Sustainable Competitive Advantage in the Class C Hospital Industry: A Qualitative Study of Strategic Factors in the Tapal Kuda Region of East Java
DOI:
https://doi.org/10.59261/jequi.v8i3.349Keywords:
Sustainable Competitive Advantage, Hospital Strategic Management, Healthcare CompetitivenessAbstract
Background: The healthcare industry is rapidly changing due to technological advancement, policy reform, rising patient expectations, and institutional competition. Class C hospitals in regional areas such as the Tapal Kuda region of East Java face challenges in sustaining competitiveness amid limited resources and dynamic healthcare demands. However, studies on sustainable competitive advantage in the Class C Hospital remain limited.
Objective: This study aims to analyze the strategic factors influencing sustainable competitive advantage in Class C hospitals in the Tapal Kuda region of East Java.
Methods: This study used a qualitative, descriptive-exploratory approach. Data were collected through semi-structured interviews with eight key informants from four Class C hospitals, including hospital directors, heads of medical services, nursing managers, and healthcare administrators. Field observations and institutional document reviews were also conducted. Informants were selected through purposive sampling, and data were analyzed thematically through data reduction, data display, interpretation, and conclusion drawing.
Results: The findings identified six strategic dimensions influencing sustainable competitive advantage: digital transformation, technological innovation, organizational resilience, adaptive leadership, human resource competence, and a patient-centered organizational culture. Electronic medical records and telemedicine were identified as important tools for improving service efficiency, while regional socioeconomic disparities, limited specialist availability, and infrastructure gaps constrained hospital competitiveness.
Conclusion: Sustainable competitive advantage in Class C hospitals is multidimensional and depends on organizational adaptability, innovation capability, strategic flexibility, and contextual responsiveness. Hospitals that integrate technology, develop competent human resources, and implement patient-centered services are more likely to achieve long-term sustainability and competitiveness.
Downloads
References
Anggraeni, S. A., Niska, F., & Nadia, D. (2025). Toward A Sustainable Competitive Advantage : Evidence From Secondary-Level Hospitals In Indonesia. 1–43.
Anggraeni, S. A., Suhariadi, F., Nadia, F. N. D., Aldhi, I. F., Rahmawati, E., Hardaningtyas, D., Sugiarti, R., & Abbas, A. (2026). Organizational Capacity For Change As A Driver Of Sustainable Competitive Advantage In Secondary Level Hospitals In Indonesia. Discover Sustainability.
BPS Jawa Timur. (2024). Statistik Kesehatan Provinsi Jawa Timur 2024 Volume 8, 2025.
Bulo, Y. S., Halim, R. E., & Satrya, A. (2026). Green Innovation As A Force For Competitive Strategy Development And Sustainable Business Performance: A Systematic Literature Review. Cogent Business & Management, 13(1), 2624161.
Bumiayu, A. (2026). Economic Reviews Journal. 5, 320–329. https://doi.org/10.56709/Mrj.V5i1.1054
Du, X. W. N., Lu S, Z. A., & S, T. (2025). “Sustainable Competitive Advantage Under Digital Transformation: An Eco-Strategy Perspective”. Chinese Management Studies, Vol. 19 No. 3 Pp. 758–782. https://doi.org/10.1108/Cms-01-2024-0077.
Hidayatinnisa, N., Setiawati, R. A., & Nurfauziah, S. (2024). The Mediating Role Of Entrepreneurial Resilience In Transforming Environmental Factor Turbulence Into Sustainable Competitive Advantage. January 2025.
Huebner, C., & Flessa, S. (2022). Strategic Management In Healthcare : A Call For Long-Term And Systems-Thinking In An Uncertain System.
Junaid, S. B., Imam, A. A., Balogun, A. O., Silva, L. C. De, Surakat, Y. A., Kumar, G., Abdulkarim, M., Shuaibu, A. N., Garba, A., Sahalu, Y., Mohammed, A., Mohammed, T. Y., Abdulkadir, B. A., Abba, A. A., Aliyu, N., Kakumi, I., & Mahamad, S. (2022). Recent Advancements In Emerging Technologies For Healthcare Management Systems : A Survey.
Karthikeyan, M., Manigandan, R., & Sasirekha, V. (2026). Exploring The Nexus Of Sustainability And Entrepreneurship: A Bibliometric Study Of Green Entrepreneurial Orientation In Smes. International Journal Of Management And Enterprise Development, 25(2), 125–158.
Kementrian Kesehatan. (2023). Profil Kesehatan Indonesia 2023.
Kyambade, M., & Namatovu, A. (2026). Resilient Leadership And Organizational Resilience: Mediation Of Nurses’ Well-Being In Ugandan Healthcare Systems. Leadership In Health Services, 39(1), 90–110.
Lestari, M. W., Sriatmi, A., & Surjoputro, A. (2024). The Impact Of Service Distinction On Durable Competitive Advantage: An Investigation In Private Hospital Outpatient Units During The COVID-19 Pandemic. South Eastern European Journal Of Public Health, 23(2), 310–315.
Lestari, M. W., Surjoputro, A., & Sriatmi, A. (2021). Sustainable Competitive Advantage Strategy In Hospital Industry To Response Policy Change In Indonesia : A Narrative Review. 7(3), 95–100.
Mesut, C. (2026). Competitive Advantage Through Strategic. Bridging Traditional Theory And Emerging Corporate Strategies, 111.
O’shannassy, T. (2008). Sustainable Competitive Advantage Or Temporary Competitive Advantage: Improving Understanding Of An Important Strategy Construct.
Popa, I. (2023). Strategic Orientation Of Romanian Healthcare Organizations From A Contingency Theory Perspective Based On Porter.
Puspaningtyas, N. (2024). Human Development Index (HDI), Stunting Prevalence, And Sanitation Access On Economic Growth In The Tapal Kuda Region, East Java. International Conference On Economics, Businessand Information Technology, 501–506.
Risyani, R., & Rahandri, D. (2022). Pengaruh Capital Intensity , Competitive Advantage , Dan Size Terhadap Corporate Reputation.
Santri, F. A., Saafi, L. O., & Kamalia, L. O. (2021). The Relationship Between The Cost Leadership Strategy And The Quality Of Health Services. 3(2), 1–7. https://doi.org/10.36566/Ijhsrd/Vol3.Iss2/81
Souza, A. M. De, Puglieri, F. N., & Francisco, A. C. De. (2024). Competitive Advantages Of Sustainable Startups : Systematic Literature Review And Future Research Directions.
Sri, B., Astuti, W., Maharani, D., Citra, E. W., & Rohmah, F. (2026). Tinjauan Literatur : Karakteristik Jasa Rumah Sakit Dalam Perspektif Pemasaran Jasa Kesehatan. 6(1), 18372–18377.
Susilowati, K. (2025). Unlocking Sustainable Competitive Advantage In Healthcare : How Workplace Values, Service Culture, And Capabilities Drive Excellence In Hospitals. 9(4), 663–676. https://doi.org/10.55214/25768484.V9i4.6038
Wang, M. C., Chen, P. C., & Fang, S. C. (2021). How Environmental Turbulence Influences Firms’ Entrepreneurial Orientation: The Moderating Role Of Network Relationships And Organizational Inertia. Journal Of Business & Industrial Marketing, 36(1), 48–59.
Downloads
Published
Issue
Section
License
Copyright (c) 2026 Siti Asiyah Anggraeni, Fendy Suhariadi, Fiona Niska Dinda Nadia
This work is licensed under a Creative Commons Attribution-ShareAlike 4.0 International License.
Authors who publish with this journal agree to the following terms:
- Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution-ShareAlike 4.0 International (CC-BY-SA). that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.
- Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.
- Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work.
