Abstract
The determinants of health status depend on public health measures and curative and care services. “Hospitals” as organizations concentrate resources—physical capital and human capital, and technology—and thereby do things which other settings simply cannot. Yet, somehow, they mean different things to different people at different times and different places. Hospitals should be defined by their functions, not by their attributes. It is evident that the trade-off in concentrating resources does not always work out well. We lay out an approach to thinking about the role of hospitals, based around their governance, business models, and system and institutional models of care. We bear in mind contingencies of ownership and payment mechanisms, and pull this all together by reflecting on decision analysis.
This is a preview of subscription content, log in via an institution to check access.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Notes
- 1.
Arrow refers to “…the operation of the medical-care industry and the efficacy with which it satisfies the needs of society…” (op. cit., p. 141) whilst emphasizing the pervasive uncertainty which implies this can never be a classically competitive market.
- 2.
“The fact that the share of older people in the population is growing faster than that of any other age group, both as a result of longer lives and a lower birth rate, should generate an automatic increase in the average. However, this intuition finds little support in the data and assessing the effect of population ageing on health and health care has proved to be far from straightforward,” op. cit. p. 68.
- 3.
The Netherlands Board for Health Care Institutions published in 2006 a document explaining that each hospital has four different functional areas: a “hot floor”, with all capital-intensive functions—operating rooms, diagnostic imaging and intensive care facilities; a hotel-like area for residential low-care nursing function; some offices for administration, staff departments and outpatient care; and utility facilities housing energy services, kitchens and not primary production line functions)—see also Chap. 10.
References
Aiken, L., et al. (2012). Patient Safety, Satisfaction, and Quality of Hospital Care: Cross Sectional Surveys of Nurses and Patients in 12 Countries in Europe and the United States. British Medical Journal, 344. https://doi.org/10.1136/bmj.e1717.
Arah, O. A., et al. (2006). Conceptual Framework for the OECD Health Care Quality Indicators Project. International Journal of Quality Health Care, 18(Suppl. 1), 5–13.
Arrow, K. J. (1963). Uncertainty and the Welfare Economics of Medical Care. The American Economic Review, 53(5), 941–973.
Busse, R., Geissler, A., Quentin, W., & Wiley, W. (2011). Diagnosis-Related Groups in Europe: Moving Towards Transparency, Efficiency and Quality in Hospitals. Maidenhead: Open University Press. World Health Organization on Behalf of the European Observatory on Health Systems and Policies.
Center for Global Development Hospitals for Health Working Group. (2015). Better Hospitals, Better Health Systems, Better Health, a Proposal for a Global Hospital Collaborative for Emerging Economies. (Washington) Box 1. What Is a Hospital? Retrieved from http://www.cgdev.org/sites/default/files/Hospitals%20for%20Health,%20Consultation%20Draft.%209.22.14.pdf.
Christensen, C. (2009). The Innovator’s Prescription a Disruptive Solution for Healthcare (p. 101). New York: McGraw Hill.
Cochrane, A. (1971). Effectiveness and Efficiency. Random Reflections on Health Services. London: The Nuffield Provincial Hospital Trust. Retrieved from http://www.nuffieldtrust.org.uk/sites/files/nuffield/publication/Effectiveness_and_Efficiency.pdf.
de la Maisonneuve, C., & Martins, J. O. (2015). The Future of Health and Long-Term Care Spending. OECD Journal: Economic Studies, 2014(1), 61–96.
Donabedian, A. (1980). Explorations in Quality Assessment and Monitoring, Vol. 1. The Definition of Quality and Approaches to Its Assessment. Ann Arbor: Health Administration Press.
Donkin, A., Goldblatt, P., Allen, J., et al. (2017). Global Action on the Social Determinants of Health. British Medical Journal Global Health, 3, e000603. https://doi.org/10.1136/bmjgh-2017-000603.
Dubos, R. (1959). Mirage of Health: Utopias, Progress, and Biological Change. New York: Harper & Row.
Duran, A., Saltman, R. B., & Dubois, H. F. W. (2011). A Framework for Assessing Hospital Governance. In R. B. Saltman, A. Duran, & H. F. W. Dubois (Eds.), Governing Public Hospitals, Reform Strategies and the Movement Towards Institutional Autonomy. Brussels: European Observatory on Health Systems and Policies. Observatory Studies Series No. 25, 38.
Ettelt, S., Nolte, E., Thomson, S., & Mays, N. (2008). Capacity Planning in Health Care: A Review of the International Experience. International Healthcare Comparisons Network. Copenhagen: European Observatory on Health Systems and Policies. Policy Brief.
Evans, R., Barer, M., & Marmor, T. (1994). Why Are Some People Healthy and Others Not? New York: Aldine de Gruiter.
Figueras, J., McKee, M., Lessof, S., Duran, A., & Menabde, N. (2008). Health Systems, Health and Wealth: Assessing the Case for Investing in Health Systems? Tallin Conference. Background Document. Copenhagen: World Health Organization – EURO.
Herrera, C. A., Rada, G., Kuhn-Barrientos, L., & Barrios, X. (2014). Does Ownership Matter? An Overview of Systematic Reviews of the Performance of Private For-Profit, Private Not-for-Profit and Public Healthcare Providers. PLoS One, 9(12), e93456. https://doi.org/10.1371/journal.pone.0093456.
Joumard, I., André, C., & Nicq, C. H. (2010). Health Care Systems: Efficiency and Institutions. Paris: OECD, Economics Department Working Papers, No. 769, ECO/WKP (2010)25.
Kringos, D. S., Boerma, W. G. W., Hutchinson, A., & Saltman, R. B. (2015). Building Primary Care in a Changing Europe. Copenhagen: European Observatory on Health Systems and Policies, Observatory Studies Series No. 38. Retrieved from https://www.ncbi.nlm.nih.gov/books/NBK458728/.
Magretta, J. (2002). Why Business Models Matter. Harvard Business Review, 80(5), 86–92, 133.
McKee, M., & Healy, J. (Eds.). (2002). Hospitals in a Changing Europe. Buckingham: Open University Press. European Observatory on Health Systems and Policies.
McKeown, T. (1965). The Modern Rise of the Population. London: Blackwell Scientific Publications.
Miller, T. S. (1997). The Birth of the Hospital in the Byzantine Empire. Baltimore, MD: Johns Hopkins University Press, quoted in M. McKee and J. Healy (Eds.), Hospitals in a Changing Europe. Buckingham: Open University Press, 2002, European Observatory on Health Systems and Policie.
Murray, C. J., & Frenk, J. (2000). A Framework for Assessing the Performance of Health Systems. Bulletin of the World Health Organization, 78(6), 717. Geneva: World Health Organization.
Nolte, E., & McKee, M. (2008). Measuring the Health of Nations: Updating an Earlier Analysis. Health Affairs, 27(1), 58–71.
Oxford English Dictionary. (n.d.). Retrieved July 18, 2018, from https://en.oxforddictionaries.com/definition/hospital.
Peters, B. G. (2004). Back to the Centre? Rebuilding the State. In A. Gamble & T. Wright (Eds.), Restarting the State (pp. 130–140). London: Blackwell Publishing.
Preston, S. H. (1980). Causes and Consequences of Mortality Declines in Less Developed Countries in the Twentieth Century. In R. A. Easterlin (Ed.), Population and Economic Change in Developing Countries (p. 315). Chicago: University of Chicago Press.
Rechel, B., Erskine, J., Dowdeswell, B., Wright, S., & Mckee, M. (2009a). Capital Investment for Health. Case Studies from Europe. European Observatory on Health Systems and Policies. Observatory Studies Series No. 18.
Rechel, B., Wright, S., Edwards, N., Dowdeswell, B., & Mckee, M. (2009b). Investing in Hospitals of the Future. European Observatory on Health Systems and Policies. Observatory Studies Series No. 16.
Rechel, B., Wright, S., Barlow, J., & McKee, M. (2010). Hospital Capacity Planning: From Measuring Stocks to Modeling Flows. Bulletin of the World Health Organization, 88, 632–636. Geneva: World Health Organization. https://doi.org/10.2471/BLT.09.07336.
Saltman, R. B., Duran, A., & Dubois, H. F. W. (Eds.). (2011). Governing Public Hospitals, Reform Strategies and the Movement Towards Institutional Autonomy. Brussels: European Observatory on Health Systems and Policies, Observatory Studies Series No. 25, 38.
Starfield, B. (1974). Measurement of Outcome: A Proposed Scheme. Milbank Memorial Fund Quarterly, Health Society, 52(1), 39–50.
Waters, H., & Hussey, P. (2004). Pricing Health Services for Purchasers: A Review of Methods and Experiences. Washington, DC: The World Bank. HNP Discussion Paper.
WHO – World Health Organization. (2000). World Health Report 2000. Health System Improving Performance. Geneva: World Health Organization.
WHO – World Health Organization. (2011). World Health Report 2010. Health System Financing; The Path to Universal Health Coverage. Geneva: World Health Organization.
WHO – World Health Organization. (n.d.). Retrieved July 18, 2018, from http://www.who.int/hospitals/en/.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2020 The Author(s)
About this chapter
Cite this chapter
Durán, A., Wright, S., Belli, P., Chanturidze, T., Jeurissen, P., Saltman, R.B. (2020). Introduction: Why This Book?. In: Durán, A., Wright, S. (eds) Understanding Hospitals in Changing Health Systems. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-28172-4_1
Download citation
DOI: https://doi.org/10.1007/978-3-030-28172-4_1
Published:
Publisher Name: Palgrave Macmillan, Cham
Print ISBN: 978-3-030-28171-7
Online ISBN: 978-3-030-28172-4
eBook Packages: Political Science and International StudiesPolitical Science and International Studies (R0)