Governance of Hospitals in Central and Eastern Europe PDF Download

Author: Przemyslaw Marcin Sowa
Publisher: Springer
ISBN: 9812877665
Category : Business & Economics
Languages : en
Pages : 276

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Book Description
This book presents a novel view of healthcare system transition in post-communist countries. It is the first region-wide comparative study of hospital governance in Eastern Europe. Comprehensive new material shows the evolution and significance of governance, complementing recent publications on the topic from industrialised countries. Throughout the book, governance is described and substantiated as a major component that, together with provider payment mechanisms, defines the hospital sector’s operations. This view subscribes to the economists’ growing appreciation of extra-financial aspects in the discussion of incentives and regulation of healthcare markets. In particular, the book explains how governance arrangements may affect the outcomes of healthcare financing reforms, and should thus be seen as a critical determinant of their success or failure. This new model of thinking about healthcare system transition emerges from an analysis of 22 countries over the course of two decades. While the primary focus of the study is on developing the hospital sector, an extensive background chapter provides a standalone introduction to the dynamically changing landscape of healthcare in Eastern Europe and an overview of the various problems and challenges the region is facing. Practitioners, policy-makers, academics and students interested in Eastern European healthcare systems, their origins, current status and ways forward, will appreciate the book’s reflections on the problem complexity, the clarity of its concepts, and its accessible style of presentation.

Author: Sorin Dan
Publisher: Springer
ISBN: 3319434284
Category : Political Science
Languages : en
Pages : 265

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Book Description
This book engages theoretically and empirically with the unprecedented wave of public management reforms in public hospitals in Europe in the past 25 years. It provides a useful overview of these reforms and studies the way in which they have influenced the ability of national policy-making institutions to co-ordinate the system of public hospitals as a whole. Using a comparative structure, as well as original empirical data collected by the author, the book examines case studies on which little has so far been published for an international audience in English.

Author: Przemyslaw Marcin Sowa
Publisher:
ISBN:
Category :
Languages : en
Pages : 0

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Book Description
This thesis comprises an overview of health care transition in post-communist countries and two original contributions to the subject's literature. The background chapter establishes the meaning of post-communist transformation by presenting key socio-economic changes and characterising health care systems emerging from transition. The first of the two original studies develops, substantiates and statistically applies a model of hospital governance transition. Going beyond the public-private delineation, the model identifies five stages of hospital governance transformation: (1) the integrated Semashko model, (2) decentralised hospital management, (3) devolved hospital ownership, (4) corporatisation, and (5) privatisation of hospitals. Each stage corresponds to a distinct distribution of decision powers, financial risks and residual claims between the sector participants; moreover, it reflects efficiency factors associated with decentralisation. Building on previous studies primarily concerned with financing arrangements, this model constitutes a more complete picture of economic incentives and the managerial capacity in the sector. The econometric analysis of 22 countries over the 22-year period 1989-2010 is based on a random trend model. Notable findings include devolution of ownership leading to increases in acute care lengths of stay, numbers of admissions, and selected measures of mortality attributable to hospital care. Corporatisation of hospitals is found to be associated with increased acute lengths of stay and bed occupancy rates. The findings suggest that decentralisation and autonomisation, as introduced in the region, did not contribute to the intended de-emphasising of inpatient care. Higher utilisation rates coinciding with increased mortality may imply that territorial governments trade-off quality for quantity of care when they are given authority over hospital care provision. Reform design features and resource constraints persistent in the transition systems offer possible explanations of this. The second study examines health care accessibility in seven countries of Central and Eastern Europe, over the five years 2005-2009, through the lens of individual-level unmet needs for examination or treatment. Investigated are the magnitude and nature of access barriers as well as the structure of inequality. The study design based on logit and multinomial logit models of individual socio-economic characteristics permits the interpretation of findings in absolute and comparative terms and shows the problem dynamics. Health care is most easily accessible in the Czech Republic and Slovakia. Affordability issues and prohibitive waiting times are prevalent in Poland and the Baltic States. Mobility and information represent relatively minor access barriers. The poorest households, the unemployed, working age cohorts, and women are more exposed than the population at large to problems in accessing health care. Over the analysed period access conditions generally improved. The outcomes show that substantial differences exist between the countries that constitute an arguably homogenous group of post-communist, new EU member states. This suggests there are policy lessons to be learned from peer transition countries. The nature of access barriers is indicative of gaps in coverage and inadequacy of public sector resources relative to need, which call for systemic solutions.

Author: Richard B. Saltman
Publisher: World Health Organization
ISBN: 9789289002547
Category : Medical
Languages : en
Pages : 0

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Book Description
Governance of public hospitals in Europe is changing. Individual hospitals have been given varying degrees of semi-autonomy within the public sector and empowered to make key strategic, financial, and clinical decisions themselves. This study explores the major developments and their implications for national and European health policy. The study focuses on hospital-level decision-making and draws together both theoretical and practical evidence. It includes an in-depth assessment of eight different country models of semi-autonomy, in the Czech Republic, England, Estonia, Israel, the Netherlands, Norway, Portugal and Spain. The evidence that emerges throws light on the shifting relationships between public-sector decision-making and hospital-level organizational behaviour and will be of real and practical value to those working with this increasingly important and complex mix of approaches. [Ed.]

Author: Joseph C. Brada
Publisher: Routledge
ISBN: 131550247X
Category : Business & Economics
Languages : en
Pages : 320

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Book Description
This volume focuses on the performance of firms as a measure of the effectiveness of corporate governance, and then attempts to draw conclusions about the relative advantages of different ownership structures. The analysis is based on studies of firms in the Czech Republic, Hungary and Poland.

Author: Elias Mossialos
Publisher: Cambridge University Press
ISBN: 0521761387
Category : Business & Economics
Languages : en
Pages : 785

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Book Description
Health system governance in Europe : the role of European Union law and policy / Elias Mossialos ... [et al.] -- Health care and the EU : the law and policy patchwork / Tamara Hervey and Bart Vanhercke -- EU regulatory agencies and health protection / Govin Permanand and Ellen Vos -- The hard politics of soft law : the case of health / Scott L. Greer and Bart Vanhercke -- Public health policies / Martin McKee, Tamara Hervey and Anna Gilmore -- Fundamental rights and health care / Jean McHale -- EU competition law and public services / Tony Prosser -- EU competition law and health policy / Julia Lear, Elias Mossialos and Beatrix Karl -- Public procurement and state aid in national health care systems / Vassilis Hatzopoulos --Private health insurance and the internal market / Sarah Thomson and Elias Mossialos -- Free movement of services in the EU and health care / Wouter Gekiere, Rita Baeten and Willy Palm -- Enabling patient mobility in the EU : between free movement and coordination / Willy Palm and Irene A. Glinos -- The EU legal network on e-health / Stefaan Callens -- EU law and health professionals / Miek Peeters, Martin McKee and Sherry Merkur -- The EU pharmaceuticals market : parameters and pathways / Leigh Hancher

Author: Andrew Coulson
Publisher: Routledge
ISBN: 1136773584
Category : Philosophy
Languages : en
Pages : 172

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Book Description
This book examines the democratic changes that took place in civil society in Central and Eastern Europe after the break up of the Soviet Union.

Author: Bernd Rechel
Publisher:
ISBN:
Category :
Languages : en
Pages : 34

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Book Description
1. The political pressure to change how hospital governance is currently organized comes from a mix of sources, including increasing costs, technological advances, changing patterns of disease, and growing patient expectations.2. This pressure to reform has prompted a review of hospital ownership and a drive, in many countries, to decentralize hospital governance.3. The key trends in decentralizing hospital governance, which may not be compatible with each other, include increasing hospital autonomy and more direct managerial control of hospitals; and decentralization to newly created administrative layers in the health system:- Hospitals with greater autonomy are perceived to be more flexible in meeting the needs of the local population and, thanks to active purchasing, more efficient performers.- Decentralizing hospital governance to allow decision making at the local level is seen as a way of promoting responsiveness to communities and to changing patterns of disease; it is also a means of moving responsibility for funding or adopting technological advances away from central government.4. Despite these apparent merits of decentralized hospital governance, there is an explicit need to:- acknowledge the tension between potential efficiency gains from centralization and the potential to improve responsiveness and flexibility with greater decentralization.- address investment decisions (e.g. strategic planning of hospital infrastructure) to ensure geographical equity and efficiency and to balance this with the 'narrower focus' decision making in a locally run system.5. There are good examples of authorities in systems with decentralized hospital governance collaborating to overcome equity and efficiency concerns, but the specific institutional and political contexts make it difficult to transfer successful models from one country to another.6. More broadly, unless this is supported by the existing country context, policy-makers will struggle to achieve the desired degree of decentralization in hospital governance.

Author: Antonio Durán
Publisher: Springer Nature
ISBN: 3030281728
Category : Political Science
Languages : en
Pages : 242

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Book Description
“This timely book provides insight into the changing role of the ‘hospital’ in the face of technological, organizational innovation and ever-tightening health budgets.”James Barlow, Imperial College Business School, UK “This book covers various relevant aspects of the hospital in different states and contexts. Underlining the importance of business models for future hospitals, this publication presents models of care from a historic and a current perspective. All authors possess a deep insight into different health care systems, not only as scholars but as experts working for world-renowned health policy institutions such as the World Health Organization, the World Bank or the European Observatory for Health Systems.”Siegfried Walch, Management Center Innsbruck, Austria “For an organisation like mine, representing those involved in the strategic planning of healthcare infrastructure, this book provides invaluable insights into what really matters – now and for the future – in the complex and contentious field of hospital development.”Jonathan Erskine, European Health Property Network, Netherlands This book seeks to reframe current policy discussions on hospitals. Healthcare services turn expensive economic resources—people, capital, pharmaceuticals, energy, materials—into care and cure. Hospitals concentrate the use and the cost of these resources, particularly highly-trained people, expensive capital, and embedded technologies. But other areas of health, such as public health and primary care, seem to attract more attention and affection, at least within the health policy community. How to make sense of this paradox? Hospitals choose, or are assigned, to deliver certain parts of care packages. They are organised to do this via “business models”. These necessarily incorporate models of care – the processes of dealing with patients. The activity needs to be governed, in the widest senses. Rational decisions need to be taken about both the care and the resources to be used. This book pulls these elements together, to stimulate a debate.

Author: Colin C. Williams
Publisher: Routledge
ISBN: 1317406931
Category : Business & Economics
Languages : en
Pages : 332

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Book Description
How many businesses start-ups conduct some or all of their trade ‘off-the-books’? And how many enterprises continue to do some of their work off-the-books once they are more established? What should be done about them? Should governments adopt ever more punitive measures to eradicate them? Or should we recognise this hidden enterprise culture and attempt to harness it? If so, how can this be done? What measures can be taken to ensure that businesses start-up in a proper manner? And what can be done to help those enterprises and entrepreneurs currently working off-the-books to legitimise their businesses? The aim of this book is to advance a new way of answering these questions. Drawing inspiration from institutional theory, informal sector entrepreneurship is explained as resulting from the asymmetry between the codified laws and regulations of a society’s formal institutions and the norms, values and beliefs that comprise a society’s informal institutions. The argument is that if the norms, values and beliefs of entrepreneurs (i.e., their individual morality) were wholly aligned with the codified laws and regulations (i.e., state morality), there would be no informal sector entrepreneurship. However, because the individual morality of entrepreneurs differs from state morality, such as due to their lack of trust in government and the rule of law, the result is the prevalence of informal sector entrepreneurship. The greater the degree of institutional asymmetry, the higher is the propensity to engage in informal sector entrepreneurship. This book provides evidence to show that this is the case both at the individual- and country-level and then discusses how this can be overcome. .