HOSPITAL MERGER: A CASE STUDY OF TAIPEI CITY HOSPITAL - USING A MIXED METHOD APPROACH TO EXAMINE THE EFFECT OF INTER-HOSPITAL LINKS AND EMPLOYEE REACTIONS ON QUALITY OF HEALTH CARE SERVICES
Wang, Chung Kwe
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Problem Public hospitals in Taipei City have been impacted by the adoption of a nationwide health insurance system, which has forced hospitals to merge in order to compete in the medical service market. This research examined the effect of inter-hospital links and employee reactions on the quality of hospital care. Methods A mixed methods strategy combining qualitative and quantitative approaches was used for this research. Specifically, the case-study method and the sample survey approach were used to capture the hospital merger process and impact. The qualitative method assists in explaining and interpreting the findings of the quantitative study. All full-time clinical professionals and support staff were invited to complete the survey; a response rate of 83.5% resulted in 1,002 validated study participants. Results Summarizing both qualitative and quantitative evidence, there is no strong evidence to support the hypothesis that structural links enhance the quality of health care. The stepwise results demonstrate that administrative links and resources’ links play significant roles in enhancing the quality of health care. Although the quality of health care has somehow been affected by negative employee reactions, it is later improved by positive employees’ cognitive developments after the merger. Conclusions This research sheds light on findings that hospital mergers are complex integrating processes that encounter managerial challenges from human factors. A successful hospital merger not only improves the quality of health care, but also provides better health care organizations to patients, professional health care workers and the society at large. This requires involvement from leaders and employees during each step of the hospital merger process, at both the organizational restructuring phase (such as structure, administration or resources), as well as the human side, particularly on employee reactions towards hospital mergers. Strategies for employee participation and effective communication are essential and can soften and smooth any negativities arising from the integration process.
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