Organizational culture and its relationship with hospital performance in public hospitals in China

Objective: To measure perceptions of organizational culture among employees of public hospitals in China and to determine whether perceptions are associated with hospital performance.

Data sources: Hospital, employee, and patient surveys from 87 Chinese public hospitals conducted during 2009.

Study design: Developed and administered a tool to assess organizational culture in Chinese public hospitals. Used factor analysis to create measures of organizational culture. Analyzed the relationships between employee type and perceptions of culture and between perceptions of culture and hospital performance using multivariate models.

Principal findings: Employees perceived the culture of Chinese public hospitals as stronger in internal rules and regulations, and weaker in empowerment. Hospitals in which employees perceived that the culture emphasized cost control were more profitable and had higher rates of outpatient visits and bed days per physician per day but also had lower levels of patient satisfaction. Hospitals with cultures perceived as customer-focused had longer length of stay but lower patient satisfaction.

Conclusions: Managers in Chinese public hospitals should consider whether the culture of their organization will enable them to respond effectively to their changing environment.