Strategic planning, budgeting practices, and organisational adaptability under high uncertainty: Evidence from hospitals in Jordan

Hospitals in Jordan operate under conditions of high uncertainty, including funding pressure, rising operating costs, changing patient demand, and disruptions affecting resources and service delivery. These conditions make long-term planning and resource allocation more difficult and require hospitals to remain adaptable while continuing to provide essential services. In this context, strategic planning systems and budgeting practices may support coordination and adaptation, but they may also become rigid if they are used mainly as formal administrative routines or financial control tools. This study examines how strategic planning systems and budgeting practices influence organisational adaptability under conditions of high uncertainty in public and private hospitals in Jordan. The study focuses on hospitals located in Amman and Zarqa. The research adopts a quantitative, deductive, and cross-sectional design based on a structured questionnaire. Data were collected from respondents working in public and private hospitals who were involved in strategic planning, budgeting, finance, management, or related decision-making activities. The final dataset consisted of 168 valid responses collected from 31 participating hospitals out of 38 eligible hospitals approached. The data were analysed using descriptive statistics and SmartPLS. The findings show that perceived uncertainty was positively related to both strategic planning systems and budgeting practices. However, the effect of uncertainty was stronger on budgeting practices, which suggests that uncertainty may appear more directly in the way hospitals manage budgets and allocate resources. The results also show that both strategic planning systems and budgeting practices had a positive effect on organisational adaptability. Strategic planning systems had the stronger effect. The group-based results showed some differences between public and private hospitals in perceived uncertainty and budgeting practices, but not in strategic planning systems or organisational adaptability. This may suggest that the clearer difference between the two sectors appears more in budgeting practices, where private hospitals may have more developed budgeting practices in responding to uncertainty. At the same time, the absence of significant differences in strategic planning systems may indicate that strategic planning exists as a basic managerial foundation in both public and private hospitals. Also, the comparison between top management and middle/functional management did not show significant differences, meaning that the main relationships were generally similar across these two groups. Overall, the study contributes to the literature by examining strategic planning systems, budgeting practices, and organisational adaptability together within the Jordanian hospital context. From a management control and accounting perspective, the study highlights how budgeting operates not only as a financial tool, but also as a mechanism for coordination, priority-setting, and managerial decision-making. Practically, the study offers insights for hospital managers on how to improve planning and budgeting practices in ways that strengthen resource allocation, responsiveness, and organisational adaptability.