Organizational Reform in the Hungarian Hospital Sector : Institutional Analysis of Hungarian Hospitals and the Possibilities of Corporatization
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World Bank, Washington, DC
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The organizational reform of public
hospitals is part of the health policy agenda worldwide as a
reaction to inefficient and low quality performance in
public institutions. A central theme of these reforms is the
possibility of improving performance in public settings
under semiautonomous circumstances. Central and East
European countries face the problem of an oversized and
hospital-based health care system inherited historically
from the former centralized totalitarian political system.
The authors analyze the Hungarian Hospital sector in terms
of recent changes and the effect of these on organizational
modalities shown earlier to play a crucial role in the
performance of public hospitals. Organizational theory and
the "organizational modality - incentive regime"
model is used to describe incongruence and general
incoherence in the everyday functioning of Hungarian
hospitals. Finally the possibilities and long-term effects
of corporatization and marketing changes are examined
according to recent political and legislative changes and a
corresponding case study.
Palabras clave
ACCOUNTABILITY, ACCOUNTING, ADAPTATION, AUDITS, BIDDING, CAPITAL COSTS, COMMUNITIES, CORRUPTION, DECENTRALIZATION, DELIVERY SYSTEMS, DEPRECIATION, DOCTORS, EMPLOYMENT, ENGINEERS, EQUIPMENT, FEASIBILITY, FINANCIAL MANAGEMENT, HEALTH CARE, HEALTH FOR ALL, HEALTH INSTITUTIONS, HEALTH INSURANCE, HEALTH OUTCOMES, HEALTH POLICY, HEALTH REFORM, HEALTH SECTOR, HEALTH SERVICES, HEALTH STATUS, HEALTH SYSTEM, HEALTH SYSTEMS, HOSPITAL BEDS, HOSPITAL MANAGEMENT, HOSPITALS, INDUCED DEMAND, INHABITANTS, MANAGERS, MARKETING, MEDICINE, MIGRATION, NURSES, NURSING, NUTRITION, PATIENTS, PERFORMANCE CRITERIA, PHARMACEUTICALS, PHYSICIANS, PRIMARY CARE, PROCUREMENT, PROFESSIONS, PUBLIC HEALTH, PUBLIC HOSPITALS, PUBLIC SECTOR, PURCHASING, QUALITATIVE DATA, SERVICE DELIVERY, TELECOMMUNICATIONS, UNIVERSITIES HEALTH SYSTEMS DEVELOPMENT & REFORM, PUBLIC HOSPITALS, HEALTH CARE SYSTEMS, HEALTH CARE FINANCE, HEALTH CARE FINANCING, HEALTH CARE ORGANIZATIONS