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The performance of academic medical centers (AMCs) differs from that of other hospitals because AMCs must combine the delivery of patient care with teaching and research.This study investigates the effects of strategic group membership as opposed to other structural determinants on the performance of AMCs.We used data from 24 German AMCs and applied data envelopment analysis with superefficiency to measure the performance of AMCs by considering AMC-specific inputs and outputs for patient care, teaching, and research. We used cluster analysis to identify strategic groups and applied regression analysis to explore their impact on performance.Our results reveal two strategic groups based on a specialization either in teaching or in research. The strategic group that specialized in research showed significantly better performance; structural variables did not play a major role.The results provide an important justification for managers to develop suitable strategic concepts for AMCs. If low organizational efficiency is detected, managers need to consider analyzing whether their AMC belongs to an appropriate strategic group. An emphasis on research may increase overall efficiency.