Study On The Relationship Between Stakeholder Orientation And Performance In Public Non-profit Hospitals

That it is expensive and difficult to see a doctor has been one of the hot topics concerning the national economy and the peoples'livehood again and again during the period of 2006 and 2008, which makes the expectation and pressure unprecedented sofar bear by the Chinese medical system reform. Every step from the debates about whether the Chinese medical reform a success or not nationwide triggered by the surpring report issued by the Scioeconomic Research Center of State Department to the healthcare reform plan that will be publicized early this year pooling efforts and intelligence of eleven ministries and commissions, is concerned about the future of the Chinese healthcare system, the health of the mass, and also the success of the construction of harmonious society or not.Macrospectively speaking, the ideal plan of healthcare reform should reach the satisfaction of relevant stakeholders, such as the mass, the government, the medical professionals, and the public. Sacrificing either of the interests during the course of reform will lead to unbalance of the overall effect and ultimate failure. Meanwhile, performance of the hospital, in a miacrospective view, should be consisted of not only the financial performance and the market performance, but also the social performance. Appropriate managing the relationship among the government, market, patients, and medical professionals, is necessary to obtain favorable financial, market and social performance. Those individuals and colonies who can influence the goal realization, or who can be affected by the course to realize proposed goal, as referred before, are the stakeholders of the hospitals. So-called stakeholder orientation refers to adopting strategies and tactics to deal with the stakeholders'interest. Under current historical and realistic background, to improve the performances of the hospitals including financial, market and social performance with the guide of stakeholder theory, accords with the interests of the society and the government, cater for the rules of hospital development, and satisfies the trend of healthcare system reform and harmonious society construction. But, investigation theoretically and empirically is pressingly needed as to how to actualize the stakeholder orientation. Therefore, this study tries to analyze and investigate the relationship between stakeholder orientation and hospital performance with empical study, based on previous studie.The pathway of the present study is to develop from the realistic background and to issue questions. Then we analyzed the current status of either of the stakeholders and necessity of research from the status and problems of healthcare supply system with the aid of stakeholder theory. Theoretically, we began from the development and evolution, construted the theoretical framework of relationship between stakeholder orientation and performance through reduction and deduction, and put forward the study hypothesis. Secondly, a questionnaire investigation was carried out via an empically method, on the public non-profit hospitals in China with the scale mearsurement on stakeholder orientation and performance. The reliability and validity of the scale were tested with a sample of 30 hospitals, and then extended to the more samples. Statistical analysis was carried out with SPSS software, including reliability and validity analysis, the relationship between stakeholder orientation and performance, and the correlation and control variables analysis. Finally, based on the previous results, stakeholder orientation management and sustainable marketing model were advanced for discussion.This thesis contains three parts, seven chapters. The first part, is the scheme, theoretical, and the realistic basis, including introduction, review, and the realistic background of the study. The second part is the main body of the thesis and also the core of creation, including model construction, empirical study, and construction of sustainable marketing model as well. The third part is the conclusion, limitations, and perspectives of the study. The main content is as the following:Chapter 1 is the introduction. This chapter introduces the research topics from the realistic phenomena, illustrates the theoretical and practical significance after reviewing current status of relavant theories. After defining the conceptions of stakeholder orientation including customer orientation, competitor orientation, employee orientatation and government orientation, and performance for the convenience of understanding and grasping, it briefly describes the objects, methods, and technical route of this study. Expectant creation, difficulties encountered and proposed solutions are distilled and described. Finally, summary of the chapter is carried out following schetcking the structure of the thesis.Chapter 2 is the review. This chapter reviews the relationship between stakeholder orientation and performance, its evaluation, and conflicts in the application of stakeholder theory, based on the retrospective study on the production, evolution, definition, classification, theoretical basis, and its measurement. This chapter ends up in the public non-profit hospital, reviewing the relationship between hospital performance and customer orientation, competitor orientation, employee orientatation or government orientation, respectively. Theories on analysis on the medical market, characteristics of medical service, and development of non-profit organization are involved in the study.Chapter 3 is the realistic background. The purpose of this chapter is to reveal the realistic significance and to lay a foundation for further discussion and analysis. The course of medical survice in China, the dilemmas and difficulties in the reform of medical service system and current status in the stakeholder management in separate aspects are reviewed.Chapter 4 is model contruction of stakeholder orientation and hospital performance and design of the empirical study. A theoretical model of stakeholder orientation and hospital performance is attempted based on the previous theoretical study and literature review, which is consisted of defining of core stakeholder in public non-profit hospital of China, relationship between stakeholder orientation and social, market, financial performance, the role of control variables, and interactive effect among different stakeholders. Detailed information on design, protocol, objectives, hypothesis, and reliability analysis of the preliminary draft of the questionnaires are reported for further construction of the framework.Chapter 5 is the statistical analysis and discussion of the empirical study. The first step is confirmation of reliability of the second round sample data after descriptive analysis. The second step with correlation and regression analysis validates the hypothesis proposed.Chapter 6 is construction of model of stakeholder orientation management and sutainable marketing. From the point of rapid transition period, the author suggests the importance and potential transition mechanism of stakeholder orientation management, especially in the special historical period with the characteristics of government orientation dominance, weak market orientation consciousness, and insufficient employee orientation. Then a sustainable marketing model, including the conception or theoretical framework, and the points of application are addressed.Chapter 7 is the conclusion, limitation, and perpectives of the study.The main results of the study are as follows:Stakeholder orientation is related to the hospital performance for the study object of public non-profit hospitals. Government orientation has a positive correlation to hospital performance. High level of government orientation will lead to improved financial performance and social performance. Employee orientation is also correlated to financial performance and social performance. Competitor orientation has no effect on the hospital performance, while the patients'orientation is negatively related to the performance.A negative correlationship trend is found among patient orientation, competitor orientation, government and employee orientation, which means patient orientation, may lead to reduction of other orientations. A positive correlation is found between government orientation and competitor orientation, employee orientation, respectively. That is to say, higher level of government orientation will result in higher level of competitor orientation and employee orientation.Hospital size affects the relation between stakeholder orientation and performance. Same level of stakeholder orientation will produce different performances in hospitals with different size. But the effect of hospital grade and stage of development do not exceed that of the hospital size.This thesis contributes to medical service in public non-profit hospitals academically and practically in four points:The first one is the oranic combination of managerial science advances and medical reform. The success of medical reform is concerned with the stability and harmony of the society. The direction of medical reform enlightens the hospital management in the late 2007 and early 2008. It also brings confusion at the same time. The result of the study will provide scientific evidences for strategy decision making in hospitals of all kinds. It contributes to the fulfillment of public health function and development of harmonious society macroscopically, and propels the proper collocation of resources and sustainable improvement of hospital performance. Meanwhile, stakeholder orientation is one of hot spots in managerial science of recent years and its application in medical fields will certainly enrich the content of strategy management and marketing management and holds great theoretical and practical significance.Few studies have been found regarding the relationship between theoretical study and hospital performance, even fewer in Chinese literatures. This study, defines the stakeholders and the core stakeholders, constructs relevant model and evaluation questionnaires through literature review and empirical study. The correlation between stakeholder orientation and performance is firstly confirmed, which lays a good foundation for further research.The third innovation is separate evaluation of social and financial performance in the healthcare field in the investigation of effect of stakeholder orientation on hospital performance, and the modulation of hospital scale, grade, and stage of development. Thus it provides theoretical and practical evidences for individualized strategy and sustainable marketing for public non-profit hospitals.The fourth innovation is the construction of sustainable marketing model, which combines the stakeholder orientation and sustainable marketing theory organically and enriches the marketing theory greatly.In conclusion, stakeholder orientation is one of the hot spots among management science and social responsibility. It may and can have a great theoretical and practical sense, especially when used in the healthcare system management during the transition period, and also enriches the content of strategy and marketing management fields. Few studies have been carried out to investigate the relationship between stakeholder orientation and performance, even fewer in China. This study may lay a helpful foundation for further study with the stakeholder orientation model, and stakeholder evaluation system, after the verification of proposed hypothesis. Another, this study issue the stakeholder orientation management and sustainable marketing model with creativity, combine the stakeholder theory and sustainable marketing organically, enrich the theoretical system of marketing, and may guide the individualized marketing strategy with the model.This study is the first time in the theoretical field and has few references, leaving some limitations and shortcomings of the study behind. Though it enlarges the vision and the methods of current marketing in non-profit hospitals, this study is just a beginning and many issues is to be learned.