Abstract

This study examines the relationships among leader-member exchange, organizational commitment, job engagement, and employee job performance in hospitals in Ho Chi Minh City. Drawing on social exchange theory and engagement theory, the research model was developed with five hypotheses, in which organizational commitment and job engagement serve as mediators between leader-member exchange and job performance. Using survey data from 405 healthcare employees and the PLS-SEM method with SmartPLS 4, the findings reveal that leader-member exchange positively influences organizational commitment, job engagement, and job performance. Furthermore, job engagement plays a stronger mediating role than organizational commitment in the relationship between leader-member exchange and job performance. These findings suggest  several managerial implications, such as enhancing humanistic leadership skills, designing meaningful jobs to strengthen engagement, and fostering an organizational culture that promotes sustainable job performance. The research contributes theoretically by clarifying the distinct mediating roles of commitment and engagement, while also providing practical evidence for the healthcare sector in the context of public human resource management reform.