Identifying organisational capability of hospitals amid the new healthcare reform in China: A Delphi study

Abstract

Objective Since China launched its nationwide systemic healthcare reform in 2009, policies such as the elimination of drug markups and the reform of medical insurance payments have forced some hospitals into a crisis threatening their survival. Both public and private hospitals have been building and strengthening their capacity to achieve sustainable development. However, the existing research has not provided a comprehensive evaluation tool required to support this effort. Therefore, this study develops an organisational capability evaluation index system to help public and private hospitals assess their current conditions. Design The Delphi method was used to construct a hospital organisational capability evaluation index system in conjunction with the boundary value method and an analytic hierarchical process. Then, a questionnaire survey was administered in 55 hospitals (32 non-profit and 23 for-profit hospitals), and Cronbach's α and a factor analysis were used to verify the index system's reliability and validity. Setting and participants A literature review and semistructured interviews with 23 hospital managers and scholars clarified the definition of hospital organisational capability and formed an indicator pool. Additionally, 20 hospital directors were selected from public and private hospitals to participate in two rounds of the Delphi consultation. Results The Delphi consultation resulted in an index system including 12 primary and 40 secondary indicators demonstrated to be reliable and valid. The three indicators with the largest weights were 'regulation capability' (0.251), 'decision-making capability' (0.121) and 'executive capability' (0.105). Conclusion This study constructed an index system based on theoretical and practical considerations, and is expected to be applied to quantitatively evaluate the organisational capability of both public and private hospitals in China, and support their adaptation to external environmental changes.