Betriebswirtschaftliche Erfolgsfaktoren des strategischen Managements börsennotierter Klinikunternehmen unter besonderer Berücksichtigung einer finanzwirtschaftlichen Perspektive. Eine explorative Analyse des strategischen Managements privatwirtschaftlicher Gesundheitsunternehmen

The present study addresses a notable gap in the German-speaking hospital management literature, which predominantly emphasizes operational concerns within individual hospital entities or macro-level concerns such as cost efficiency and allocative justice. Strategic management aspects receive insufficient attention, both at the hospital and hospital group levels, mirroring similar neglect in Anglo-Saxon management literature. Despite a relative abundance of literature on operations management, quantitative investigations into strategic management's impact on hospital business success remain scarce, with a predominance of operation-centric empirical studies.

Consequently, this study endeavors to explore the performance-relevant dimensions of strategic management activities within hospital groups, supplementing existing literature. Through an explorative analysis of financial data from listed hospital groups, the study aims to address two key research questions employing a mixed-methods approach: (1) discerning disparities in investment, financing, and operational activities between successful and unsuccessful companies, and (2) identifying management activities correlating with firm performance metrics such as revenue growth, profit growth, and profitability.

The second part of the thesis delves into various models of corporate growth and strategic management, establishing a conceptual framework for empirical research. The ensuing research, detailed in the third part, unfolds in distinct phases: qualitative analysis encompassing company profiling, extreme value assessment, and descriptive examination of financial data from 77 listed global hospital groups; quantitative analysis utilizing t-tests and multiple regression to pinpoint performance predictors; and case studies based on financial and content analysis of high-performing companies' annual reports. Finally, this mixed-methods approach is extended and refined by through a questionnaire, followed by qualitative examination, aiming to expand the primarily used secondary statistical data. The need for this extension, integrating explorative qualitative dimensions, aligns with the research objectives and has the potential to complement the dominant quantitative findings.

The concluding chapters elucidate and deliberate on empirical findings and also formulate success factors for each performance indicator through triangulating quantitative and qualitative analyses. This includes the results the extended data collection and qualitative data analysis indicating, for example, that growth is linked to increased cash flow and liquidity, but higher growth also reduces free cash flow. Profit growth correlates with revenue growth and capital structure, with higher debt indicating greater profit growth. Profitable companies show higher revenue and operational profit.

As a whole, the study confirms hypotheses regarding hospital company performance. Regression models demonstrate strong explanatory power, supporting limited management activities (AH1) and minimal research activity (AH2). Partial support is found for the influence of capital structure on growth (AH3), while hypothesis AH4 lacks confirmation, except in a single case study. Revenue growth analysis reveals significant predictors, including operational cash flow and investment ratios. Profit growth is influenced by leverage and continuous investment, as evidenced by case studies. Profitability depends significantly on company size, with specific determinants identified. Business model scoring highlights the importance of operational cash flow growth. Overall, the study underscores the critical role of various management activities in hospital company performance, emphasizing strategic diversification and financial management for sustainable growth and risk mitigation.