Toward a Sustainable Competitive Advantage: Evidence From Secondary-level Hospitals in Indonesia

This study addresses the challenge hospitals face in maintaining a Sustainable Competitive Advantage (SCA) amidst the dynamic healthcare industry and resource limitations. The aim is to analyze the factors impacting SCA, focusing on Organizational Capacity for Change (OCC) as a mediating variable and exploring the moderating roles of Competition Intensity (CI) and Organization Inertia (OI). Using a stratified quantitative approach, data from 957 individual respondents and 96 organizational-level respondents across 33 hospitals were analyzed. Multi-stratified equation modeling, along with moderation and mediation analysis, were employed to test the hypotheses. The findings reveal that OI strengthens the relationship between OCC and SCA, while CI enhances the effect of Change Commitment (CC) on OCC. Specifically, the study highlights the critical role of commitment and participation in change processes in shaping OCC within mid-level hospitals. The results suggest that stable systems and structures, coupled with competitive pressures, are essential for translating change into sustainable practices. This research offers valuable insights for hospital management, especially in competitive environments with limited resources, recommending strategies to build a sustainable competitive advantage by fostering organizational change readiness and adaptive decision-making.