The end of the decentralised model of healthcare governance?

Byrkjeflot, Haldor; Neby, Simon

doi:10.1108/14777260810893944

Cited by 42 publications

(19 citation statements)

References 15 publications

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“…The explanation for the developments is found in incremental dynamics, creating institutional change that to a large extent depends on national contexts. (Byrkjeflot and Neby, 2008)…”

Section: Literature Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

“…Choosing the most appropriate model of the health care system in any country is essential for efficient use of material resources, improvement of quality, and accessibility of health care (Wendt, 2019). Many studies around the world have focused on the creation and optimization of health care financing models around the world (Reibling et al, 2019). Leading countries strive to expand access to free health care, rationalize their sources, and allocate resources to improve health care management and prevent cost duplication (Schneider and Popic, 2018).…”

Section: Introductionmentioning

confidence: 99%

“…Many studies around the world have focused on the creation and optimization of health care financing models around the world (Reibling et al, 2019). Leading countries strive to expand access to free health care, rationalize their sources, and allocate resources to improve health care management and prevent cost duplication (Schneider and Popic, 2018). Although none of the contemporary models of the world health system can claim universal applicability, it is necessary to analyze the parameters of these models.…”

Section: Introductionmentioning

confidence: 99%

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Models of Financing and Organization of Health Care System-International Experience

Hasanovna

2019

IJMSBA

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The paper analyzes the features of financing and health care system in the world. The issues of scientific research are investigated using methods of comparison, generalization, empirical analysis. The problems of the mechanism of financing the health care system in Uzbekistan, the ways of their elimination and the author’s suggestions for improvement of the sphere are stated. The analysis of international experience drew the following conclusions: no country has a transparent model, no model is perfectly formed, and only one source of funds provides more than 70% of government spending on budget and insurance models. The most factors in ensuring sustainability such as access to free health care, efficient use of resources, and access to health care, the availability of employment mean that no state can meet all health care needs at the expense of public funds without personal insurance or additional payments. After analyzing the existing models of healthcare financing and organization applied by the leading countries, proposals were made for further phased improvement of healthcare financing in the Republic of Uzbekistan.

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“…The explanation for the developments is found in incremental dynamics, creating institutional change that to a large extent depends on national contexts. (Byrkjeflot and Neby, 2008)…”

Section: Literature Reviewmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Models of Financing and Organization of Health Care System-International Experience

Hasanovna

2019

IJMSBA

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“…The manager's function is more explicit and takes on a more general responsibility in the department and the professions. Some authors examined the role of decentralization and initiatives as management and organizational practices in the execution of objectives (Byrkjeflot and Neby, 2008).…”

Section: Initiatives Dimensionmentioning

confidence: 99%

Strategy Execution: An Empirical Analysis of Obstacles Faced by Master of Business Administration Executive Students

Ayandé¹,

Sabourin²

2011

American Journal of Economics and Business Administration

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Problem statement:This study examines obstacles faced by MBA executive students, regarding five dimensions of obstacle management. The purpose of the research is to assess the relative importance of these dimensions and to establish empirical linkages among obstacles and factors such as overall perception of the organization in terms of obstacle management, span of control of the best management practices, age and success, in order to better understand the influence of those obstacles in light of organizational strategy execution. Approach: A survey questionnaire was administered to 512 managers to study the five pre-defined dimensions regarding obstacles in strategy execution faced by MBA executive students. We used Principal Component Analysis and then ANOVA analysis to examine the empirical linkages between the dimensions of strategy execution identified in previous research and socio-demographic variables such as age, span of control, success, tenure and experience. Results: We found that the dimensions that came first in order of importance, were the obstacles related to emotions, followed by the immediate action, integrity, initiatives and finally the obstacles related to rules. This study also found a linkage between the Emotions dimension (getting a commitment for your objectives) and the variable Eval 1 (How would you score your organization in terms of managing the five obstacle dimensions?) and Eval 2 (What would be the score of your organization if the management of the 25 (Obstacles) practices had been mastered?) Moreover, our results reveal a connection between the immediate action dimension and Eval 2 . The integrity dimension highlighted the linkage with the Eval 1 . We showed the tie-ins between the initiatives dimension and the Eval 2 . The rules dimension reveals three linkages with the socio-demographic variables such as age, Eval 1 and Eval 3 (I believe that my success in work-related activities is often a matter of luck). We also found that the younger the MBA executive students were, the more their perception of obstacles related to the rules dimension was important. This research found many connections between the five dimensions regarding obstacles in organizational strategy execution. The set of obstacles faced by MBA executive students did not register the same impact according to strategy execution. However, additional work is necessary in order to generalize our findings. Conclusion: This study proves a contribution by identifying a set of specific obstacles for each facet of strategy execution faced by MBA executive students in the execution of their organizational objectives.

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The inequalities reduction through healthcare decentralisation in low‐middle income countries: The case of Tunisia

Giusti

Romolini

Persiani

2023

Health Planning & Management

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Healthcare decentralisation is a model of public service management founds on the wider distribution of the decisional power about healthcare. The decision power is split by central government also with the local health authorities. Since the 1980s, at worldwide level this reform has being applied for guaranteeing equity, efficiency, quality and financial sustainability in the healthcare services provision. In the last years, healthcare decentralisation is happening especially in low‐middle income countries. With regard to the analysis of the effectiveness of decentralisation in healthcare, the obtained results are mixed. This study aims to investigate the contribution of management in the first steps of decentralisation's implementation for reducing health inequalities in Tunisia. To have the management's point of view, a survey was sent to all directors of the Tunisian regional hospitals. Health management was able to offer operative and timely solutions to the homogenisation and the improvement of healthcare services supply in Tunisia. For healthcare managers the guarantee of an equal and effective Tunisian healthcare system is into the application of a differentiated decentralisation. The differentiated decentralisation of healthcare system allows to resolve regional issues in Tunisia. These interventions permit to obtain consistent positive results about the satisfaction of Tunisian population health needs. The differentiated decentralisation of healthcare system could also be useful for similar countries, for example, of MENA are of low‐middle income countries.

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The end of the decentralised model of healthcare governance?

Cited by 42 publications

References 15 publications

Models of Financing and Organization of Health Care System-International Experience

Models of Financing and Organization of Health Care System-International Experience

Strategy Execution: An Empirical Analysis of Obstacles Faced by Master of Business Administration Executive Students

The inequalities reduction through healthcare decentralisation in low‐middle income countries: The case of Tunisia

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