The new era of National Health Insurance has impacted the management of the small medium hospitals significantly. For the purpose of survival and maintaining good performance, the small medium hospitals need to adopt a suitable strategic management. 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 medium hospitals using the viewpoint of Balanced Scorecard(BSC). 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 18-item questions for internal business process, innovation and learning, customer as well as financial perspectives. Two hundred and fifty questionnaires were mailed to the hospital CEOs with 103 were returned, representing a response rate of 41.2%. Factor analysis, Chi-Square test, ANOVA and Scheffe's test were used for the statistical analysis. The results of this study showed that 35.2% of the hospitals were analyzer, followed by defender (24.2%), reactor(24.2%), and prospector(16.5%), respectively. Regarding the influence of the hospital size on hospital strategies, we found that the larger the hospital is, the more the prospectors are (p<0.01). Hospitals using prospector strategies showed better internal business performances while comparing with reactors (p<0.01) On the other hand, defender hospitals had better financial performance comparing with analyzers (p<0.05). There were no significant findings in either innovation or customer perspectives. Our conclusion suggests that most of the studied hospitals are still analyzers due to the size of the hospitals. Prospector usually are larger hospitals and have better internal business performance, while other performance indicators remain unknown.
The new era of National Health Insurance has impacted the management of the small medium hospitals significantly. For the purpose of survival and maintaining good performance, the small medium hospitals need to adopt a suitable strategic management. 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 medium hospitals using the viewpoint of Balanced Scorecard(BSC). 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 18-item questions for internal business process, innovation and learning, customer as well as financial perspectives. Two hundred and fifty questionnaires were mailed to the hospital CEOs with 103 were returned, representing a response rate of 41.2%. Factor analysis, Chi-Square test, ANOVA and Scheffe's test were used for the statistical analysis. The results of this study showed that 35.2% of the hospitals were analyzer, followed by defender (24.2%), reactor(24.2%), and prospector(16.5%), respectively. Regarding the influence of the hospital size on hospital strategies, we found that the larger the hospital is, the more the prospectors are (p<0.01). Hospitals using prospector strategies showed better internal business performances while comparing with reactors (p<0.01) On the other hand, defender hospitals had better financial performance comparing with analyzers (p<0.05). There were no significant findings in either innovation or customer perspectives. Our conclusion suggests that most of the studied hospitals are still analyzers due to the size of the hospitals. Prospector usually are larger hospitals and have better internal business performance, while other performance indicators remain unknown.