1.Introduction

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Hospital Image and attractiveness have been issues of interest to both scholars and managers. Nurses are direct care providers that compose the largest number of staff in most health care systems. Staff shortages present nurses with ever increasing levels of stress and working hours, coupled with demands on nursing manpower imposed from other sectors, underpin and further exacerbate the problem of nursing manpower shortages throughout the healthcare system (Lin & Huang, 2014; Adler & Ghiselli, 2015).

In the changing environment of health care, there are many concerns about attractiveness of the nursing profession (Jafaraghaee, Mehrdad & Parvizy, 2014; Udofot, Inyang & Akpan (2015). Questions like whether young people are attracted to this profession and whether the profession can retain the current working nurses are raised by researchers in this field ( Kuokkanen, Leino-Kilpi & Katajisto, 2003; Gregory, Way, LeFort, Barrett & Parfrey , 2007; Loi, Hang-Yue & Foley, 2006).

In recent years, hospitals ha ve begun attaching importance to patients’ needs and the creation of a hospital image. Some scholars also defined “hospital” image believe that “hospital image” is the sum of a person’s belief, idea (Shu, 2010; Kotler & Clarke, 1987), and impression of a certain hospital; it is a conceptual definition. Hospital image as social associations and hospital staff’s overall impression and evaluation of hospitals, the performance and characteristics of hospitals (Li, Tong & Wu, 2004; Isenhour, Lukaszewski, & Stone, 2014) Hospital image is expressed through various constituents, including many intangible impressions. A good image affects the public’s trust towards a hospital.

In Taiwan, the government permits the setup of corporate and private medical institutions whose business management adheres by the multiple goals of “serving public interests” and “achieving private gains”. Therefore, the purpose of this study is to compare Private and Non-Profit Proprietary Hospitals in terms of clear hospital image and compensation/benefit system on nursing organizational attractiveness, with hospital nurses as participants. Through the research, practical and theoretical research implications for academic and medical management practice can be proposed, which shall serve as a reference or basis for the government during system design. Additionally, practical strategic recommendations can be put forth for healthcare organizational managers.

2. Methodology

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2.1 Research Design and Participants

Two hospitals with different attributes in Taiwan were selected in this study, including Private and Non-Profit Proprietary Hospitals. The two hospitals are regional hospitals accredited as excellent in the hospital accreditation. For the questionnaire respondents, the hospital Nurses were the main targets. The structured questionnaire was the data collection method adopted. The questionnaire contents are in reference to domestic and foreign literatures, which were finalized after undergoing expert validity testes conducted by hospital management research scholars.

According to the above calculation equation, the hospitals samples from two case hospitals in this study tallied as of the end of June 2016 include 2,449 persons. The questionnaires were distributed from July to August 2016. 1,138 valid copies were obtained, with the questionnaire recovery rate of 46.47%. Thus, relevant research statistics were carried out. The questionnaire and research design in this study were reviewed and passed by the Human Subject Committee (IRB 1050507), and all the respondents signed the Human Subject Consent.

2.2 Research Tools and Reliability and Validity Tests

The self-prepared questionnaire in this study includes the background attribute data of respondents who filled out the questionnaire, hospital image, compensation/benefit system, and organizational attractiveness scales. The 5-point Likert scale was adopted to measure the satisfaction towards organizational attractiveness items. The scale is divided into “highly satisfied” 5 points, “satisfied” 4 points”, “average” 3 points, “dissatisfied” 2 points, and “highly dissatisfied” 1 point. The questionnaire development in reference to domestic and foreign literature involves the establishment of original questionnaire questions and the determination of preliminary draft contents. The questionnaire scoring method was then selected. Finally, the questionnaire was modified based on actual interviews and the theoretical control basis to complete the questionnaire. After the prediction of the preliminary draft, the questions were slightly modified. The variables and dimensions measured are said to possess certain validity. The overall reliability analysis of the empirical data shows the Cronbach’s α value of 0.923. Thus, the empirical data in this study is said to possess a certain degree of reliability.

The scales underwent expert validity tests by three scholars with medical management expertise. The experts’ mean Content Validity Index, CVI for the appropriateness of the questions is 0.901. Prior to the questionnaire survey implementation, official documents were sent to the hospitals to obtain their consent. The purpose of this is to solicit possible opinions on questionnaire question revision. The hospital image consists of 15 questions, with the α value of 0.941; the compensation /benefit system consists of 15 questions, with the α value of 0.955; the organizational attractiveness consists of 15 questions, with the α value of 0.956 (as shown in Table 1).

Average variable extracted (AVE), Complex validity (CV), Standard deviation (SD)

In terms of empirical analysis, the confirmatory factor analysis was adopted in this study. Hospital image, compensation/benefit system, and organizational attractiveness scales underwent construct validity analysis. The split-half reliability concept was applied for division into two measurement systems. In terms of convergent validity, since the factor loads all reached the significant standard (p < 0.001), after the AVE value square rooting, the values all exceed the correlation coefficients of dimensions in pairs. Clearly, the scales in this study possess a certain degree of discriminant validity (Table 2).

2.3 Statistical Analysis

The archiving and analysis of research data were done through the SPSS for Windows 18.0 package software, with the significant standard of 0.05. Descriptive statistics and screening were applied to eliminate erroneous information and carry out statistical analysis. For the deductive statistics part, regression analysis was employed to explore the relationships among hospital image, compensation/benefit system, and organizational attractiveness.

Table 1    Table 2

3. Results

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Among the valid samples recovered, the male respondents account for 21 persons (3.1%) and the female respondents account for 652 parsons (96.9%). The age group of 31-50 years old comprises the majority of 352 persons (52.9%), followed by “under 30 years old”, accounting for 314 persons (46.7%) and “above 51 years old”, accounting for 3 persons (0.4 %). For the years of employment, “below five years” takes up the majority of 362 persons (53.8%), followed by 6-15 years (35.5%). As for education level, university takes under the most of 634 persons (94.2%), followed by senior high school, taking up 28 persons (4.2%). Those that need to shift systems for 545 persons (81%), those that need not shift systems for 128 persons (19%). For the compensation (i.e. salary), $30,000-$49,999 takes up the majority of 525 persons (78%), followed by under $29,999 accounting for 72 persons (10.7%), as shown in Table 3.

Through correlation analysis, this study gained an initial insight into the correlations among the three research variables, namely, hospital image, compensation/benefit system, and organizational attractiveness. The analysis results show that hospital image, compensation/benefit system, and organizational attractiveness all show a positive correlation. Compensation/benefit system and organizational attractiveness show a positive correlation, both showing a positive correlation and both reaching the significant standard ( p ＜0.001) (Table 4).

The impact of work motivation and work involvement on work satisfaction was further analyzed in this study. During regression analysis targeting the controlled variables and independent variables, the problem of collinearity may arise. The study first carried out Variance Inflation Factor (VIF value < 10) and Conditional Index (CI value < 10) tests on relevant variables to avoid the problem of collinearity Private Hospitals regression model different test results show the F-statistic of 34.451 ( p ＜0.001); Non-Profit Proprietary Hospitals regression model difference test results show the F-statistic of 37.900 ( p ＜0.001) (See Table 4).

The regression model in Table 4 shows that concerning the factors affecting organizational attractiveness, the factors affecting Non-Profit Proprietary Hospitals include Age, Hospital image, and compensation/benefit system, reaching the statistically significant standard ( p ＜0.01); the factors affecting Private Hospitals include Age, Education level, Hospital image, and compensation/benefit system, reaching the statistically significant standard ( p ＜0.1). Among the factors affecting organizational attractiveness, the male nurses in Private Hospitals have lower satisfaction towards organizational attractiveness compared to the female nurses. Hospital image and compensation/benefit system have a positive impact on organizational attractiveness. In Non-Profit Proprietary Hospitals the male nurses have higher satisfaction towards organizational attractiveness compared to the graduate school in Non-Private Hospitals have lower satisfaction towards organizational attractiveness compared to the university nurses.

Table 3    Table 4

4.Discussion

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This study also found that for the respondents, Gender showed differences in terms of organizational attractiveness. Unlike previous studies, Explored the impact of employer image on organizational attractiveness from the functional and symbolic architecture. In terms of gender (Chen & Chien, 2015), no significant difference was found, possibly because of the organizational characteristics of healthcare, specifically labor intensive, knowledge intensive, and a high degree of professional division of labor.

The greater the satisfaction towards hospital image and compensation/benefit system, the higher the organizational attractiveness would be. Leopold (2010) believes that proper benefit system management enables a company to obtain positive results in terms of organizational attractiveness, employee retention rates, and productivity.

5. Conclusion

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5.1. Possible explanations of the results

The present study topic is timely and relevant, because the attractiveness is important than ever has been. The attractive organizations are able to meet the challenges in working life, like competition of young and knowledgeable employees; collaboration and mutual respect; sharing the know-how and experiences together with transferring the knowledge to younger generation. Therefore it is time to think of ways how organizations are able to attract skilled and qualified employees, who are committed to their work and the organization.

This way, outstanding talents hospitals wish to attract can be recruited. While the intangible asset of hospital organizational reputation is enhanced, the attractiveness of the hospital to job seekers will be increased, which will help the hospital accumulate important internal human resources capital to achieve a competitive advantage and more desirable performance.

5.2. Limitations of the study and suggestions for future research

Since this study only Nurses from hospitals with different attributes as participants for discussing hospital image and the impact of compensation/benefit system on organizational attractiveness, it is recommended that follow-up research takes on the perspective of individual differences as the starting point in order to explore whether there are other personal attribute factors that produce a mediating effect on the relationship between organizational characteristics and organizational attractiveness.