Cultural and Institutional Differences in Healthcare Quality Across Three North-American Nations

The meaning of health service quality differs across cultural and institutional contexts. This poses a problem for different stakeholders—patients, healthcare providers, and hospital leaders—when it comes to understanding what constitute quality care and how to provide this care most effectively. Our study sheds light on this issue by empirically examining how country and technology integration influence patient care quality (PCQ) delivered in hospitals in the three contiguous countries of North America—the US, Canada and Mexico. We use survey methodology to empirically test a moderated mediation model, whereby country moderates the mediating role of technology integration on PCQ. The results support our proposed model. Our study has implications for operations, healthcare and international management literature by highlighting the important role of a country’ institutional and cultural attributes on PCQ as well as the role of technology integration and quality leadership in this process. Given the increase in globalization, travel and migration among both healthcare workers and the general population, the results imply that physician and nursing staff should be sensitive to cultural and institutional differences in healthcare stakeholder definitions of quality care, which may ultimately affect hospitals’ ability to provide care for all patients.