Extending Miles & Snow's strategy choice typology to the German hospital sector

Hospitals' strategy choices represent highly relevant factors that affect organizational performance and survival. This study assesses the differences among hospitals' strategic choices. This strategy definition and assessment reflects the typology proposed by Miles and Snow, who distinguish four strategy types: defender, analyzer, prospector, and reactor. Synthesis of empirical evidence from previous studies that have applied Miles and Snow's typology in the hospital sector using various methodological approaches and measures provides hints for industry-specific patterns and avenues for further research. Taking an extended view of strategic choice, the authors conduct an empirical survey of a sample of 178 German hospitals. The authors apply a multi-item measure of the Miles and Snow strategy types in the hospital sector and identify hybrid strategy types that deviate from the four strategy types defined by Miles and Snow. Overall, seven distinct strategy types emerge from this analysis. There exist three distinct hybrid types in particular. Strategy choice is systematically related to hospital size and teaching status but not to ownership and location. The significant variance in performance for the seven different strategy types justifies the distinction between them. The results support the idea of industry-specific strategy choices. Policy makers should analyze the structural context in which hospitals operate and intervene through political and regulatory means.