Hastanelerde Rekabet Stratejileri ve Performans / Competitive Strategies and Performance in Hospitals

Year 2012, Volume: 16 Issue: 1, 401 - 424, 30.05.2012

Mahmut Akbolat Oğuz Işık

Abstract

Özet: Bu çalışmada Türkiye'de faaliyette bulunan hastanelerin bir rekabet stratejisininolup olmadığı, rekabet stratejileri varsa hangi stratejileri izledikleri ve rekabet stratejileri ileperformansları arasında bir ilişki olup olmadığı araştırılmaktadır. Çalışmada veri toplamaaracı olarak hastane yöneticilerine uygulanan bir anket ve Sağlık Bakanlığı 2007 Yılı YataklıTedavi Kurumları İstatistik Yıllığı kullanılmıştır. Çalışma 165 hastane üzerinde gerçekleştirilmiştir.Çalışmanın bulgularına göre sağlık sektörüne girişte en önemli engeller, giriş maliyetlerininyüksek olması ve yasal düzenlemelerdir. Hastane yöneticileri yeni hizmet alanlarınagirerken rakiplerinin pozisyonlarını dikkate almaktadırlar. Özel hastaneler daha önde olmaküzere tüm hastaneler farklılaşma stratejisini izlemektedir. Bunu odaklanma ve toplam maliyetliderliği stratejileri takip etmektedir. Herhangi bir rekabet stratejisi izlediğini belirten hastanelerinperformansı, hiçbir strateji izlemeyen hastanelerden daha yüksektir. Ancak, rekabetstratejilerinden herhangi birini izleyen hastanelerin performansları arasında istatistiksel açıdananlamlı fark bulunmamaktadır. Ayrıca hastanelerin mülkiyet biçimi de performanslarınıetkilemektedir.Anahtar Kelimeler: Rekabet Stratejileri, Performans, Hastane.
Abstract: The purpose of this study is to investigate hospitals, have been operating inTurkey whether they have a competitive strategy, and to investigate if they have a competitivestrategy, what strategies are followed, and to investigate whether relationship betweencompetitive strategies and performance. The data that used in the study was obtained froma questionnaire that was created by utilizing related literature and 2007 Inpatient FacilitiesStatistical Almanacs of Ministry of Health. Study was conducted on 165 hospitals. Accordingto the findings of study, the most important barriers to entry in the health sector are highentry costs and legal regulations. Hospital administrators have been taking into account ofthe positions of their competitors, while they enter to new service areas. Although privatehospitals are more ahead, all hospitals have been following to differentiation strategy. Totalcost leadership and focus have been following it. Performances of hospitals that have a strategyare higher than hospitals that have not have a strategy. However, if they have any competitivestrategies, there is not any statistically significant difference of performance among hospitals.In addition performances of hospitals are affected from ownership of hospitals.Keywords: Competitive Strategies, Performance, Hospital.

Keywords

Rekabet Stratejileri, Performans, Hastane

References

• Acar, Durmuş (2005). Küresel Rekabette Maliyet Yönetimi ve Yaklaşımları: Tekstil Sektörü ile ilgili Bir Araştırm. Ankara: Asil Yayın Dağıtım Ltd. Şti.
• Altunışık, Remzi, Coşkun, Recai, Bayraktaroğlu Serkan ve Yıldırım, Engin (2005). Sosyal Bilimlerde Araştırma Yöntemleri SPSS Uygulamalı. Sakarya: Sakarya Kitabevi. Bamezai, Anil, Zwanziger, Jack, Melnick, Glenn A. & Mann, Joyce M. (1999). “Price Competition and Hospital Cost Growth in The United States (1989-1994)”, Health Economics, (8), pp.233–243.
• Barca, Mehmet (2002). “Stratejik Yönetim Yaklaşımları: Rekabet Avantajı Yaratmada Sinerjik Etki”. İçinde Stratejik Boyutuyla Modern Yönetim Yaklaşımları, İ. Dalay, R. Coşkun ve R. Altunışık (Eds). İstanbul: Beta Basım Yayım Dağıtım, ss.27-45.
• Campbell-Hunt, Colin (2000). “What Have We Learned About Generic Competitive Strategy? A Meta-Analysis”. Strategic Management Journal, (21), ss.127-154.
• Capps, Cory, Dranove, David & Satterthwaite Mark (2003). “Competition and Market Power in Option Demand Markets”. The RAND Journal of Economics, 34 (4), ss. 737- 763.
• Chang, Hsihui, Cheng, Mei-Ai & Das, Somnath (2004). “Hospital Ownership and Operating Efficiency: Evidence from Taiwan”, European Journal of Operational Research, (159), pp. 513-527.
• Chrisman, James J., Hofer, Charles W. & Boulton William R. (1988). “Toward a System for Classifying Business Strategies”, The Academy of Management Review, 13 (3), pp. 413–428.
• Cleverley, William O. & Harvey, Roger K. (1992). “Competitive Strategy for Successful Hospital Management”. Hospital & Health services Administration, 37 (1), pp. 53–69.
• Collins, David J. & Montgomery, Cynthia A. (2000). “Kaynaklara Dayalı Rekabet 1990’lı Yıllarda Strateji”, Şirket Stratejisi, Harvard Business Review, (Çev. A. Gürsel), İstanbul: MESS (Türk Metal Sanayicileri Sendikası) Yayını, ss. 41-67.
• Craig, James C. & Grant, Robert M. (1993). Strategic management, London: Kogan Page in association with AMED.
• Dinçer, Ömer (2003). Stratejik Yönetim ve İşletme Politikası. (6. Baskı). İstanbul: Beta Basım Yayım Dağıtım.
• Dess, Gregory G. & Davis, Peter S. (1984). “Porter’s Generic Strategies as Determinants of Strategic Group Membership and Organizational Performance”. The Academy of Management Journal, 27 (3), pp. 467-488.
• Ersoy, Korkut ve Kavuncubaşı, Şahin (1995). “Mülkiyet Yapısı ve Örgütsel Performans”. Toplum ve Hekim, 10 (66), ss. 107-113.
• Ginn, Gregory O. & Young, Gary J. (1992). “Organizational and Environmental Determinants of Hospital Strategy”. Hospital and Health Services Administration, 37 (3), pp. 291-302.
• Ginter Peter M, Swayne, Linda E. & Duncan, W. Jack. (1998). “Strategic Management”. Handbook of Health Care Management, W. J. Duncan, P. M. Ginter and L. E Swayne (Eds). USA: Blackwell Business, pp.117-151.
• Goldstein, Susan Meyer, Ward, Peter T., Leong, G. Keong & Butler, Timothy W. (2002). “The Effect of Location, Strategy, and Operations Technology on Hospital Performance”. Journal of Operations Management, (20), pp.63-75.
• İplikçioğlu, İsa (2003). “Kapitalist Sistem ve Küresel Pazarda Rekabet Avantajı Sağlamayı Amaçlayan Firmalar İçin Olası Alternatif Rekabet Stratejilerinin Analizi”. Verimlilik Dergisi, (4), ss. 79-106.
• Joskow, Paul L. (1980). “The Effects of Competition and Regulation on Hospital Bed Supply and the Reservation Quality of Hospital”, the Bell Journal of Economics, 11 (2), pp. 41–447.
• Kumar, Kamalesh, Subramanian, Ram & Yauger, Charles (1997). “Pure Versus Hybrid: Performance Implications of Porter’s Generic Strategies”. Health Care Management Review, 22 (4), pp. 47-60.
• Lamont, Bruce T., Marlin, Dan, Hoffman & James J. (1993). “Porter’s Generic Strategies, Discontinuous Environments, and Performance: A Longitudinal Study of Changing Strategies in The Hospital Industry”. Health Services Research, 28 (5), pp. 623-640.
• Luft Harold S., Garnick, Deborah. W., Hughes, Ronda G., Hunt, Sandra S., McPhee, Stephen J. & Robinson, James C. (1988). “Hospital Competition, Cost, and Medical Practice”. The Journal of Medical Practice Management, 4 (1), pp. 10-15.
• Melnick, Glenn A, Keeler, Emmett & Zwanziger, Jack (1999). “Market Power and Hospital Pricing: Are Nonprofits Different?”. Health Affairs, 18 (3), pp. 167-173.
• Melnick, Glenn A. & Zwanziger, Jack (1988). “Hospital Behavior under Competition and Cost-Containment Policies. The California Experience, 1980 to 1985”. The Journal of the American Medical Association, 260 (18), pp. 2669-2675.
• Morrisey, Michael A. (2001). “Competition in Hospital and Health Insurance Markets: A Review and Research Agenda”. Health Services Research, 36 (1), pp. 191-221.
• Özdamar, Kazım (1999). Paket Programlar ile İstatistiksel Veri Analizi. Eskişehir: Kaan Kitabevi.
• Porter, Michael E. (2000). Rekabet Stratejisi Sektörler ve Rakip Analizi Teknikleri. (Çev. G. Ulubilgen). İstanbul: Sistem Yayıncılık.
• Porter, Michael E. (1998). On Competition. Harvard Business School Pres.
• Porter, Michael E. (1985). Competitive Advantage: Creating and Sustaining Superior Performance, New York: Simon and Schuster Trade.
• Robinson, James C. & Luft, Harold S. (1987). “Competition and the Cost of Hospital Care, 1972 to 1982”. The Journal of the American Medical Association, 257 (23), pp. 3241-3245.
• Robinson, James C. & Luft, Harold S. (1985). “The Impact of Hospital Market Structure on Patient Volume, Average Length of Stay, And The Cost of Care”. Journal of Health Economics, 4 (4), pp. 333-356.
• Sadler, Philip. (1993). Strategic Managemen. USA, Kogan Page Limited, Milford, CT.
• Santerre, Rexford E. & Adams, Ammon S. (2002). “The Effect of Competition on Reserve Capacity: The Case of California Hospitals in the Late 1990s”. International Journal of Health Care Finance and Economics, 2 (3), pp. 205-218.
• Schermerhorn, John R. Jr. (2007). Management 9e. Hoboken New Jersey: John Wiley & Sons, Inc.
• Segev, Eli (1989). “A Systematic Comparative Analysis and Synthesis of Two Business- Level Strategic Typologies”. Strategic Management Journal, 10 (5), pp. 487-505.
• Sparks, Janet D. (1999). A Methodology for Estimating the Level of Aggressiveness in Competitive Bidding Markets. Blacksburg, Virginia: A Dissertation of the Degree Master of Science in Civil and Environmental Engineering.
• Swayne, Linda E., Duncan, W. Jack & Ginter, Peter M. (2006). Strategic Management of Health Care Organization. Fifth edition, Blackwell Publishing.
• Szilagyi, Andrew D, Jr. & Schweiger, David M. (1984). “Matching Managers to Strategies: A Review and Suggested Framework”. The Academy of Management Review, 9 (4), pp. 626–637.
• Zuckerman, Alan M. (2002). Improve Your Competitive Strategy A Guide for The Healthcare Executiv. Chicago: Health Administration Pres.
• Zwanziger, Jack, Melnick, Glenn A. & Bamezai, Anil (2000). “The Effect of Selective Contracting on Hospital Costs and Revenues”. Health Services Research, 35 (4), pp. 849- 867.