“A Structural Model of Sustainable Competitive Advantage in Palestinian Private Hospitals: An Examination of the Interactions Among Work Ethics, Information System, Service Quality, and Customer Value” رسالة دكتوراة

Abstract

Background: This study examines the interplay of work ethics, service quality, and information systems in influencing customer value and fostering sustainable competitive advantage in Palestinian private hospitals. The research addresses the challenges faced by healthcare institutions in conflict-affected regions, focusing on the role of ethical practices, technological integration, and service quality. Methods: This study employed a quantitative cross-sectional design, collecting data from a systematically random sample of 384 hospitalized patients in three private hospitals in the West Bank. A structural model was constructed and analyzed using Smart-PLS to examine both direct and mediating relationships among the variables. Results: The findings reveal that work ethics (𝛽 = 0.180, p = 0.002) and service quality (𝛽 = 0.417, p = 0.000) positively influence customer value, with service quality as the stronger driver. However, information systems (𝛽 = 0.043, p = 0.233) do not significantly impact customer value directly but contribute to a sustainable competitive advantage when integrated with other strategies. Notably, customer value negatively impacts sustainable competitive advantage (𝛽 = -0.405, p = 0.000), suggesting operational challenges in enhancing value perceptions. Service quality emerged as the most critical factor in achieving sustainable competitive advantage (𝛽 = 0.560, p = 0.000), while work ethics showed mixed effects (𝛽 = - 0.137, p = 0.024), enhancing customer value without directly translating to a competitive edge. Information systems directly support SCA (𝛽 = 0.165, p = 0.002) but lack mediating effects through customer value. Conclusion: the results underscore the importance of aligning ethical practices, service quality, and technological advancements with strategic goals to enhance customer value and sustain competitive success. This study contributes to the literature by offering a comprehensive structural model tailored to the unique context of Palestinian private hospitals, providing VI actionable insights for improving operational efficiency and patient satisfaction in challenging environments.