A review of the experience of hospital autonomy in Pakistan

Abdullah, Muhammad Tanweer; Shaw, Jane

doi:10.1002/hpm.855

Cited by 32 publications

(30 citation statements)

References 16 publications

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“…It was suggested that transforming the public hospitals to autonomous units can improve its management, reduce allocation of its public resources, and increase the accountability of these hospitals . This transformation is only possible by reducing direct government control and assigning the daily decisions to the hospitals' executive managers instead of top‐level managers …”

Section: Introductionmentioning

confidence: 99%

Health system organizational reform in governing Iranian public hospitals: A content analysis to comprehend the barriers in Board of Trustees' hospitals

Jafari

Habibirad²,

Pourtaleb

et al. 2018

Health Planning & Management

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It appears that "implementing regulation" and "financial problems" embrace over 50% of the barriers. Apparently, the new approach to hospitals' autonomy has not achieved the desired goals. Considering the contextual factor, the evidence and identification of the clear role of various stakeholders should be essential determinants. Partial implementation of this policy without paying attention to the other aspects would end in failure. The results showed insufficient budget to be the most influential factor that posed a dilemma in implementing the BOTs' policy. However, BOTs in Iranian health system need to strive toward a higher level of performance that will improve effectiveness and efficiency now more than ever.

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Section: Introductionmentioning

confidence: 99%

Health system organizational reform in governing Iranian public hospitals: A content analysis to comprehend the barriers in Board of Trustees' hospitals

Jafari

Habibirad²,

Pourtaleb

et al. 2018

Health Planning & Management

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show abstract

“…But McPake () could find no evidence for increased productivity or improvements in quality in Columbia. Pearson () also states that accountability has been improved in terms of timely and accurate financial reports to government, but that there has been no change in accountability to local communities (Abdullah and Shaw's findings concerning Pakistan may be an exception). Local managers have found that they have more freedom in terms of day to day management, at least.…”

Section: Public Hospital Reform Across the Worldmentioning

confidence: 97%

“…But most have made little change in respect of personnel management. In general, staff has remained on civil service terms and conditions (for example, in the Northwest Frontier Province in Pakistan—Abdullah and Shaw, ). As noted in respect of Europe (Saltman et al ., ), politicians and senior civil servants are reluctant to give hospitals a significant degree of autonomy, because of the sensitive and politicized nature of healthcare.…”

Section: Public Hospital Reform Across the Worldmentioning

confidence: 99%

Public hospital autonomy in China in an international context

Allen

Cao

Wang

2013

Health Planning & Management

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Following decades of change in health care structures and modes of funding, China has recently been making pilot reforms to the governance of its public hospitals, primarily by increasing the autonomy of public hospitals and redefining the roles of the health authorities. In this paper, we analyse the historical evolution and current situation of public hospital governance in China, focussing the range of governance models being tried out in pilot cities across China. We then draw on the experiences of public hospital governance reform in a wide range of other countries to consider the nature of the Chinese pilots. We find that the key difference in China is that the public hospitals in the pilot schemes do not receive sufficient funding from government and are able to distribute profits to staff. This creates incentives to charge patients for excessive treatment. This situation has undermined public service orientation in Chinese public hospitals. We conclude that the pilot reforms of governance will not be sufficient to remedy all the problems facing these hospitals, although they are a step in the right direction.

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“…According to Kumaranayake (1997), while increasing privatization of healthcare delivery has become central to health sector reforms in many countries, the problems of private institutions, financing, and delivery of health services are dealt mainly through regulation. Since privatization is partly in response to poor or unprofessional patient care and mismanagement of resources in the public sector, the need for regulation is even greater (Abdullah and Shaw, 2007).…”

Section: Regulationmentioning

confidence: 99%

A “DIRE” needs orientation to Saudi health services leadership

Al-Borie

Abdullah

2013

Leadership in Health Services

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Purpose -In recent years, effective leadership initiatives have been emphasized in the healthcare industry all over the world. This paper aims to examine contemporary healthcare development in the Kingdom of Saudi Arabia (KSA) and prescribe four essential policy dimensions to its leadership, depicting the imperative needs for direction, integration, revision, and evidence -the "DIRE needs" approach. Design/methodology/approach -The paper reviews literature on the contemporary KSA health system and provides guidelines for policy reforms vis-à -vis the emerging challenges. Findings -First, the paper offers a conceptual model to examine the ongoing and future health policy development of the KSA. It identifies four key policy dimensions -direction, integration, revision, and evidence and links these to the scope of broader health sector reforms. Second, it characterizes these dimensions as key initiatives for health resource capacity and infrastructural development, essentially the primary health care, which need to be taken up by KSA mainstream health services leadership. Third, it underlines the importance of integrating institutional research and information systems for evidence-based policy-making and practicable implementation. Fourth, it offers a social science research perspective to the need for multi-dimensional health policy reforms in the KSA. Research limitations/implications -This paper opens up KSA health leadership initiatives that may be viewed as the DIRE needs, to be mainstreamed in the domains of policy and strategic planning, research and development, and healthcare management practices. Originality/value -Social research in KSA health policy and planning is rare. This paper introduces a context-specific multi-dimensional model that provides critical insights into challenges and complexities that the Saudi health leadership must attend to. It defines a set of four essential benchmarking dimensions for guiding future policy reforms.

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A review of the experience of hospital autonomy in Pakistan

Cited by 32 publications

References 16 publications

Health system organizational reform in governing Iranian public hospitals: A content analysis to comprehend the barriers in Board of Trustees' hospitals

Health system organizational reform in governing Iranian public hospitals: A content analysis to comprehend the barriers in Board of Trustees' hospitals

Public hospital autonomy in China in an international context

A “DIRE” needs orientation to Saudi health services leadership

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