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NTU Management Review Vol. 32 No. 3 Dec. 2022

tudinal analysis may be another direction for future studies.

5. Originality/Contribution

This study re-examines the effects of various strategies on hospital performance. Our
findings indicate that outsourcing strategies can yield high performance in terms of both
efficiency and health-care quality. Increases in efficiency achieved through outsourcing

do not occur at the cost of health-care quality, which should alleviate concerns regarding
the existence of a trade-off between efficiency and health-care quality. Our theoretical
framework contributes to the literature on collaboration and strategic alliances between
clinical health-care institutions. Second, considering Taiwan’s single-payer health-care
system, we use the HHI value of each region as a proxy for competitive intensity in that

region. Although competition has been explored as a factor affecting hospital performance
in numerous studies with mixed findings, few such studies have adopted the dynamic
competition perspective as the theoretical background. Our empirical findings indicate
that competitive intensity moderates the strategy-performance relationship. This study

contributes to the field of health-care management by applying the dynamic competition
perspective to health-care management strategy decisions.

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