The Impact of Internal and External Integration on Hospital Performance in Context with Supply Chain Value Addition

The performance of an organization is affected by activities of other supply chain members. The key issue in a supply chain is the coordinated management and control of all these activities, which is achieved through proper integration of the supply chain. Therefore, this study was conducted with the aim of investigating the effect of internal and external integration on the performance of hospital with the mediating role of added value of the supply chain in Hazrat Valiasr Bafaq Hospital.

The current cross-sectional research was conducted with the structural equation approach in 1400. The statistical population included all the employees (250 people) of Hazrat Waliasr Bafaq Hospital, 163 of whom were randomly selected based on Cochran's formula. Data collection tools included value added questionnaires of supply chain, internal integration, external integration and performance. The validity of the instruments was investigated and confirmed using convergent and divergent validity, and reliability was studied using Cronbach's alpha and composite reliability. The structural equations model and SPSS 24 and LISREL 8 software were used to analyze the data.

Findings showed that internal integration with a significant value of 1.925 and path coefficient = 0.177 does not affect performance, and external integration with a significant value of 5.670 and path coefficient = 0.446 had a positive and significant effect on performance. Moreover, internal integration with a significant value of 2.281 and path coefficient = 0.265, and external integration with a significant value of 5.586 and path coefficient = 0.495 had a significant positive effect on the added value of the supply chain. The added value of the supply chain had a positive and significant effect on performance with a significant value of 2.315 and path coefficient = 0.231. In addition, the added value of the supply chain explains the mediating role between integration and performance. The quality of the final model of the research had a good fit with the overall model fit index (0.38).

The findings of this study showed that External integration has a significant effect on both the performance and supply chain value addition. But internal integration only affects supply chain value addition. It was also found that interdepartmental coordination is one of the important parameters for improving hospital performance. According to the results of this research, it is suggested that all the internal activities of the hospital be carried out based on a written program. Moreover, a special focus on the added value of the supply chain should be included as one of the hospital's strategies.