Bakgrund och problem: Sverige är ett av de mest hållbarhets medvetna länderna i världen (Robecosam, 2021) med ett stort antal företag som prioriterar och rapporterar CSR-aktiviteter. Med det i åtanke är CSR ett växande intressant ämne vilket är ett omdiskuterat inom akademisk forskning, framförallt vilken effekt den har för företag som implementerar det. Vi valde att utforska vidare på detta i Sverige i förväntan av att se ett samband med förbättrat ekonomiskt resultat för de företag som engagerar sig i CSR.Syfte och bidrag: Föreliggande studie har syftet att undersöka vilken påverkan corporate social responsibility (CSR) har på corporate financial performance (CFP) hos svenska börsnoterade små- och medelstora företag under år 2019. Det forskningen är tänkt att bidra till är ökad förståelse för CSR och vilken betydelse det har för företag som implementerar det. De som kan dra nytta av den informationen är investerare, forskare och företag.Metod: Det valda metodvalet var multipel linjär regression med 1 oberoende variabel, vilket representerar CSR, och 3 kontrollvariabler. Den oberoende variabeln som användes var ESG. De kontrollvariabler som användes var kapitalstruktur, företagsstorlek och ålder. De valda beroende variabler var Return on equity (ROE), Return on assets (ROA) och Tobins Q vilket representerade finansiell prestation (CFP).Slutsats: Föreliggande studiens slutsats var att metodvalet visade sig vara insignifikant och därför kunde inte syftet visa om CSR påverkar CFP positivt. Det rekommenderas därför att använda andra metodval vid undersökning av CSR-CFP relationen hos små- och medelstora företag (SME) i framtida studier. / Background and problems: Sweden is one of the most sustainability-conscious countries in the world (Robecosam, 2021) with a large number of companies prioritizing and reporting CSR activities. With that in mind, CSR is a growing topic of interest which is debated within academic research, especially the effect it has on companies that implement it. We chose to explore this further in Sweden in the expectation of seeing a connection with improved financial results for the companies that engage in CSR.Purpose and contribution: The purpose of this study is to investigate the impact corporate social responsibility (CSR) has on corporate financial performance (CFP) in Swedish listed SMEs during the year 2019. What the research is intended to contribute to, is increased understanding of CSR and what significance it has for companies that implement it. Those who can benefit from the findings of this research paper are investors, researchers and companies.Method: The choice of method was a multiple linear regression with 1 independent variable, that represented CSR, and 4 control variables. The variables used were ESG as the independent variable. For control variables, capital structure, company size and age were used. The selected dependent variables were return on equity (ROE), return on assets (ROA) and tobin's Q which represented corporate financial performance (CFP).Conclusion: The conclusion of the present study was that the choice of method was found to be insignificant and therefore the aim of showing that CSR affects CFP positively could not be confirmed. It is recommended to use other methodological choices when examining CSR-CFP from small- and medium sized enterprises (SME) in future studies.

D. Tech (Department of Business Administration, Faculty of Management Sciences), Vaal University of Technology. / Small and Medium Enterprises (SMEs) are economic drivers and key in job creation in emerging economies. In the past, the difficulties faced by women have deprived them of opportunities to establish and run successful businesses. Previous research reveals that women’s involvement in businesses creates sustainable economic growth, thereby reducing poverty. Women-owned SMEs in South Africa receive minimal government support, and many women lack the resources required to run a business successfully. Ensuring growth and profitability in women-run enterprises can alleviate the extent to which women have been disadvantaged in South Africa. In the Fourth Industrial Revolution, women have a significant role in creating jobs, which can grow the South African economy. This study aimed to determine the influence of strategy implementation in women-owned SMEs in South Africa, specifically Gauteng Province. The study considered constructs such as strategy implementation, financial performance and SME survival in women-owned SMEs. Against this background, a deductive reasoning based quantitative approach was adopted using a cross-sectional survey design to assess the connection between the constructs under consideration. The final sample consisted of 347 women entrepreneurs and managers and employees of selected SMEs in various regions of Gauteng Province. The data collected were analysed using the Statistical Packages for the Social Scientists (SPSS) version 25.0 software. Statistical analyses techniques applied in the study included descriptive statistics, exploratory factor analysis, person correlations and regression analyses. The results of the study showed that corporate and business strategies exert a significant influence on SME financial performance. However, operational strategy was statistically insignificant. Financial performance, in turn, influenced SME survival. Additionally, all three strategies, namely, corporate, business and operational, significantly influenced SME survival. Thus, the financial performance and ultimate survival of women-owned SMEs in South Africa are both dependent on strategy formulation and implementation. The research is practical in that its results may be used as a reference source for ideas in strategy formulation and implementation in stakeholder committees. The results may then be directed towards alleviating the challenges facing women-owned SMEs in South Africa and stimulate their chances of success. The study, therefore, has implications in generating employment, improving the efficiency and effectiveness of women-owned SMEs. Theoretically, the study contributes by closing the gap in literature within the area of the nexus between strategy implementation, financial performance and SME survival in the context of South Africa.

Financial performance measurement plays an important role in leading decision-makers through strategic innovation, such as business model innovation. To convey relevant information, it is important that the practices used to measure financial performance are appropriate to what is being measured. This thesis focuses on the financial performance measurement supporting the transition towards circular business models (CBMs), which has been under-researched. More specifically, this thesis aims to identify the key practices that enable the financial performance measurement of CBMs and support the transition from linear business models to CBMs. Additionally, it seeks to contribute with insights about the financial outcomes of CBMs in the context of sustainable-oriented technologies. This thesis consists of a compilation of three papers, a systematic literature review and two empirical studies. The outset of this thesis lies in the systematic literature review, which examines the financial aspects addressed in CBM literature and in relation to the transition towards CBMs. The empirical studies examine the financial performance measurement practices that support the transition towards two different types of CBMs, namely result- oriented CBMs and sufficiency-driven CBMs. Both studies are based on an action case study, which involved collaborative development of financial performance measurement tools with practitioners from the manufacturing industry. The results of this thesis emphasize the customer-centric aspect of financial performance measurement of CBM. The key practices identified by this thesis suggest considering costs involved in customer-value creation when measuring performance. The findings also highlight the importance of taking the offering perspective for defining the cost structure and engaging with customers early in the transition to reduce uncertainty about future cash flows and hidden costs. Life Cycle Costing (LCC) is proposed as a measurement technique. However, the results suggest adapting the LCC perspective, by addressing providers’ or users’ cost, to satisfy the different needs of decision makers. To cover the long-term returns of the CBM offering, multiple use cycles of the offering and of its underlying assets should be considered in the LCC. In terms of cost management, the findings of this thesis suggest an outside-in approach to reduce costs while enhancing customer value creation and re-creation. Finally, this thesis underscore the necessity of employing the recommended practices from various evaluation perspectives to bolster the iterative transition process toward CBMs. Regarding the financial outcomes of CBMs, this thesis shows that the transition towards CBMs in the context of sustainability-oriented technologies holds promising financial advantages for both providers and customers. Technological innovation and retained product ownership contribute to improving the financial performance of CBMs. / Finansiell prestationsmätning spelar en viktig roll när det kommer till att vägleda beslutsfattare genom strategiska innovationer. Avhandlingen syftar till att identifiera de viktigaste praktiker som möjliggör finansiell prestationsmätning av cirkulära affärsmodeller och som stödjer övergången från linjära affärsmodeller till cirkulära affärsmodeller. Dessutom strävar avhandlingen efter att bidra med insikter om lönsamhet för företag som introducerar cirkulära affärsmodeller i samband med införandet av hållbara teknologier. Denna avhandling består av tre artiklar och en kappa. Artiklarna utgörs av en systematisk litteraturöversikt samt två empiriska studier. Avhandlingens utgångspunkt är den systematisk litteraturöversikten, som granskar de ekonomiska aspekter som behandlas i litteraturen om cirkulära affärsmodeller samt i relation till övergången från linjära till cirkulära affärsmodeller. De empiriska artiklarna undersöker de praktiker för finansiell prestationsmätning som stödjer övergången till två olika typer av cirkulära affärsmodeller. Dessa är resultatorienterade cirkulära affärsmodeller och suffiency-driven cirkulära affärsmodeller. Båda studierna bygger på aktionsbaserade fallstudier som involverar samarbete med stora tillverkningsföretag. Avhandlingens resultat framhäver ett kundcentrerat perspektiv vid finansiell prestationsmätning av cirkulära affärsmodeller. En av de viktigaste praktikerna för prestationsmätning som identifierats betonar vikten av att hänsyn tas till kostnader som är involverade i att skapa kundvärde. Resultaten understryker också vikten av att överväga hela erbjudandet som perspektiv när kostnadsstrukturen definieras. Beräkning av livscykelkostnaden (LCC) föreslås som mätmetod. Resultaten visar dock på vikten av att LCC anpassas genom att ta hänsyn både till leverantörers och användares kostnadsstrukturer för att tillgodose beslutsfattares olika behov. För att möjliggöra en långsiktig lönsamhet i en cirkulär affärsmodell bör flera användningscykler för den ingående tillgången ingå i erbjudandet till kund redan vid affärsmodellens designstadium. Cirkulära erbjudanden kan medföra både ökade och reducerade kostnader samt kassaflödesförändringar på systemnivå. Dessa förändringar föreslås att inkluderas i mätningen av cirkulära affärsmodellers finansiella prestation. Vidare framhåller resultaten behovet av att använda föreslagna praktiker utifrån olika utvärderingsperspektiv för att stödja en övergångsprocess mot cirkulära affärsmodeller. Slutligen, när det gäller lönsamheten för cirkulära affärsmodeller indikerar avhandlingens resultat att övergången från linjära till cirkulära affärsmodeller medför potentiella ekonomiska fördelar för både leverantörer och kunder. Teknologisk innovation samt behållande av produktägande i en cirkulär affärsmodell kan bidra till att förbättra en industriell tillverkares ekonomiska prestation. / <p>Funding agencies: MISTRA REES, VINNOVA, Division of Business Administration at Linköping University</p>

Denna uppsats syftar till att förklara samband mellan insynsägande och svenska börsnoterade företags finansiella prestation. Insynsägande definieras i uppsatsen som andelen ägande innehavd av styrelse och företagsledning. Finansiell prestation operationaliseras i uppsatsen som Tobin’s Q och ROIC. Syftet uppnås genom en kvantitativ analys av sekundärdata inhämtad från Holdings och Börsdata för perioden 2017-2022. Resultatet framställs genom korrelationer, deskriptiv statistik och regressionsanalyser. Utfallet kan inte styrka att insynsägande har någon signifikant effekt på finansiell prestation. Det kan med anledning av resultatet inte bevisas att svenska börsnoterade företags finansiella prestationer påverkas av insynsägandets omfattning. Då studien är genomförd på ett stort urval bör utfallet ligga nära hela populationen, vilket innebär samtliga bolag noterade på Large- och Mid cap. Den bristande effekt insynsägande har på finansiell prestation förklaras främst av stewardship-teorin och av de särdrag som definierar nordisk bolagsstyrningskultur. Studien har kunnat bidra till att fylla kunskapsluckan kopplat till insynsägande i Norden. / This essay aims to explain the relationship between insider ownership and the financial performance of listed Swedish companies. Insider ownership is in this essay defined as the share of ownership held by the board and the company's management. Financial performance is operationalized in this essay using Tobin's Q and ROIC. The purpose is achieved through a quantitative analysis of secondary data obtained from Holdings and Börsdata for the period 2017-2022. The results are obtained through correlations, descriptive statistics, and regression analyses. The findings do not provide evidence that insider ownership has any significant effect on financial performance. Consequently, it cannot be proven that the financial performance of listed Swedish companies is affected by the extent of insider ownership. As the study is conducted on a large sample, the outcome should be close to the entire population, which includes all companies listed on the Large- and Mid cap. The lack of impact insider ownership has on financial performance is primarily explained by the stewardship theory and by the characteristics that define the Nordic corporate governance culture. The study has been able to contribute to filling the knowledge gap linked to insider ownership in the Nordic region.

Mergers and acquisitions (M&amp;A) are a popular way of growing a company. This is challenged by previous research that shows that an M&amp;A-transaction generally harms the financial key metrics of the acquiring company. The main focus of this report is to examine if there is an effect on financial ratios for Scandinavian companies partaking in an M&amp;A as an acquirer. The effect is captured by the movements in the key metrics return on equity (ROE), return on assets (ROA), return on invested capital (ROIC), EBIT-margin. In addition, both ESG-ranking and underlying non-financial values, like if the deal was domestic or not, the age of the executives and board gender diversity, are looked at for a better understanding of what differences there are between the performance of M&amp;As.  A database of Scandinavian companies acting within Europe was created containing the specific deal characteristics over a period of three years prior as well as three years after the deal. The statistical methods used to analyze this data were Wilcoxon signed-rank test, bivariate Pearson Correlation and Independent Samples t-test. The generated results in the aggregated dataset showed a negative performance of ROE and ROIC in the period after the deal, compared to the period prior to the deal. This result was also seen in the sub-set of foreign deals with an additional negative performance of ROA for the acquirer while the sub-set of domestic deals did not show any significant negative performance in the period after the deal. We found that it was not possible to analyze the post-period effect on ESG-ranking as the data for our included companies was too scarce. Our findings suggest, when looking at our certain key metrics, that M&amp;A-transactions are not economically justified and that executives might be partially motivated by something other than economic performance when deciding upon an M&amp;A. It is furthermore possible to conclude that the disclosing of ESG data has not been a priority for companies in the past and continues to be ignored by the masses which makes it difficult to progress academically in this field.

Titel: Är det lönsamt att investera i hållbarhet?   Nivå: Examensarbete på grundnivå (kandidatexamen) i ämnet företagsekonomi   Författare: Haben Ablelom Gebremeskel   Handledare: Jan Svanberg   Datum: 2024 – Mars   Syfte: Företag i dagens samhälle befinner sig i en allt mer påträngande situation där de måste arbeta hållbart eller bedriva verksamhet på ett hållbart sätt, och detta har blivit centralt sedan flera år tillbaka. I och med att hållbarhet blir allt mer viktig och finansiella sektorn spelar en viktig roll för länders samhällsekonomier började forskningsvärlden undersöka sambandet mellan ESG-betyg och företagens finansiella prestationer. Mycket av den tidigare forskning har presenterat varierande och motstridiga resultat. Till följd av detta undersöker denna studie sambandet mellan finansiella sektorns finansiella prestationer och ESG-betyg. Studiens syfte är att undersöka samt analysera om det finns ett samband mellan företagets ESG-betyg och finansiell prestation inom den europeiska finanssektorn.   Metod: Studien använder sig av en kvantitativ metod som tillämpar en deduktiv ansats. Den sekundärdata som använts har hämtats ifrån Refinitiv Eikon. Studiens urval består av 160 finansbolag som verkar i 23 olika länder inom den europeiska kontinenten, dessa företag har analyserats under en tidsperiod på 3 år. Studiens data har analyserats med hjälp av bivariat-, univariat- och multivariat analys.   Resultat och slutsats: Resultatet visade inte på något signifikant samband mellan ESG-betyg och finansiella prestationer, men inte heller mellan S-betyget samt G-betyget och finansiella prestationer. Resultatet visade ett signifikant positivt samband mellan den enskilda dimensionen E-betyget och ROA. Utifrån legitimitet- och intressentteorins antaganden stärker företag som engagerar sig i just miljöfrågor sitt legitimitet och förtroende hos företagets intressenter och i samhället.   Examensarbetets bidrag: Denna studie bidrar med en uppdaterad analys angående sambandet mellan hållbarhetsrapportering och finanssektorns finansiella prestationer. Studiens resultat bidrar med nyttig information för finanssektorns samtliga intressenter. Utifrån studiens resultat kan det konstateras att investerare, intressenter och bolag som engagerar sig i just miljöfrågor får en tydlig förklaring då studie fann ett signifikant samband mellan miljöaspekten och företagets finansiella prestationer, resterande resultat visar att europeiska finanssektorn är fortsatt till intresse för forskningsvärld.   Förslag till framtida forskning: Ytterligare undersökningar bör göras gällande relationen mellan ESG-betyg och finanssektorns finansiella prestationer, ett förslag till framtida forskning är att inkludera ytterligare variabler som står i förhållande till studerade ämnet. Detta kan göras genom att använda sig av olika databaser som publicerar företagens ESG-betyg, på så sätt kan antalet av både beroende och oberoende variabler få en ökning vilket ökar studiens trovärdighet.

Le aziende a controllo familiare sono considerate in molti Paesi la struttura proprietaria dominante, e la ricerca accademica si è progressivamente concentrata negli ultimi decenni sugli aspetti peculiari che differenziano le aziende familiari dalle altre strutture proprietarie. Nonostante questa convergenza, molti studi hanno sviluppato teorie contrastanti, in modo particolare sulla capacità delle aziende familiari di generare performance finanziarie superiori. Di converso, pochi studi hanno concentrato l’attenzione sulle scelte strategiche che posso spiegare il (maggiore o minore) differenziale di performance delle aziende familiari. Partendo dall’assunto che punti di forza e di debolezza possano coesistere nelle aziende familiari, identificare se siano gli uni o gli altri a prevalere è una sfida complessa se non si prendono in considerazione le scelte strategiche effettuate dalle aziende familiari. Partendo da questo gap nella letteratura, il presente lavoro cerca di misurare l’impatto che la proprietà familiare può avere sulle performance aziendali concentrandosi su tre aspetti principali della strategia d’impresa: il livello di conformità strategico alla media di settore (mediante la creazione di un indice che approssima le principali determinanti della business strategy), l’avvio di un processo di internazionalizzazione attraverso investimenti diretti esteri (IDE), e le implicazioni delle strategie di acquisizione. / The family business is widely considered the dominant property structure around the world and the research on this field has increased rapidly in the last decades to understand whether and in which aspects family firms differ from other organizations. Despite this convergence, the actual body of research on family firms is populated by conflicting theories and findings, especially on the relationship with financial performance. On the other hand, few studies focus their attention on which strategic choices may explain the financial differences between family firms and non-family peers. Starting from this research gap, we think that both positive and negative aspects may coexist in family firms, and it would be difficult to identify which predominate without considering how family principals frame strategic decisions. In our thesis, we try to disentangle the effect of family ownership on firm performance focusing on three main aspects of firm strategy: the level of strategic conformity through the creation of a composite index (in which we incorporated six items that can be considered as key determinants of the business strategy), the departure of the internationalization process through foreign direct investments (FDI), and the implications of acquisition strategies.

This research explores the relationship between the organisational culture and financial performance of a South African investment bank by means of quantitative research. The Denison Organizational Culture Survey was used to measure the organisational culture of the investment bank and was administered to a sample of 327 employees. Income statement ratio analysis was selected as a means to assess the financial performance. The results indicate that very few of the financial measures selected could be shown to be correlated with the organisational cultural traits or subscales. Correlations between the cultural dimensions of team orientation, agreement, customer focus and vision were found with certain financial measures. Although these correlations were above the 0.50 level, the levels of significance were not sufficient in all cases to draw conclusions with confidence. The only cultural trait that was found to be correlated with financial measures was the consistency trait. / Industrial and Organisational Psychology / M.Com. (Industrial and Organisational Psychology)

This study explores the financial performance measurement of South Africa's Top Companies. It aims to find a conclusion on the research problem, that is 'Do South Africa's Top Companies use the available arsenal to measure their financial performance?' Commerce and industry are the cornerstones of the economy of a country. This study purports to contribute to the ways and means of minimising the risk of business failures due to the resultant effects on the economy. The sample comprises of sixty companies. The sampling frame is the first hundred companies of the Financial Mail 200 Top Performers for 2004. The arsenal that is available to measure financial performance is researched in the financial literature. Mainly, this covers ratio analysis and interpretation, and the bankruptcy prediction models. To arrive at a conclusion on the research problem, a research instrument is developed from the host of financial ratios in the literature, including the bankruptcy prediction models. The research instrument comprises of popular ratios that are also found to be 'logical', as well as the ratios that make up the Z-Score bankruptcy prediction model. The instrument is called the Ratio Map and Z-Score and is applied to test the financial strengths/weaknesses of the Top Companies. In addition to the Ratio Map and Z-Score, the measures applied by the Top Companies as 'highlights' are analysed. This is done to determine the extent at which the measures unearth the strengths/weaknesses of the Top Companies. The conclusion drawn is that the Top Companies do not utilise the available arsenal to measure their financial performance. The supporting evidence is that the most frequently applied 'highlights' measures by the Top Companies cover only one area of the many financial fields of a company, that is, share performance. On the other hand, the analyses per Ratio Map and Z-Score have not revealed major material weaknesses in the financial position of the Top Companies. It is proposed that: ïf  More information be given in the notes to the financial statements to facilitate meaningful analysis; and ïf  A follow-up research study be done to assess the trends of the Top Companies. / Business Management / D.Comm. (Business Management)

所有權結構、支付制度與競爭係影響醫院績效之關鍵因子，本研究援用相關文獻之發現，推論出三項因素對醫院績效之關係，並以我國獨特之總額預算制度為研究對象，蒐集、串連與合併不同來源之資料，實證檢視衝量競爭與所有權結構對醫院營運績效與醫療品質之聯合效果。 台灣於民國91年7月實施醫院總額預算制度後，浮動點值制度之設計為醫院間引入了衝量競爭(即虛假價格競爭)，而結算後之點值則係反映出醫院間衝量競爭後之結果，醫院除了需面對支付點值所致之財務衝擊外，尚須面對自全民健保實行後，備受醫院詬病之核減制度之衝擊，因此，本文首先嘗試估算醫院受到核減與支付點值所致之財務衝擊程度。無論是國外或國內之研究，對於不同所有權結構醫院之績效表現是否有差異性，一直無法獲得一致性之結論，除了納入營運效率之績效指標外，本研究亦採用疾病別與醫院層級別之醫療品質指標來檢視不同所有權結構醫院之績效表現。更以考量核減與支付點值所致之財務衝擊程度，取代目前文獻僅以總額前、後之二元變數，評估財務衝擊程度對營運效率、醫療品質與財務績效之影響。最後，則是檢視總額預算制度下，醫院受到之財務衝擊度是否會縮小不同所有權結構醫院之營運效率與醫療品質表現之差距。 實證研究發現，不同所有權結構醫院之營運效率並未有顯著差異，但不同所有權結構醫院在某些疾病別品質指標(子宮肌瘤切除手術之住院超過7日機率與再入院率)與醫院層級品質指標(院內感染率與淨死亡率)表現上則有差異性；且公立或非營利醫院受到核減與支付點值之財務衝擊高於私立醫院，因此不同所有權結構醫院之行為與績效存有某些差異性。台灣的醫院在總額預算制度下，若受到之財務衝擊程度愈大，其營運效率會變差、醫療品質也受到負面之影響、財團法人醫院之醫務利益率與稅後淨利率也會降低，但現金流量比則會增加，故財務衝擊愈大，醫院之績效愈低。若同時考量財務衝擊度對不同所有權結構醫院之營運效率與醫療品質之聯合效果後，可發現財務衝擊雖然不會縮小公立(或非營利)醫院與私立醫院營運效率之差距，卻縮小公立(或非營利)醫院與私立醫院醫療品質之差距，故以台灣資料可部分支持「不同所有權結構醫院績效差距縮小之因素係競爭力量之崛起」之論點。 / Hospital ownership, payment system and competition are all key drivers to influence hospital performance. This research infer and depict the association of these three drivers from the related literature and empirically examined the effects of fictitious price competition due to the floating point-value system and ownership on hospital operational performance and quality of care by combing and merging different sources of data. Deduction rate of claim and the floating point-value system are the two controversial debates to the payment system. I attempt to estimate hospital financial pressures as precipitated by deduction rate of claim and floating point-value system. To investigate whether for-profit, not-for-profit, and government hospitals differ in operating performance and quality of care, five diagnose-level and two hospital-level quality indicators are selected. Different from prior research, the financial pressure is captured by hospital data instead of a binary variable (pre and post global budget) and I examine the effect of financial pressure on hospital operational efficiency, quality of care and financial performance. Finally, we test whether differences in operational efficiency and quality care among hospitals with different ownership forms will mitigate or narrow, as hospital financial pressure increases. The results show that for-profit, not-for-profit and government hospitals are far more alike than different in operational efficiency, but ownership affects not only the rate of readmission and the rate of the length of stay larger than 7 days of uterine myomectomy, but also the hospital-level quality indicators: the rate of nosocomial infection and hospital mortality rate. I also find higher financial pressure incurred at government or not-for-profit hospitals than for-profits hospitals. Given my findings, we conclude that hospital ownership status affect performance in terms of quality of care and financial pressure from rate of deduction and float point-value system. The study shows that financial pressure adversely affects operational efficiency and quality of care. As not-for proprietary hospital financial pressure increases, the profit margin and net profit ratio will decrease, but the cash flow ratio will increase. Nonetheless, deduction rate of claim and global budget has a negative impact on hospital performance. This research further considers the joint effect of financial pressure on difference between quality of care and efficiency of for-profit hospitals and the other two types. My results indicate that hospital financial pressure mitigates the difference of quality of care between for-profit hospital and not-for profit (or government) hospitals, but does not narrow the difference in quality of care between for-profit hospital and not-for profit (or government) hospitals. This finding partly supports that increased competition should force not-for-profit (or governmental) hospitals to be increasingly similar to their for-profit counterparts.