Towards a Model of Sustainable Competitiveness of Health Organizations
Abstract
:1. Introduction
- O1.
- The first objective was to synthesize the theoretical approaches concerning the issue of sustainable competitiveness and competitive advantage of health organizations, as well as their determinants.
- O2.
- Considering the theoretical approaches, to shape the first form of the model of sustainable competitiveness of health organizations.
2. Theoretical Background
2.1. Approaches to the Concepts of Competitiveness and Corporate Sustainability
2.2. Sustainable Competitiveness of Health Organizations
2.3. Towards a Model of Sustainable Competitiveness of Health Organizations
3. Materials and Methods
3.1. Research Design
3.2. Sampling
3.3. Items
3.4. Instrument
3.5. Data Analysis
4. Results
4.1. Preliminary Considerations
4.2. Factor Extraction and Rotation
5. Discussion
5.1. Identifying and Naming the Factors
- (1)
- Factor 1—Economic Dimension (the third column of the Table 4) cumulates 19.851% of the common variability of all the 51 original variables and is significant and positively correlated with the 17 variables related to: informational resources (IR_1—Provision of informational resources—0.850 and IR_2—Informational resources efficiency—0.696), technical resources and technologies (TR_1—Technical resources—0.805 and TR_2—New technologies—0.685), material resources (MR_1—Provision of material resources—0.788, MR_3—Consideration of patients’ needs—0.639 and MR_2—Material resources efficiency—0.569), infrastructure (IN_1 – Infrastructure—0.784), financier resources (FR_1—Provision of financial resources—0.749, FR_4—Cost of medical services—0.665, FR_3—Financial resources efficiency—0.620, FR_2—Financial resources efficiency—0.614 and FR_5—Investments—0.569), economic performances (EP_3—Economic performances compared with objectives set—0.674, EP_1—Economic performances compared with that of main competitors—0.594 and EP_2—Economic performances compared with five years ago—0.509), and management and leadership (ML_5—Leadership—0.386); therefore, the most appropriate name to define it would be Economic Dimension. It is noted that, on this factor, loaded-together variables describe both economic resources and results.
- (2)
- Factor 2—Quality Dimension (the fourth column of the Table 4) cumulates 17.056% of the common variability of all the 51 original variable and is significant and positively correlated with the 12 variables related to: quality of health services (QS_6—Effectiveness—0.880, QS_5—Efficiency—0.825, QS_7—Safety—0.817, QS_6—0.880, QS_2—Accessibility—0.788, QS_4—Continuity of care—0.771, QS_1—Professional competence—0.746, QS_8—Free choice—0.629 and QS_3—Interpersonal relationships—0.620), patients’ satisfaction (PS_1—Evaluation of patient satisfaction—0.653), management and leadership (ML_2—Performance management—0.553 and ML_1—Development of mission, vision and values—0.529), and market share (MKS_1—339); therefore, the most appropriate name to define it would be Quality Dimension.
- (3)
- Factor 3—Social Dimension (the fifth column of the Table 4) cumulates 16.512% of the common variability of all the 51 original variable and is significant and positively correlated with the 11 variables related to: employee satisfaction (ES_2—Evaluation of employee insatisfaction—0.835, ES_3—Employee satisfaction compared with last evaluation—0.812, ES_1—Evaluation of employee satisfaction—0.717 and ES_4—Employee satisfaction compared with that of main competitors—0.578), human resources (HR_3—Staff competencies—0.774, HR_4—Staff involvement—0.748, HR_2—Human resources development—0.735 and HR_1—Staffing—0.503), patients’ quality of life (QL_1—0.637) and patients’ satisfaction (PS_2—Patient satisfaction compared with last evaluation—0.620 and PS_3—Patient satisfaction compared with that of main competitors—0.502); therefore, the most appropriate name to define it would be Social Dimension. It is noted that, as in case of the Economic Dimension, on this factor loaded-together variables describe both human resources and social results.
- (4)
- Factor 4—Strategic Dimension (the sixth column of the Table 4) cumulates 15.590% of the common variability of all the 51 original variable and is significant and positively correlated with the 11 variables related to: innovation (INV_2—Transfer of know-how—0.698 and INV_1—Implementation of innovative medical processes—0.623), organizational change (SCH_2—Implementing the changes—0.678, SCH_1—Planning the changes—0.623 and SCH_3—Control of changes—0.568), strategy and planning (SP_3—Implementation of strategy—0.667, SP_4—Control of strategy—0.636, SP_1—Substantiation of strategy—0.619 and SP_2—Development of strategy—0.598) and management and leadership (ML_4—Relationships with stakeholders—0.527 and ML_3—Employee motivation—0.507); therefore, the most appropriate name to define it would be Strategic Dimension.
5.2. Implications
6. Conclusions
Author Contributions
Conflicts of Interest
Abbreviations
OECD | Organization for Economic Co-operation and Development |
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Characteristics | Share in the Sample | Characteristics | Share in the Sample | ||
---|---|---|---|---|---|
Country region | South–East | 14.09% | Profession | Physicians | 29.21% |
South | 32.99% | Other medical staff with higher education | 12.71% | ||
Bucharest–Ilfov | 52.92% | ||||
Nurses | 31.62% | ||||
Organizations’ age (years) | Less than 5 | 0.00% | Non-medical staff with higher education | 15.81% | |
5–10 | 9.97% | ||||
10–15 | 10.65% | Non-medical staff with secondary education | 10.65% | ||
15–20 | 4.81% | ||||
Over 20 | 74.57% | Education | High school | 13.40% | |
Organizations’ size (employees) | Less than 10 | 0.00% | College | 18.56% | |
10–49 | 37.46% | Bachelor degree | 41.92% | ||
50–249 | 37.11% | Master | 20.96% | ||
More than 250 | 25.43% | PhD | 5.15% | ||
Seniority within organization (years) | Less than 5 | 20.96% | Management level | Top-level managers | 8.595 |
5–10 | 42.61% | Middle-level managers | 16.49% | ||
10–15 | 16.84% | First-line managers | 15.12% | ||
More than 15 | 19.59% | Executants | 59.79% |
No. | Factor Components | No. of Items | Variables | References |
---|---|---|---|---|
1 | Human resources | 4 | HR_1—Staffing, HR_2—Human resources development, HR_3—Staff competencies, HR_4—Staff involvement | [6,16,18,19,20,23,25,26,27] |
2 | Financial resources | 5 | FR_1—Provision of financial resources, FR_2—Efficient management of financial resources, FR_3—Efficient management of financial resources, FR_4—Cost of medical services, FR_5—Investments | [19,23,25,27] |
3 | Technical resources and technologies | 2 | TR_1—Technical resources, TR_2—New technologies | [6,16,19,23,25,27] |
4 | Informational resources | 2 | IR_1—Provision of informational resources, IR_2—Efficient management of informational resources | [19,27] |
5 | Infrastructure | 1 | IN_1—Infrastructure | [6,19,27] |
6 | Material resources | 3 | MR_1—Provision of material resources, MR_2—Efficient management of material resources, MR_3—Consideration of patients’ needs | [19,23,25,27] |
7 | Management and leadership | 5 | ML_1—Development of mission, vision and values, ML_2—Performance management, ML_3—Employee motivation, ML_4—Relationships with stakeholders, ML_5—Leadership | [27] |
8 | Strategy and planning | 4 | SP_1—Substantiation of strategy, SP_2—Development of strategy, SP_3—Implementation of strategy, SP_4—Control of strategy | [23,24,27] |
9 | Innovation | 2 | INV_1—Implementation of innovative medical processes, INV_2—Transfer of know how | [6,16,19,27] |
10 | Organizational change | 3 | SCH_1—Planning the changes, SCH_2—Implementing the changes, SCH_3—Control of changes | [6,27] |
11 | Quality of health services | 8 | QS_1—Professional competence, QS_2—Accessibility, QS_3—Interpersonal relationships, QS_4—Continuity of care, QS_5—Efficiency, QS_6—Effectiveness, QS_7—Safety, QS_8—Free choice | [6,19,20,23,24,25,26,28] |
12 | Employee satisfaction | 4 | ES_1—Evaluation of employee satisfaction, ES_2—Evaluation of employee insatisfaction, ES_3—Employee satisfaction compared with last evaluation, ES_4—Employee satisfaction compared with that of main competitors | [26,27] |
13 | Patient satisfaction | 3 | PS_1—Evaluation of patient satisfaction, PS_2—Patient satisfaction compared with last evaluation, PS_3—Patient satisfaction compared with that of main competitors | [6,23,25,26] |
14 | Quality of life for patients | 1 | QL_1—Quality of life for patients | [20,24,27] |
15 | Economic performances | 3 | EP_1—Economic performances compared with that of main competitors, EP_2—Economic performances compared with five years ago, EP_3—Economic performances compared with objectives set | [6,18,19,23,25,27] |
16 | Market share | 1 | MKS_1—Market share | [19] |
Kaiser-Meyer-Olkin Measure of Sampling Adequacy | 0.930 | |
---|---|---|
Bartlett’s test of sphericity | Approx. Chi-Square | 16,073.540 |
df | 1275 | |
Sig. | 0.000 |
No. | Variable | Factors (Dimensions) | Communalities | |||
---|---|---|---|---|---|---|
Factor 1 (Economic Dimension) | Factor 2 (Quality Dimension) | Factor 3 (Social Dimension) | Factor 4 (Strategic Dimension) | |||
1 | IR_1 | 0.850 | 0.306 | 0.145 | 0.086 | 0.845 |
2 | TR_1 | 0.805 | 0.120 | 0.247 | 0.123 | 0.739 |
3 | MR_1 | 0.788 | 0.372 | 0.248 | 0.082 | 0.828 |
4 | IN_1 | 0.784 | 0.195 | 0.305 | 0.152 | 0.769 |
5 | FR_1 | 0.749 | 0.223 | 0.142 | 0.294 | 0.718 |
6 | IR_2 | 0.696 | 0.131 | 0.298 | 0.317 | 0.691 |
7 | TR_2 | 0.685 | 0.205 | 0.216 | 0.267 | 0.629 |
8 | EP_3 | 0.674 | 0.353 | 0.152 | 0.343 | 0.719 |
9 | FR_4 | 0.665 | 0.358 | −0.059 | 0.425 | 0.754 |
10 | MR_3 | 0.639 | 0.367 | 0.214 | 0.315 | 0.689 |
11 | FR_3 | 0.620 | 0.416 | −0.005 | 0.499 | 0.806 |
12 | FR_2 | 0.614 | 0.331 | 0.083 | 0.503 | 0.746 |
13 | EP_1 | 0.594 | −0.016 | 0.357 | 0.436 | 0.685 |
14 | FR_5 | 0.569 | 0.456 | 0.262 | 0.412 | 0.771 |
15 | MR_2 | 0.569 | 0.226 | 0.330 | 0.441 | 0.677 |
16 | EP_2 | 0.509 | 0.247 | 0.274 | 0.447 | 0.595 |
17 | ML_5 | 0.386 | 0.276 | 0.282 | 0.373 | 0.444 |
18 | QS_6 | 0.161 | 0.880 | 0.045 | 0.091 | 0.811 |
19 | QS_5 | 0.070 | 0.825 | 0.145 | 0.162 | 0.734 |
20 | QS_7 | 0.148 | 0.817 | 0.130 | 0.070 | 0.711 |
21 | QS_2 | 0.316 | 0.788 | 0.148 | 0.020 | 0.743 |
22 | QS_4 | 0.351 | 0.771 | 0.163 | −0.008 | 0.745 |
23 | QS_1 | 0.212 | 0.746 | 0.248 | −0.091 | 0.671 |
24 | PS_1 | 0.230 | 0.653 | 0.411 | 0.198 | 0.685 |
25 | QS_8 | 0.296 | 0.629 | 0.052 | 0.099 | 0.495 |
26 | QS_3 | 0.121 | 0.620 | 0.318 | 0.183 | 0.535 |
27 | ML_2 | 0.403 | 0.553 | 0.160 | 0.516 | 0.760 |
28 | ML_1 | 0.321 | 0.529 | 0.263 | 0.505 | 0.707 |
29 | MKS_1 | 0.031 | 0.338 | 0.248 | 0.293 | 0.353 |
30 | ES_2 | 0.196 | 0.139 | 0.835 | 0.296 | 0.843 |
31 | ES_3 | 0.161 | 0.137 | 0.812 | 0.322 | 0.808 |
32 | HR_3 | 0.181 | 0.298 | 0.774 | 0.270 | 0.794 |
33 | HR_4 | 0.220 | 0.284 | 0.748 | 0.282 | 0.768 |
34 | HR_2 | 0.260 | 0.272 | 0.735 | 0.269 | 0.754 |
35 | ES_1 | 0.178 | 0.200 | 0.717 | 0.309 | 0.681 |
36 | QL_1 | 0.045 | 0.406 | 0.637 | 0.140 | 0.592 |
37 | PS_2 | 0.173 | 0.372 | 0.620 | 0.322 | 0.656 |
38 | ES_4 | 0.238 | 0.495 | 0.578 | 0.332 | 0.746 |
39 | HR_1 | 0.305 | 0.029 | 0.503 | 0.046 | 0.349 |
40 | PS_3 | 0.421 | 0.082 | 0.502 | 0.419 | 0.612 |
41 | INV_2 | 0.346 | −0.010 | 0.359 | 0.698 | 0.736 |
42 | SCH_2 | 0.310 | 0.132 | 0.374 | 0.678 | 0.713 |
43 | SP_3 | 0.213 | 0.125 | 0.431 | 0.667 | 0.692 |
44 | SP_4 | 0.199 | 0.157 | 0.462 | 0.636 | 0.683 |
45 | SCH_1 | 0.359 | 0.001 | 0.445 | 0.636 | 0.731 |
46 | INV_1 | 0.354 | 0.099 | 0.314 | 0.623 | 0.622 |
47 | SP_1 | 0.156 | 0.086 | 0.519 | 0.619 | 0.685 |
48 | SP_2 | 0.262 | 0.015 | 0.523 | 0.598 | 0.700 |
49 | SCH_3 | 0.425 | 0.107 | 0.355 | 0.568 | 0.641 |
50 | ML_4 | 0.423 | 0.482 | 0.160 | 0.527 | 0.715 |
51 | ML_3 | 0.416 | 0.490 | 0.228 | 0.507 | 0.722 |
Eigenvalue | 10.124 | 8.698 | 8.421 | 7.951 | ||
Percent of variance | 19.851 | 17.056 | 16.512 | 15.590 | ||
Cumulative percent | 19.851 | 36.907 | 53.419 | 69.009 | ||
Cronbach’s Alpha | 0.966 | 0.941 | 0.942 | 0.949 | 0.980 |
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Stefan, S.C.; Popa, I.; Dobrin, C.O. Towards a Model of Sustainable Competitiveness of Health Organizations. Sustainability 2016, 8, 464. https://doi.org/10.3390/su8050464
Stefan SC, Popa I, Dobrin CO. Towards a Model of Sustainable Competitiveness of Health Organizations. Sustainability. 2016; 8(5):464. https://doi.org/10.3390/su8050464
Chicago/Turabian StyleStefan, Simona Catalina, Ion Popa, and Cosmin Octavian Dobrin. 2016. "Towards a Model of Sustainable Competitiveness of Health Organizations" Sustainability 8, no. 5: 464. https://doi.org/10.3390/su8050464