The effects of healthcare governance and ownership structure on the performance of hospitals in Ghana

Abstract

Purpose – The purpose of this study is to examine the effects of health-care governance and ownership structure on the performance of hospitals in Ghana. Design/methodology/approach – The study uses multiple regression models based on a sample of 132 hospitals in Ghana. Findings – The results of the study indicate that hospitals with a governing board perform better than those without a governing board. The results of this study also suggest that board characteristics and ownership structure are important in explaining the performance of hospitals in Ghana. The results further indicate that mission-based and private hospitals with effective board governance structures exhibit better performance than public hospitals. Originality/value – This study makes a number of new and meaningful contributions to the extant literature and the findings support managerialism, stakeholder and resource dependency theories. The findings also have important implications for the effective governance of hospitals.

The place of private care governance in the South African health care system

“…In this study, it is established that cost control is crucial to maintaining the profitability of the hospital, while still maintaining customer satisfaction. Again, it has been suggested that for effective hospital board, medical staff participation is necessary . The board's small to medium size also implies that crucial decisions in relation to both management and clinical issues can be taken with promptness.…”

“…The board's small to medium size also implies that crucial decisions in relation to both management and clinical issues can be taken with promptness. The board also has the knowledge and information of top‐level insiders such as medical professionals, the chief executive officer, and other administrators . Thus, insiders' knowledge and experience will afford the board the ability to monitor and govern more effectively …”

“…Thus, it is necessary to ensure the effective management of the day‐to‐day activities of the organization . To see if this is achieved, the hospital's mission, its objectives, and supporting and monitoring systems at the operational level must be examined . Furthermore, Abor explains that the responsibility and accountability for the overall operation of the health facility must be identified .…”

“…To see if this is achieved, the hospital's mission, its objectives, and supporting and monitoring systems at the operational level must be examined . Furthermore, Abor explains that the responsibility and accountability for the overall operation of the health facility must be identified . In other words, hospital governance specifically refers to a shared process of top‐level organizational leadership, policy making, and decision making of the board, chief executive officer, senior management, and clinical leaders …”

“…These “four worlds” are interdependent making hospitals complex organizations. Hospitals are not only vital institutions in providing care and performing as autonomous business entities but also require a well‐adjusted and efficient administrative framework in terms of management to achieve their strategic ends . In both the public and private sectors, therefore, the effective and efficient governance and management of hospitals require the responsible and effective use of funds, professional management, and competent governing structures to ensure accountability, transparency, and participation.…”