small size category (86%), with simply structured management teams, that is, without the basic management bodies of the other groups, where, given the lack of advisory bodies at their disposal (fewer than 4), decision- making is centralized.
Group 4, made up of 19 hospitals, is characterized by its correlation with the negative side of the first axis. These hospitals are the ones that can be said to engage in strategies relating to human resources management and marketing. They have performance assessment systems and stuff promotion schemes. the various groups of professionals within these hospitals undergo training in technical skills specific to their job category, health care management skills, and issues relating to quality and patient care. Also, the clinical and nursing divisions are deeply involved in the management of human resources.
With respect to marketing strategies in these Centers,various marketing techniques, such as positioning techniques (the facility itself or the services it offers), diversification and continuous analysis of the services (product) range and market quota and segmentation analysis are used. These centers are also characterized by their use of communication tools, such as the design of a corporate image and involvement in health education and information activities. Finally, it is worth mentioning in relation to this group the high level of commitment on the part of management towards boosting quality practices.
In this group, which is the one that shows most initiative in undertaking strategic practices,75% of the hospital are public and 25% are private. They vary in size, the majority (47.4%) being large, 37% medium and 16% small. The management terms in most of these hospitals, unlike those in the other groups, are more complex, in other word, they include more members then those mentioned in the basic management team described earlier. The average amount of hi-tech equipment used in this group falls below the average for the sample.
Table 7 shows the variables used to provide a more detailed description of the groups that emerged from the classification.
3.3.3 link between strategies and results
The different groups that emerged were generally characterized as either engaging or not engaging in strategic practices in various functional areas, therefore, if any significant differences can be found to exist between the result of the results the various groups, they can be postulated to bear some relation to the fact that some engaged in certain strategic practices while others did not. For the purpose of this paper, two kinds of results are considered, on the one hand ,those relating to clinical performance and, on the other,those relating to financial performance.
3.3.3.1 Clinical performance
The selected performance variables were, in absolute terms,admissions, number of stay, and total number of surgical procedures, and in relative terms , rate of occupancy, rotation ratio, ratio of first visit/later and average length of stay.
there are some existing studies of Spanish hospitals that use these indicators; such is the case of Prior and Sola [43] who use performance variable such as patient discharges,number of stay and number of consultations. Gonzalez and Barber [44],meanwhile, use measure such as average length of stay. primary consultations, subsequent consultations, number of emergencies attended, and number of surgical procedures on out-patients,plus an indicator for the technology used .