The influence of contextual factors on organisational performance: evidence from Portuguese hospitals

This study aims to investigate the impact of key contextual factors, specifically those related to governance structures and resource availability, on the operational and financial performance of hospitals.

Adopting a quantitative research design, the analysis applies a multivariate regression model to assess the relationship between governance structure and the allocation of material, financial and human resources with hospital performance outcomes. Empirical data were collected from the official websites of 40 hospitals within the Portugue National Health Service (NHS) and the Ministry of Health's benchmarking platform.

Findings indicate a significant and positive association between governance quality and the availability of financial and human resources, with both operational efficiency (measured through production outputs) and financial performance. In contrast, the presence of an external auditor, while essential for regulatory oversight, shows a negative correlation with financial resources, reflecting its role in financial scrutiny and constraint. A reduction in financial resources impacts, indirectly, on the hospital productivity.

This study contributes to the health management literature by integrating multiple contextual variables, governance and organisational resources to evaluate their combined impact on hospital performance, a dimension still underexplored in empirical research. Furthermore, it introduces a novel methodological contribution by employing structural equation modelling (SEM) within the context of healthcare management. Although based on data from Portugal, the methodological and analytical framework is applicable to comparative studies and may be replicated in other national healthcare systems.