these
different strategies and hospital performance.
This project was a cross-sectional and non-experimental study with a
hospital as the unit of analysis. We used an eleven- items questionnaire (Conant, 1990)
to classify hospitals into four different strategic types: prospector, defender, analyzer
and reactor. (Miles & Snow,1978). We also used Kaplan & Norton’s Balanced
Scorecard to measure the hospital performance, which including 17- item questions for
internal business process, innovation and learning, customer as well as financial
perspectives. Four hundred and twenty three questionnaires were mailed to the
hospital CEOs with 151 were returned, representing a response rate of 35.7%. Factor
analysis, Chi-Square test, ANOVA and Scheffe’s test were used for the statistical
analysis.
The distribution of bed size were 49.7% under 50-beds, 15.2% with 51-100 beds,
11.9% with 101-150 beds, 5.3% with 151-200 beds, 3.3% with 201-250 beds, as well
as 14.6% with greater than 250 beds. The results showed that 37.7% of the hospitals
were analyzer, followed by defender (26.5%), reactor (24.5%), and prospector
(11.3%), respectively. From a factor analysis of 17 items related to the balanced
scorecard, we obtained six measures of internal business perspective (α=0.80), all six
items had factor loading above 0.60 and eigenvalues above 1.0 derived from principal
components analysis with varimax rotation. Innovation and learning perspective was
measured by 5 measures (α=0.76) with factor loading above 0.60 and eigenvalues
greater than 1 . Customer perspective included 4 measures (α=0.59) with factor
loading above 0.50 and eigenvalues greater than 1. In addiction , we obtained two
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