Antecedents of hospital resilience: integrating resources, capabilities, and contingencies

Hospitals play a crucial role in crisis response, and their capacity to remain resilient relies on key technological and informational assets, such as information and communication technologies (ICTs), digital skills, and information integration capabilities. While prior research has acknowledged the relevance of these assets, findings remain inconsistent due to varying contextual conditions. Drawing on the Contingent Resource-Based View (CRBV), this study develops a research framework that examines not only the direct effects of technological and informational resources and capabilities on hospital resilience but also the moderating role of two operational contingencies: service complexity (measured through service variety and case mix index) and operational efficiency (measured through average length of stay, bed occupancy rate, and turnover interval). Using a dataset that combines primary survey and secondary data, the proposed framework was tested through hierarchical moderated regression analysis. Results confirm the positive effects of ICTs, digital skills, and information integration on hospital resilience. Furthermore, operational efficiency moderates the relationships between ICTs and digital skills and resilience, while service complexity moderates only the relationship between internal information integration and resilience. No moderating effect of operational efficiency was observed for information integration capabilities, suggesting that efforts to enhance coordination should be pursued irrespective of efficiency levels. These findings highlight the need for context-sensitive strategies when leveraging digital resources to build resilient healthcare systems.