Zhihua ZHANG

Date of Award

2-2023

Degree Type

Dissertation/Thesis

Advisor(s)

Gordon LIU

Second Advisor

Sarah WU

Third Advisor

Henry MO

Abstract

Since the beginning of the 21st century, a series of challenges have been confronting global health development, including significant factors affecting human health such as population aging, severe infectious diseases, and climate change. In particular, the COVID-19 that swept the globe in the past three years has posed a major comprehensive test to the global health governance system. As both the last line of defense for human health and the largest consumer of health resources, how the hospital can "improve quality and promote efficiency" based on limited resources is the core of the first priority. Previous studies have proven that improvement of management practice is an effective lever to enhance hospital performance outcomes, however, quantitative analytic methods are rarely employed to examine the management score. One of the main reasons is the difficulty of measuring organizational management score, which results in very few studies that focused on hospital management practice in China.

In addition, the influence of hospital management change on its performance and management has always been an important topic in the management research community. However, it remains unclear how management change influences management practice and performance output and its influencing mechanism. There are few existing studies on hospital CEO turnover which, as an important management context, is rarely studied in terms of its influencing mechanism on management practice and performance.

This dissertation applies both the World Management Survey (WMS), a cross-national and cross-industry quantitative research method derived from McKinsey's experience accumulated in its years of management practice, and the scientific double-blind interview method to quantitatively evaluate the management score of Chinese hospitals in a systematical, practical and effective manner. It not only serves as a useful supplement to the assessment of Chinese hospitals, but also leads to the analysis of the influence of management practice on hospital performance, so it can promote hospitals to develop in a high-quality way.

To this end, this dissertation is completed based on the localized and modified WMS-CHMS and MOPS-CHMS questionnaire data collected by the research team of the China Health Economics Research Center between 2014-2021 and by referring to hospitals’ multi-dimensional four comprehensive performance indicators and integrating them with the performance data from government authorities. In this dissertation, firstly, the influence of management practice on hospital performance is empirically investigated using cluster analysis, OLS regression, and mediation effect model, using hospital management score as the core variable. It is found that management practice positively influences hospital performance output. In addition, this dissertation further explores the influencing mechanism of management practice on hospital performance under the special context of CEO turnover. The results show the partial mediating effect of management practice in the influence of CEO turnover on performance. These findings provide scientific and systematic first-hand materials and methodical management practice solutions for the betterment of the modern hospital management system.

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