Abstract
It is acknowledged in the literature that most understanding and knowledge on healthcare outsourcing are not derived from the healthcare sector but from other industries. Previous research on outsourcing in China mainly focus on studying China as an outsourcing destination. It is in this context that this research has explored the conceptual validity of the factors affecting outsourcing identified in the Western outsourcing literature in a public and a private hospital in China. A theoretical framework was developed from the literature whereby management at both hospitals were interviewed to identify the factors affecting outsourcing in the two Chinese hospitals. In the absence of guidance from the existing literature in making cultural adaptions and adjustments in implementing outsourcing in China, this research provides valuable and empirical insights into how Guanxi and Mianzi has guided and shaped the social behaviour on the basis of reciprocal obligations in building a highly trusted and committed outsourcing partnership. This original finding demonstrates how Guanxi and Mianzi contribute to enhance the loyalty and commitment of suppliers and employees, in lieu of contracts in Western outsourcing context, which has provided profound understanding on the impacts of informal controls in implementing a Western developed model in Hospital A and Hospital B. The development of two revised conceptual frameworks has clearly contributed to fill the literature gap and provided insights into the decision-making process in a non-Western context of implementing outsourcing in the Chinese healthcare sector.