A widening gap? Static and dynamic performance differences between specialist and general hospitals

Vera, Antonio; Petratos, Pythagoras; Salge, Torsten Oliver

doi:10.1007/s10729-016-9376-0

Cited by 7 publications

(11 citation statements)

References 52 publications

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“…In practice, the number of specialized healthcare units, such as single specialty hospitals [7][8][9] and ambulatory surgery centres [10], has grown rapidly. Several empirical studies have also shown that specialized units outperform general hospitals both in cost efficiency [8,11] and in patient satisfaction [12,13]. literature on the link between focus and performance by supporting the notion that hospital focus is an important driver of quality and productivity for routine patients.…”

Section: Introductionmentioning

confidence: 90%

“…In practice, the number of specialized healthcare units, such as single specialty hospitals [ 7 , 8 , 9 ] and ambulatory surgery centres [ 10 ], has grown rapidly. Several empirical studies have also shown that specialized units outperform general hospitals both in cost efficiency [ 8 , 11 ] and in patient satisfaction [ 12 , 13 ].…”

Section: Introductionmentioning

confidence: 99%

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Does Focus Improve Performance in Elective Surgery? A Study of Obesity Surgery in Sweden

Svarts

Urciuoli

Thorell

et al. 2020

IJERPH

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Recent studies have found positive effects from hospital focus on both quality and cost. Some studies indicate that certain patient segments benefit from focus, while others have worse outcomes in focused hospital departments. The aim of this study was to establish the relationship between hospital focus and performance in elective surgery. We studied obesity surgery procedures performed in Sweden in 2016 (5152 patients), using data from the Scandinavian Obesity Surgery Registry (SOReg) complemented by a survey of all clinics that performed obesity surgery. We examined focus at two levels of the organization: hospital level and department level. We hypothesized that higher proportions of obesity surgery patients in the hospital, and higher proportions of obesity surgery procedures in the department, would be associated with better performance. These hypotheses were tested using multilevel regression analysis, while controlling for patient characteristics and procedural volume. We found that focus was associated with improved outcomes in terms of reduced complications and shorter procedure times. These positive relationships were present at both hospital and department level, but the effect was larger at the department level. The findings imply that focus is a viable strategy to improve quality and reduce costs for patients undergoing elective surgery. For these patients, general hospitals should consider implementing organizationally separate units for patients undergoing elective surgery.

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Section: Introductionmentioning

confidence: 90%

Section: Introductionmentioning

confidence: 99%

Does Focus Improve Performance in Elective Surgery? A Study of Obesity Surgery in Sweden

Svarts

Urciuoli

Thorell

et al. 2020

IJERPH

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show abstract

“…Miller and Adam ( 15 ), Singh ( 29 ), and Bromiley ( 30 ) have commonly used “return on assets” (ROA) to measure the operational performance of firms. Vera et al ( 31 ) also uses ROA as an indicator of hospital financial performance which is frequently used in the hospital sector. Therefore, the research selects ROA as the dependent variable to measure the performance.…”

Section: Methodsmentioning

confidence: 99%

How slack resource affects hospital financial performance: The evidence from public hospitals in Beijing

Chen

Song²,

Zhu³

2022

Front. Public Health

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BackgroundBeijing is a city with high concentration and congestion of quality medical resources in China. While moderate slack seems to be beneficial to the improvement of medical quality. The actual relationship between hospital slack resources and their performance deserves further exploration. The study aims to analyze the slack resources of public hospitals in Beijing and investigate the relationship between slack and hospital financial performance. Finding a reasonable range of slack to optimize resource allocation.MethodsThe panel data of 22 public hospitals in Beijing from 2005 to 2011 were selected as the sample, and the DEA model was applied to measure the main variable using DEAP 2.1. Descriptive statistical analysis was performed using Excel and STATA 15. Pearson correlation coefficient analysis and variance inflation factor test were performed for each variable to avoid multicollinearity. The HAUSMAN test was used to determine the appropriate panel regression model, and then to analyze the influence relationship between the variables.ResultsFrom 2005 to 2011, hospital slack resource transitioned from high to low. The slack measured by the DEA model has an inverted U-shaped relationship with financial performance, with ROA increasing from 4.088 to 8.083 when slack increases from 0 to about 0.378, and then showing a decreasing trend; slack measured by financial indicators has a transposed S-shaped relationship with financial performance, with ROA increasing when slack increase from 3.772 to 5.933.ConclusionsThe slack resources of Beijing public hospitals decreased year by year from 2005 to 2011. Moderate slack resources are conducive to the improvement of healthcare quality, but when slack resources increase to a certain level, it will have a negative impact on healthcare quality. Therefore, hospital managers should control the slack within a moderate range according to the hospital operation policy and development plan to obtain the best performance.

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“…Previous literatures have described the concept of slack resources as including “thinking time”, which is particularly important for the improvement of output of healthcare providers as knowledge workers [ 12 ]. Job satisfaction is also one of factors related to individual performance, which has been widely studied, while literature has shown that job satisfaction of hospital staff is also one of the organizational performance indicators of hospitals [ 13 ]. Niskala, et al [ 14 ] has also pointed out that job satisfaction, which is positively correlated with healthcare service performance, has been critical to the functioning of healthcare organizations.…”

Section: Introductionmentioning

confidence: 99%

“…The clinicians’ job satisfaction is a key topic for healthcare managers and patients to focus on. Managers can save on the financial costs associated with high clinician turnover by improving job satisfaction [ 15 ], while there is also a positive dynamic relationship between clinicians’ job satisfaction and patient satisfaction [ 13 ]. In addition, there is evidence in the field of health care that job satisfaction is related to slack resources of hospitals, while Choi, et al [ 16 ] has pointed out that the staffing and resources of the department can affect the improvement of job satisfaction of nurses.…”

Section: Introductionmentioning

confidence: 99%

Slack resources and individual performance of clinicians: the mediating role of job satisfaction and empirical evidence from public hospitals in Beijing, China

Wei

Song

Zhu

et al. 2023

BMC Health Serv Res

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Background Clinicians in Chinese public hospitals face a complex and severe clinical practice environment, and the individual performance of clinicians is key to improving the output of the healthcare industry. This study aims to explore the mechanism of slack resources in improving individual performance of clinicians and the role of job satisfaction in this process, while the study framework is based on the widely applied Job-Demands Resources theory. Methods Based on the study framework composed of slack resources, individual performance, and job satisfaction, hypotheses have been put forward, and questionnaires have been distributed to representative clinicians in tertiary public hospitals. Finally, 318 valid data collected from clinicians have been obtained. To verify the hypotheses, multiple linear regression models have been established to explore the relationship between variables, and the three-stage regression models have been used to verify the presence of mediating role. Results All four hypotheses proposed in this study have been proved to be held. Clinicians' job satisfaction has played a mediating role in the impact of slack resources and its three dimensions on individual performance. Among them, there has been a complete mediating role for staff slack, while time and space dimensions have played a partial mediating role in the impact of slack resources on individual performance. Conclusions In public hospitals in environments where behavior is subject to significant government interference, it is necessary and feasible to retain appropriate slack resources to improve individual performance. From the perspective of resources management in hospitals, it is necessary for public hospitals to implement a strategy of reserving an appropriate portion of time, staff and space in order to have the conditions to improve clinicians' satisfaction. The existence of slack resources in public hospitals can improve the job satisfaction of clinicians, and then improve the individual performance through the process.

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A widening gap? Static and dynamic performance differences between specialist and general hospitals

Cited by 7 publications

References 52 publications

Does Focus Improve Performance in Elective Surgery? A Study of Obesity Surgery in Sweden

Does Focus Improve Performance in Elective Surgery? A Study of Obesity Surgery in Sweden

How slack resource affects hospital financial performance: The evidence from public hospitals in Beijing

Slack resources and individual performance of clinicians: the mediating role of job satisfaction and empirical evidence from public hospitals in Beijing, China

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