<![CDATA[This review critically examines whether market orientation (MO), dynamic capabilities (DC), and competitive advantage (CA) explain distinct portions of hospital performance and whether a coherent integration can be proposed without assuming causality. Three complementary Scopus searches covering 2000–2026 and conducted on 3–4 October 2026 returned 2,586 records. After 680 overlaps/duplicates and 499 non-primary document types were removed, 1,407 records were screened, 44 assessed for eligibility, and 34 included (MO 13; DC 13; CA 8). An auditable source inventory and a design-sensitive narrative evidence map were used; neither pooled effects nor formal risk-of-bias scores were produced. MO–performance associations were generally favorable but often operated through service innovation or competencies and sometimes varied by context. Organizational DCs were linked to performance, while flexibility and adaptability provided adjacent rather than interchangeable evidence. CA–performance evidence was thinner than CA-formation evidence, with non-financial and financial results differing. No included study tested the complete MO → DC → CA → performance sequence. The framework differentiates intelligence acquisition, repeatable resource reconfiguration, relative value positioning, and independently observed hospital outcomes. The proposed links are hypotheses, not an established serial mechanism. Single-database coverage, single-reviewer screening, abstract-based verification for some reports, and selective CA eligibility limit inference.]]>
