Decentralization has become a popular management strategy in many European health care systems. The term describes a wide variety of power transfer arrangements and accountability systems. The logic of decentralization is grounded in an intrinsically powerful idea; that smaller organizations, properly structured and steered, are inherently more agile and accountable than larger organizations. In a world where large organizations control wide swathes of both public and private sector activity, the possibility of establishing more locally operated, locally responsible institutions holds out…mehr
Decentralization has become a popular management strategy in many European health care systems. The term describes a wide variety of power transfer arrangements and accountability systems. The logic of decentralization is grounded in an intrinsically powerful idea; that smaller organizations, properly structured and steered, are inherently more agile and accountable than larger organizations. In a world where large organizations control wide swathes of both public and private sector activity, the possibility of establishing more locally operated, locally responsible institutions holds out great attraction. This text explores the capacity and impact of decentralization within European health care systems. It examines both the theoretical underpinnings as well as recent practical experiences, drawing upon both published literature and evidence collected directly from the field. The book also assesses the appropriateness of management processes within health systems for implementing a successful decentralization strategy. Decentralization in Health Care will appeal to health policy makers, postgraduates taking courses in health services management, HR, health policy and health economics, and human resource professionals.
Richard B. Saltman is Research Director of the European Observatory on Health Systems and Policies and Professor of Health Policy and Management at the Rollins School of Public Health, Emory University in Atlanta, Georgia. Vaida Bankauskaite is Research Fellow at the European Observatory. In 2001, she was awarded the US government-funded Hubert H. Humphrey Fellowship, part of the Fullbright Fellowship, and spent one year studying health care policy and management along with professional affiliation at the World Bank, Washington DC. Her research focuses on health care reforms and decentralization, inequalities in health, health care legislation and patients rights. Karsten Vrangbaek is a lecturer at the University of Copenhagen, Denmark.
Inhaltsangabe
Part one: Strategic Dimensions Introduction The question of decentralization Central issues in the decentralization debate Patterns of decentralization across European health systems Towards a typology for decentralization in health care Key factors in assessing decentralization and recentralization in health systems Drawing lessons for policymaking Part two: Assessing Recent Experience Approaches to studying decentralization in health systems Effects of decentralization and recentralization on economic dimensions of health systems Effects of decentralization and recentralization on political dimensions of health systems Effects of decentralization on managerial dimensions of health systems Effects of decentralization on clinical dimensions of health systems Effects of decentralization and recentralization on equity dimensions of health systems Information strategies for decentralization Implementation of health care decentralization Privatization as decentralization strategy Annex Description of the structure and development of decentralization in health care in selected countries in Europe and Canada Index
Part one: Strategic Dimensions Introduction The question of decentralization Central issues in the decentralization debate Patterns of decentralization across European health systems Towards a typology for decentralization in health care Key factors in assessing decentralization and recentralization in health systems Drawing lessons for policymaking Part two: Assessing Recent Experience Approaches to studying decentralization in health systems Effects of decentralization and recentralization on economic dimensions of health systems Effects of decentralization and recentralization on political dimensions of health systems Effects of decentralization on managerial dimensions of health systems Effects of decentralization on clinical dimensions of health systems Effects of decentralization and recentralization on equity dimensions of health systems Information strategies for decentralization Implementation of health care decentralization Privatization as decentralization strategy Annex Description of the structure and development of decentralization in health care in selected countries in Europe and Canada Index
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