ArticleIsrael journal of health policy research2017
Re-thinking barriers to organizational change in public hospitals.
Article in Israel journal of health policy research, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers.
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Who cites it
16 citing papers in PubMed.
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- Financial performance of hospitals in Europe - a scoping review.BMC health services research · 2025Article
- The Future Hospital in Global Health Systems: The Future Hospital Within the Healthcare System.The International journal of health planning and management · 2025Review
- Improving postoperative care for neurosurgical patients by a standardised protocol for urinary catheter placement: a multicentre before-and-after implementation study.BMJ open quality · 2025Observational
- A qualitative study of the barriers and facilitators impacting the implementation of a quality improvement program for emergency departments: SurgeCon.BMC health services research · 2024Article
- Hospitals' financial performance across European countries: a scoping review protocol.BMJ open · 2024Article
- A comprehensive review on the risks assessment and treatment options for Sarcopenia in people with diabetes.Journal of diabetes and metabolic disorders · 2023Review
- Health reforms and policy capacity: the Canadian experience.Policy & society · 2023Article
- Journey Through the Fractalization of Multilevel Governance: Levers for Adapt Healthcare Organizations Toward Migrant Populations in Canada.Health services insights · 2023Article
- Acute Stroke Care during COVID-19: National Data.Infectious disease reports · 2022Article
- Screening, Diagnosis and Management of Sarcopenia and Frailty in Hospitalized Older Adults: Recommendations from the Australian and New Zealand Society for Sarcopenia and Frailty Research (ANZSSFR) Expert Working Group.The journal of nutrition, health & aging · 2022Review
- An Implementation-Effectiveness Study of a Perioperative Delirium Prevention Initiative for Older Adults.Anesthesia and analgesia · 2020Article
- Structural effects of the information revolution on tax-funded European health systems and some potential policy responses.Israel journal of health policy research · 2019Article
- A systems science perspective on the capacity for change in public hospitals.Israel journal of health policy research · 2017Article
- Establishing Appropriate Agency Relationships for Providers in China.Inquiry : a journal of medical care organization, provision and financingArticle
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2 authors.
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No grant is acknowledged in the PubMed record.
Abstract
Public hospitals are well known to be difficult to reform. This paper provides a comprehensive six-part analytic framework that can help policymakers and managers better shape their organizational and institutional behavior. The paper first describes three separate structural characteristics which, together, inhibit effective problem description and policy design for public hospitals. These three structural constraints are i) the dysfunctional characteristics found in most organizations, ii) the particular dysfunctions of professional health sector organizations, and iii) the additional dysfunctional dimensions of politically managed organizations. While the problems in each of these three dimensions of public hospital organization are well-known, and the first two dimensions clearly affect private as well as publicly run hospitals, insufficient attention has been paid to the combined impact of all three factors in making public hospitals particularly difficult to manage and steer. Further, these three structural dimensions interact in an institutional environment defined by three restrictive context limitations, again two of which also affect private hospitals but all three of which compound the management dilemmas in public hospitals. The first contextual limitation is the inherent complexity of delivering high quality, safe, and affordable modern inpatient care in a hospital setting. The second contextual limitation is a set of specific market failures in public hospitals, which limit the scope of the standard financial incentives and reform measures. The third and last contextual limitation is the unique problem of generalized and localized anxiety
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