Examining the impact of clinical quality and clinical flexibility on cardiology unit performance-Does experiential quality act as a specialized complementary asset?

In this study we examine the association of clinical quality and clinical flexibility capabilities on cardiology unit length of stay and cost performance. These relate to the operational performance of cardiology units and capture the timeliness and cost efficiency of cardiac care. We also investigate the complementary role played by the experiential quality in enhancing the impact of clinical quality and clinical flexibility on operational performance measure. Experiential quality relates to patient-centered delivery of care by a hospital. We collect and combine data for 876 U.S. hospitals from four distinct sources and undertake multi-level analyses that consider a hierarchical structure in which the hospital is nested within county and state. To disentangle the effects at the levels of states, counties, and hospitals, we use the mixed-effects modeling approach. The results obtained from econometric analyses indicate that clinical quality and clinical flexibility reduce cardiology unit average length of stay. Clinical flexibility also helps in reducing the average cost of cardiology units. Experiential quality moderates the impact of clinical quality on length of stay and plays a complementary role in the relationship between clinical flexibility and cost. The paper discusses the implications of the findings and presents directions for future research. (C) 2013 Elsevier B.V. All rights reserved.