Leadership Styles and Its Outcome in Mongolian Hospitals

Abstract

Aim: This study investigates differences in clinical leadership styles between rural and urban public hospitals in Mongolia, comparing these against international benchmarks to identify insights for policy and administrative improvement.

Material and methods:  This study was conducted using quantitative method, multicentre cross-sectional design, sampling 1,458 healthcare professionals from 12 sites across Mongolia, including both urban and rural regions. Stratified random sampling ensured diverse geographical representation. The MLQ-5X questionnaire was used to assess leadership styles and outcomes after validating the tool’s reliability in Mongolian version by principal component analysis. The score of leadership style and outcome were compared with European Reference Score (ERS) using one sample T-test.

Results: Compared with ERS, Mongolian hospital managers employed significantly lower transformational and transactional leadership styles. Passive-avoidant leadership style was significantly more prevalent compared with ERS in both settings (p<0.001). Leadership outcome scores of heads of departments and directors of hospitals were lower than ERS.  

There was no statistical difference between rural and urban ratings of transformational leadership. Passive/avoidant leadership was rated slightly lower in rural areas. All components of transformational leadership were strongly and positively correlated with leadership outcomes such as Extra Effort, Effectiveness, and Satisfaction, with correlation coefficients ranging from r = 0.684 to 0.876 (p < 0.01). Leadership outcomes such as effectiveness, satisfaction, and extra effort were perceived similarly across both settings, indicating broadly consistent leadership practices across geographic regions.

Conclusions: Passive-avoidant leadership style is the dominant approach among both settings. Contrary to expectations, leadership style perceptions did not significantly differ between rural and urban healthcare settings in Mongolia. This suggests a relatively uniform leadership culture within the public health sector. Policymakers and administrators in Mongolia should enhance leadership training oriented to transformational and transactional styles to improve performance across diverse healthcare environments.