title: A widening gap? Static and dynamic performance differences between specialist and general hospitals.
abstract: This paper develops and tests a dynamic model of hospital focus. It does so by tracing the performance trajectories of specialist and general hospitals to identify whether a performance gap exists and whether it widens or shrinks over time. Our longitudinal analyses of all hospital organizations within the English National Health Service (NHS) reveal not only a notable performance gap between specialist and general hospitals in particular with regards to patient satisfaction that widens over time, but also the emergence of a gap especially with regards to hospital staff job satisfaction. These findings reflect the considerable potential of specialization as a means to enhance hospital effectiveness. However, they also alert health policy makers to the threat of a widening performance gap between specialist and general hospitals with potential negative repercussions at the patient and health system level.
authors.affiliation: Organization and HR Management Group, German Police University, Zum Roten Berge 18-24, 48165, Muenster, Germany. antonio.vera@dhpol.de.
authors.forename: Antonio
authors.initials: A
authors.lastname: Vera
authors.affiliation: Saïd Business School, Oxford University, Park End Street, Oxford, OX1 1HP, UK.
authors.forename: Pythagoras
authors.initials: P
authors.lastname: Petratos
authors.affiliation: Innovation, Strategy and Organisation Group (ISO), TIME Research Area, RWTH Aachen University, Kackertstrasse 7, 52072, Aachen, Germany.
authors.forename: Torsten Oliver
authors.initials: TO
authors.lastname: Salge
mesh_terms: D004739:England; D006769:Hospitals, General / Q000191:economics / Q000592:standards*; D006779:Hospitals, Public / Q000191:economics / Q000592:standards*; D006782:Hospitals, Special / Q000191:economics / Q000592:standards*; D006801:Humans; D007588:Job Satisfaction; D007902:Length of Stay / Q000706:statistics & numerical data; D017060:Patient Satisfaction / Q000706:statistics & numerical data; D010564:Personnel, Hospital / Q000523:psychology; D013222:State Medicine / Q000191:economics
keywords: Focus; Hospitals; Mixed-effect growth models; Performance; Specialization