A multi-dimensional SWOT-based strategic planning framework for tertiary public hospitals during the 15th Five-Year Plan period

A case study at one large tertiary public hospital in Shenzhen found that multi-dimensional SWOT analysis can translate assessments of internal capacity and external conditions into a four-part strategic planning framework. Researchers surveyed 531 hospital staff members and external stakeholders, evaluated the hospital across 14 performance dimensions, and collected open-ended suggestions for institutional planning. The resulting matrix combined four strategy types—SO, ST, WO and WT—to connect identified strengths, weaknesses, opportunities and threats with corresponding planning responses.

The empirical study examined strategic planning for the hospital during China’s 15th Five-Year Plan period. Internal staff members accounted for 478 respondents, or 90.02% of the sample, while 53 external stakeholders represented 9.98%. A self-designed semi-structured questionnaire used a five-point Likert scale to assess overall organizational performance, while its open-ended questions gathered planning proposals.

Frequency statistics and cross-analysis were applied to the responses to construct the SWOT analysis. The authors characterized the smaller external group as supplying complementary validation rather than an equally balanced stakeholder perspective. The analysis identified service attitude and humanistic care, the hospital’s geographical location, and community health center construction as its core internal strengths.

Its main weaknesses were insufficient competitiveness in academic disciplines, a lack of high-level talent, and insufficient competitiveness in employee compensation. On the external side, national and local policy support and regional economic development emerged as the leading opportunities. Competition from surrounding hospitals and cost-control pressure associated with medical insurance payment reforms were the foremost threats.

Three-dimensional cross-validation showed that the perceived service advantage was consistent with service attitude receiving the highest score in the scale-based assessment and improving service levels appearing frequently in open-ended suggestions. Weaknesses in research capability and talent cultivation also received low scale scores, aligning with comments about disciplinary competitiveness and the shortage of high-level talent. These findings were organized into a strategic planning matrix containing four forms of action.

The authors’ stated contribution is to move SWOT analysis beyond environmental description and use it as a prescriptive planning framework. The study was designed to demonstrate and empirically test the framework through a single-hospital case rather than to evaluate a broad sample of hospitals. Its evidence base combines quantified performance perceptions with open-ended input from both internal and external stakeholders, while three-dimensional cross-validation checks the consistency of major findings.

The concentration on one institution and the predominance of internal staff limit how widely the specific diagnoses can be generalized. The authors nevertheless argue that the methodological structure and generic SO, ST, WO and WT strategic archetypes may be adaptable to hospitals in other healthcare systems, provided that local contextual factors are incorporated. The case offers a structured way to derive hospital strategies from combined performance ratings, stakeholder comments and SWOT evidence, with the hospital-specific findings serving as a worked planning example for tertiary public hospitals.

Subject of Research: Development and empirical testing of a SWOT-based strategic planning framework for tertiary public hospitals

Article Title: A multi-dimensional SWOT-based strategic planning framework for tertiary public hospitals during the 15th Five-Year Plan period

Article References: Wu, X., Yang, Q., Liang, Y., Zhao, W., Wang, W., Ahmad, I. S., Fang, Z., & Wu, B. (2026). A multi-dimensional SWOT-based strategic planning framework for tertiary public hospitals during the 15th Five-Year Plan period. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15797-0

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15797-0

Keywords: SWOT analysis, hospital strategy, tertiary public hospitals, health services research, stakeholder surveys, Shenzhen, hospital performance, strategic planning, medical insurance reform, workforce talent, multi-dimensional, SWOT-based