Skip to main content
SpringerLink
Log in
Book cover

Understanding Hospitals in Changing Health Systems pp 139–165Cite as

Palgrave Macmillan

Hospitals in Different Environments: A Messy Reality

  • Chapter
  • First Online:

Abstract

We recognize that hospitals in developing countries may well not be in the same situation as, for example, Europe. This is also true for the ex-Communist, Former Soviet Union countries which come from the Semashko tradition. Hospitals in the developing world can be said to have largely bifurcated between, on the one hand, public hospitals dealing somehow, often not well, with overwhelming needs of the bulk of the population and, on the other, world-class institutions for the privileged. A few institutions manage frugal innovation on cost/performance. In the Communist world, health systems over-focused on hospitals which were intensely bureaucratized and over-specialized, and fell behind Western practices and evidence-based medicine. This time dependence has made it difficult for ex-Communist systems to reform.

This is a preview of subscription content, log in via an institution.

Chapter
USD   29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD   79.99
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Softcover Book
USD   99.99
Price excludes VAT (USA)
  • Compact, lightweight edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info
Hardcover Book
USD   99.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Learn about institutional subscriptions

References

  • Alkire, B. C., Raykar, N. P., Shrime, M. G., Weiser, T. G., Bickler, S. W., Rose, J. A., et al. (2015). Global Access to Surgical Care: A Modelling Study. Lancet, 3(6), e316–e323.

    Google Scholar 

  • Bonilla-Chacin, M. E., Murrugarra, E., & Temourov, M. (2005). Health Care During Transition and Health Systems Reform: Evidence from the Poorest CIS Countries. Social Policy and Administration, 39(4), 381–408.

    Article  Google Scholar 

  • Cattel, D., Eijkenaar, F., & Schut, F. T. (2018). Value-Based Provider Payment: Toward a Theoretically Preferred Design. Health Economics Policy and Law, 27, 1–19. https://doi.org/10.1017/S1744133118000397.

    Article  Google Scholar 

  • Chanturidze, T., Ugulava, T., Duran, A., Ensor, T., & Richardson, E. (2009). Georgia: Health System Review. Health Systems in Transition, 11(8), 1–116. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0003/85530/E93714.pdf.

    Google Scholar 

  • Christiansen, T., & Vrangbaek, K. (2018). Hospital Centralization and Performance in Denmark – Ten Years on. Health Policy, 122, 321–328.

    Article  Google Scholar 

  • Cuellar, A. E., & Gertler, P. J. (2003). Trends in Hospital Consolidation: The Formation of Local Systems. Health Affairs, 22, 77–87.

    Article  Google Scholar 

  • Dahlgren, G. (2014). Why Public Health Services? Experiences from Profit-Driven Health Care Reforms in Sweden. International Journal of Health Services, 44(July), 507–524.

    Article  Google Scholar 

  • Davis, C. (1983). Economic Problems of the Soviet Health Service: 1917–1930. Soviet Studies, XXXV(3), 343–361.

    Article  Google Scholar 

  • Davis, C. (2006). Commentary: The Health Crisis in the USSR: Reflections on the Nicholas Eberstadt 1981 Review of Rising Infant Mortality in the USSR in the 1970s. International Journal of Epidemiology, 35(6), 1400–1405. Retrieved from https://academic.oup.com/ije/article/35/6/1400/660128.

    Article  Google Scholar 

  • Duran, A., & Saltman, R. B. (2013). Innovative Strategies in Governing Public Hospitals. Eurohealth, 19(1), 3–7. Retrieved March 5, 2019, from http://www.euro.who.int/__data/assets/pdf_file/0018/186021/EuroHealth-v19-n1.pdf.

    Google Scholar 

  • Duran, A., & Saltman, R. B. (2015). Governing Public Hospitals. In R. Blank, E. Kuhlmann, I. L. Bourgeault, & C. Wendt (Eds.), International Handbook of Healthcare Policy and Governance (pp. 443–461). Basingstoke: Palgrave Macmillan, Chapter XX.

    Chapter  Google Scholar 

  • Duran, A., Chanturidze, T., Gheorghe, A., & Moreno, A. (2019). Assessment of Public Hospital Governance in Romania: Lessons From 10 Case Studies. International Journal of Health Policy and Management, 8(4), 199–210. Retrieved from https://www.ijhpm.com/article_3581.html.

    Article  Google Scholar 

  • Eckstein, H. (1958). The English Health Service Its Origins, Structure and Achievements. Cambridge: Harvard University Press.

    Google Scholar 

  • English, M., Lanata, C., Ngugi, I., & Smith, P. (2006). The District Hospital, Chapter 65. In D. Jamison, J. Breman, A. Measham, G. Alleyne, M. Claeson, D. Evans, P. Jha, A. Mills, & P. Musgrove (Eds.), Disease Control Priorities in Developing Countries (2nd ed.). Washington, DC: World Bank and Oxford University Press. Retrieved from https://openknowledge.worldbank.org/handle/10986/7242 (License: CC BY 3.0 IGO).

    Google Scholar 

  • EuroDRG. (2019). Diagnosis-Related Groups in Europe: Towards Efficiency and Quality Webpage. Publications. Retrieved January 27, 2019, from http://eurodrg.eu/publications.html.

  • Feshbach, M. (1990). The Health Crisis in the USSR. Boston: Institute for the Study of Conflict, Ideology and Policy, Boston University. Publication Series, No 4. Retrieved from https://www.bu.edu/iscip/pubseries/pubseries4feshbach.pdf.

  • Fidler, A., Bredenkamp, C., & Schlippert, S. (2009). Innovations in Health Services Delivery from Transition Economies in Eastern Europe and Central Asia. Health Affairs, 28(4), 1011–1021.

    Article  Google Scholar 

  • Haberfellner, E. M., Grausgruber, A., Grausgruber-Berner, R., Ortmair, M., & Schöny, W. (2006). Deinstitutionalization of Long-Stay Psychiatric Patients in Upper Austria – Utilization of Healthcare Resources and Costs of Outpatient Care. Psychiatrische Praxis, 33(2), 74–80.

    Article  Google Scholar 

  • Hagen, T., Saltman, R. B., & Vrangbaek, K. (2015). New Strategies for Elderly Care in Denmark and Norway. Eurohealth, 21(2), 23–26.

    Google Scholar 

  • IHME – Institute for Health Metrics and Evaluation. (2019). Global Burden of Disease Study 2016. Seattle: Institute for Health Metrics and Evaluation, University of Washington. Retrieved from http://ghdx.healthdata.org/gbd-2016.

  • Jakubowski, E., & Saltman, R. B. (2013). Recent Health System Governance Reforms. Brussels: European Observatory on Health Systems and Policies. Occasional Series, 91 [Earlier Version Published as ‘Comparative Governance Arrangements in Eleven Countries’ in Appendix 4 of Slutbetankande av Statens Vard och Omsorgutredning (Final Report of the Swedish Government’s Commission on Health and Social Care), SOU 2012:33, Stockholm, May 2012, pp. 289–374].

    Google Scholar 

  • Kahn, K. L., Keeler, E. B., Sherwood, M. J., Rogers, W. H., Draper, D., Bentow, S. S., Reinisch, E. J., Rubenstein, L. V., Kosecoff, J., & Brook, R. H. (1990). Comparing Outcomes of Care Before and After Implementation of the DRG-Based Prospective Payment System. Journal of the American Medical Association, 264, 1984–1988.

    Article  Google Scholar 

  • Kissick, W. L. (1967). Planning, Programming, and Budgeting in Health. Medical Care, 5, 201–220.

    Article  Google Scholar 

  • La Forgia, G., & Harding, A. (2009). Public-Private Partnerships and Public Hospital Performance in São Paulo, Brazil. Health Affairs, 28(4), 1114–1126. https://doi.org/10.1377/hlthaff.28.4.1114.

    Article  Google Scholar 

  • Lekhan, V., Rudiy, V., & Nolte, E. (2004). Health Care Systems in Transition, Ukraine. Copenhagen: European Observatory on Health Care Systems, HiT, Vol. 6, No. 7. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0010/96418/E84927.pdf.

  • Lipsky, M. (1981). Street Level Bureaucrats. Washington: Russell Sage Foundation.

    Google Scholar 

  • Madiba, T. E., & Biccard, B. (2017). The African Surgical Outcomes Study: A 7-Day Prospective Observational Cohort Study. South African Journal of Surgery, 55(3), 75.

    Google Scholar 

  • Magnussen, J., Vrangback, K., & Saltman, R. B. (Eds.). (2009). Nordic Health Care Systems: Recent Reforms and Current Policy Challenges. London: Open University Press/McGraw-Hill Education.

    Google Scholar 

  • McKee, M., & Healy, J. (Eds.). (2002). Hospitals in a Changing Europe. Buckingham: Open University Press. European Observatory on Health Systems and Policies.

    Google Scholar 

  • McKee, M., & Nolte, E. (2004). Health Sector Reforms in Central and Eastern Europe: How Well Are Health Services Responding To Changing Patterns of Health? Demographic Research, 2(7), 163–182.

    Article  Google Scholar 

  • McKenna, H., & Dunn, P. (2015). Devolution: What It Means for Health and Social Care in England. London: Kings Fund, Briefing. Retrieved from https://www.kingsfund.org.uk/sites/default/files/field/field_publication_file/devolution-briefing-nov15.pdf.

  • Mladovsky, P., Srivastava, D., Cylus, J., Karanikolos, M., Evetovits, T., Thomson, S., & McKee, M. (2012). Health Policy Responses to the Financial Crisis in Europe. Brussels: European Observatory on Health Systems and Policies, Policy Brief.

    Google Scholar 

  • Mossialos, E., Wenzl, M., Osborn, R., & Anderson, C. (Eds.). (2015). International Profiles of Healthcare Systems 2014. New York: Commonwealth Fund. Retrieved from https://www.commonwealthfund.org/sites/default/files/documents/___media_files_publications_fund_report_2015_jan_1802_mossialos_intl_profiles_2014_v7.pdf.

    Google Scholar 

  • OECD. (2018). OECD Reviews of Health Systems: Kazakhstan 2018. Paris: OECD Publishing. https://doi.org/10.1787/9789264289062-en.

    Book  Google Scholar 

  • Pollitt, C., & Sorin, D. (2011). The Impacts of New Public Management in Europe: A Meta-Analysis. COCOPS Work Package 1 Deliverable 1.1. Research Report. Retrieved from http://www.cocops.eu/wp-content/uploads/2012/03/WP1_Deliverable1_Meta-analysis_Final.pdf.

  • Preker, A. S., Carrin, G., Dror, D. M., Jakab, M., Hsiao, W., & Arhin, D. (2002). Role of Communities in Resource Mobilization and Risk Sharing: A Synthesis Report. Washington, DC: The World Bank.

    Google Scholar 

  • Rogo, K. (2018). Redefining Government Role in PPP: Success Factors. Johannesburg: The World Bank. May 2018 Presentation.

    Google Scholar 

  • Rouse, W. B. (2009). Health Care as a Complex Adaptive System: Implications for Design and Management (pp. 1–9). Bridge: National Academy of Engineering.

    Google Scholar 

  • Rurik, I., & Kalabay, L. (2009). Primary Healthcare in the Developing Part of Europe: Changes and Development in the Former Eastern Bloc Countries that Joined the European Union Following 2004. Medical Science Monitor, 15(7), PH78–PH84.

    Google Scholar 

  • Ryan, M. (1990). Doctors and the State in Soviet Union. New York: Palgrave Macmillan.

    Book  Google Scholar 

  • Saltman, R. B. (2018). The Impact of Slow Economic Growth on Health Sector Reforms: A Cross-National Perspective. Health Economics Policy and Law, 1–24. https://doi.org/10.1017/S1744133117000445.

  • Saltman, R. B. (2019). Structural Effects of the Information Revolution on Tax Funded European Health Systems and Some Potential Policy Responses. Israel Journal of Health Policy Research, 8, 8. Retrieved from https://ijhpr.biomedcentral.com/articles/10.1186/s13584-018-0284-2.

    Article  Google Scholar 

  • Saltman, R. B., & Young, D. W. (1981). The Hospital Power Equilibrium: An Alternative View of the Cost Containment Dilemma. The Journal of Health Politics, Policy and Law, 6, 391–418.

    Article  Google Scholar 

  • 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.

    Google Scholar 

  • Schieber, G., Anthony, R., Berman, P., Cleland, C., & Rice, J. (1992). Health Care Financing in Russia. Washington, DC: US Agency for International Development.

    Google Scholar 

  • Schultz, D. S., & Rafferty, M. P. (1990). Soviet Health Care and Perestroika. American Journal of Public Health, 80(2). Retrieved from https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.80.2.193.

  • Scîntee, S. G., Vlădescu, C., Sagan, A., & Hernández-Quevedo, C. (2018). The Unexpected Outcomes of the Closure of 67 Inpatient Care Facilities in 2011 in Romania. Health Policy, 122(11), 1161–1164. https://doi.org/10.1016/j.healthpol.2018.08.010.

    Article  Google Scholar 

  • Sheiman, I. (2013). Rocky Road from the Semashko to a New Health Model. Bulletin of the World Health Organization, 91, 320–321. https://doi.org/10.2471/BLT.13.030513.

    Article  Google Scholar 

  • Sorenson, M.-L., & Burau, V. (2015). Why We Need to Move Beyond Diagnosis-Related Groups and How We Might Do So. Journal of Health Services Research and Policy, 21(1), 64–66. https://doi.org/10.1177/1355819615586444.

    Article  Google Scholar 

  • Stevens, R. (1993). In Sickness and in Wealth: American Hospitals in the Twentieth Century. New York: Basic Books.

    Google Scholar 

  • Stubnya, G., Nagy, Z., Lammers, C. H., Rihmer, Z., & Bitter, I. (2010). Deinstitutionalization in Europe: Two Recent Examples from Germany and Hungary. Psychiatria Danubina, 22(3), 406–412.

    Google Scholar 

  • Taube, M., Mitenbergs, U., & Sagan, A. (2012). The Impact of the Crisis on the Health System and Health in Latvia. In S. Thomson, J. Figueras, T. Evetovits, M. Jowett, P. Mladovsky, A. Maresso, J. Cylus, M. Karanikolos, & H. Kluge (Eds.), Economic Crisis, Health Systems and Health in Europe: Country Experience. Brussels: European Observatory on Health Systems and Policies.

    Google Scholar 

  • Telen, M. J. (2014). Teaching Evidence-Based Medicine in the Former Soviet Union Lessons Learned. Transactions of the American Clinical and Climatological Association, V125, 88–103.

    Google Scholar 

  • The Economist. (2018). An Affordable Necessity. Both in Rich and Poor Countries, Universal Health Care Brings Huge Benefits. The Economist, 26 April, Special Report: Universal Health Care. Retrieved May 20, 2018, from https://www.economist.com/special-report/2018/04/28/both-in-rich-and-poor-countries-universal-health-care-brings-huge-benefits.

  • Truitt, E., Thompson, R., Blazey-Martin, D., NiSai, D., & Salem, D. (2016). Effect of the Implementation of Barcode Technology and an Electronic Medication Administration Record on Adverse Drug Events. Hospital Pharmacy, 51, 474–483.

    Article  Google Scholar 

  • Tucker, S., Hughes, J., Burns, A., & Challis, D. (2008). The Balance of Care: Reconfiguring Services for Older People with Mental Health Problems. Aging & Mental Health, 12(1), 81–91.

    Article  Google Scholar 

  • Tulchinsky, T. H., & Varavikova, E. A. (1996). Addressing the Epidemiologic Transition in the Former Soviet Union: Strategies for Health System and Public Health Reform in Russia. American Journal of Public Health, 86, N3. Retrieved from https://ajph.aphapublications.org/doi/pdf/10.2105/AJPH.86.3.313.

    Article  Google Scholar 

  • Vladescu, C., Scîntee, S. G., Olsavszky, V., Hernández-Quevedo, C., & Sagan, A. (2016). Romania: Health System Review. Health Systems in Transition, 18(4), 1–170. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0017/317240/Hit-Romania.pdf?ua=1.

    Google Scholar 

  • WHO – World Health Organization. (2011). World Health Report 2010. Health System Financing; The Path to Universal Health Coverage. Geneva: World Health Organization.

    Google Scholar 

  • WHO – World Health Organization. (2012). WHO Country Cooperation Strategy: India 2012–2017. New Delhi: WHO – World Health Organization. Regional Office for South-East Asia. Retrieved from https://apps.who.int/iris/handle/10665/161136.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Oxford Policy Management, Oxford, UK

    Tata Chanturidze

  2. Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA

    Richard B. Saltman

Authors
  1. Tata Chanturidze
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Richard B. Saltman
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Tata Chanturidze .

Editor information

Editors and Affiliations

  1. ALLDMHEALTH, Seville, Spain

    Antonio Durán

  2. Independent Consultant, Ingleton, UK

    Stephen Wright

Rights and permissions

Reprints and permissions

Copyright information

© 2020 The Author(s)

About this chapter

Check for updates. Verify currency and authenticity via CrossMark

Cite this chapter

Chanturidze, T., Saltman, R.B. (2020). Hospitals in Different Environments: A Messy Reality. 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_7

Download citation

Publish with us

Policies and ethics

Search

Navigation