Son yıllarda hizmet sektöründeki hızlı gelişmeler, sektör içinde hizmet konusuna verilen önemin bir göstergesidir. İşletmeler sürekli olarak değişen ve gelişen çevre koşullarına uyum sağlayabilmek konusunda çeşitli hizmetlerden yararlanmaktadır. Sektörel farklılık nedeniyle, hizmetlerde sektörlere göre değişim göstermektedir. Her alanda hizmete olan talep gibi, sağlık kuruluşları alanında da giderek artan bir talep söz konusudur. Sağlık kuruluşlarında da önemi giderek artan hizmetin içsel pazarlama yaklaşımıyla çalışanların performansı üzerinde de etkileri yadsınamayacak durumdadır. Bu çalışma, içsel pazarlama uygulamalarının hastane performansı üzerine etkisini inceleyen bir araştırmadır. İçsel pazarlamanın hastane performansı üzerine etkisini incelemek için iki aşamalı bir araştırma tasarlanmış ve hastaneler üzerinde uygulanmıştır. İlk aşamada kavramın ve kavrama yönelik unsurların daha iyi anlaşılabilmesi için keşfedici bir araştırma yürütülmüştür. İkinci aşamada ise, Ahmed, Rafiq, Saad (2003) tarafından geliştirilmiş olan içsel pazarlama karması ölçeği ile hipotezler frekans analizi ve basit regresyon analizi yöntemleri ile araştırma yapılmıştır. Araştırma sonuçlarına göre, içsel pazarlama bileşenleri ve hastane performansı arasında anlamlı ve pozitif yönlü bir ilişki bulunmaktadır. Bu durum hastane yöneticilerinin dış müşterilere verilen önemin içsel müşteri olarak tanımlanan çalışanlara da verilmesi gerektiğinin bilincinde olmalarını sağlarak hastanenin performansını artırmasına da yardımcı olur.

The need of global competitiveness, which the today’s organizations meet as an important advantage as well as a relative disadvantage in the struggle for existence of today’s organizations, force the service based businesses to adaptation and change as well as other businesses for being in global competition. A widely used expression by the people in the community, which is "customer is our benefactor", stresses, that the importance of customers value comes from very old times. In the competitive environments, which are increasing in recent years, for companies, that presents and produces similar products for similar prices and quality, is the customer satisfaction comes as first of distinguishing features. The most important requirement to survive in the ever increasing competitive markets is to capture the customer point of view of the production of products and services and to provide customer satisfaction with producing products and services according to customer requirements. The point to consider of providing customer satisfaction is to satisfy internal customers, and to provide best quality service to external customers by making the internal customers as loyal employees. The rapid progress in the service sector over the past few years indicates the importance attached to the issue of service within the sector. Business enterprises make use of a variety of service in an effort to adapt themselves to the ever-changing and developing circumstances. In the business environment, which earns different dimensions with changing time and values, the structures of customers also shows differences. By considering the possibility of the person performing the purchase, in the situation of people, which are going through to the adoption step after the purchase step, whom requirements are met, to become a regular shopper of the same product, businesses continues their activity by adopting the concept of “I sell what is required by people“ instead of” I sell what I produce”. Also in the service industry, which highlights the human factor, to stand out this idea depends on the satisfaction of employee in terms of morale and finance, by responding their met and needs, and by providing them a comfortable and safety place to work. Ensuring the satisfaction of the employees within the organization provides to create a significant impact on customer satisfaction. Because any problem, which likely to occur by processes in the business, could affect the service, which is being offered to customers, businesses should keep in mind, that the employees are very important factor, by considering their own processes at first. The idea of overlooking the human factor, in terms of to targeting the success in an increasingly competitive environment for businesses, is accepted in work life especially in recent years and this idea take place in the basic elements of organizational culture such as mission and vision. At this point, the concept of the customer is defined in the business as internal and external customers and all business activities focus on this two important concepts, and have begun to show the efforts, which needed to be close to them. In the marketing of internal marketing services, which began to take place in the literature in the 1980’s, emphasizes the importance of the employees. The internal marketing, which qualify the employees as customers, by giving the same importance to customers and the employees, helps to provide customer satisfaction by employee satisfaction. Due to sectoral differences, changes in services differ from Sector to Sector. As in every other field, there is an increasing demand in the field of health organizations. The importance of internal marketing approach is also increasing in health organizations and its impact on the Performance of employees cannot be disregarded. The internal marketing, which is one of the modern marketing approaches, have an important role in terms of implementation in service businesses. In this regard, with result of employee satisfaction and later with customers satisfaction, the occur of applications to increase business performance comes into being. The increasing of business performance can be achieved in hospital businesses just like in all other service sectors, by providing the satisfaction of internal and external customers in the scope of internal marketing. Two basic idea exists under internal marketing concept. Everyone in the organization have a customer and internal customers should be happy in their work for to transport of more effective service to the final customer. There are some important concepts, which needs to carefully emphasize by management such as communications, technology, culture, socialization, orientation, relationship of employee and customer satisfaction for applying the concept of internal marketing, which aims to increase the customer satisfaction by increasing the employee satisfaction. With internal marketing, the commitment of employees to business is increased and the working force turnover decreases, and there are also savings about recruitment, training costs, defective product / service delivery and so on. The resources, which are used for the recruitment of new employees, and training of them could be utilized to achieve the goals such as to develop the skills of existing employees. Also, the decline in the rate of severance leads to less stress by existing employees. As well as the concepts of business, perceptions about the workers in service enterprises, which are in direct contact with the customer, should be considered as an important factor, which determines the customer satisfaction. In service businesses, the employees are in the position, where the connection between the customers and service providers is established. The employees, which have a huge contact with customers, directly affects the business, how it is perceived by the customer. Under the concept of internal marketing, which is a strategy to sharp the business products as to fit the needs of people and a philosophy that employees are treated as customers, lies two basic idea. Two basic idea exists under internal marketing concept. Everyone in the organization have a customer and internal customers should be happy in their work for to transport of more effective service to the final customer. Internal marketing is a planned and similar to marketing effort, which is applied to combine employees for effective implementation of common and operational strategies, to coordinate them functionally and to defeat the resistance to change for achieving customer satisfaction through creation progress of motivated and customer focused employees. With internal marketing, the company can target to achieve external customer satisfaction by organizing the business activities by the satisfaction of both internal and external customers, by housing the capable staff for achieving ultimate company mission and by using all their employees internal communication and other motivating elements. The most important objective of the internal marketing is to plan and establish close and flexible relationships according to employees, for continuously improving their internal processes. In order to maintain business existence, businesses should gain customers, satisfy them, provide the satisfaction, and expenditure all effort to keep the customer. For providing a better service to customers, the training and developing of all employees, the correct orientation, supervision and motivation is very necessary. Because, when the personnel, which offers products or service and have direct contact with customers, is good in human relations, well trained and experienced, the personnel becomes the enterprise's core strength with customer satisfaction. Internal marketing approaches all employees and all departments within the company as internal customer and analyzes the employees and departments with in the company as internal provider. The basic assumption of this approach is to increase the quality of the sevices, which offered to external customers, by increasing the quality of service businesses with internal customers, and because of this, by adding the issue of customer satisfaction to the pointed assumption, the businesses provides emphasizing the importance of issues such as the training, which will provides employees satisfaction, compensation, communication. This paper examines the effects of internal marketing applications on hospital performances. A twofold research to reveal the relation between internal marketing and hospital performance was designed and conducted on hospitals. In the first stage, a research was conducted in order to provide a better understanding of the concept and its basic elements. In the second stage, on the other hand, comprised the internal marketing diversity scale, developed by Ahmed, Rafiq, Saad (2003), as well as a hypothesis frequency Analysis and a Research that used simple regression Analysis methods. According to results of our research, there is a significant and positive correlation between the components of internal marketing and hospital performance. This situation provides a positive contribution to hospital performance by providing the hospital managers with aware of needs to give the importance, that given to foreign employees, to employees, which defined as internal customers.