Decentralization In Health Care: Strategies And Outcomes (European Observatory on Health Systems and Policies)

Decentralization has become a popular management strategy in many European health care systems. The term describes a wide variety of power transfer arrangements and accountability systems. The logic of decentralization is grounded in an intrinsically powerful idea; that smaller organizations, properly structured and steered, are inherently more agile and accountable than larger organizations. In a world where large organizations control wide swathes of both public and private sector activity, the possibility of establishing more locally operated, locally responsible institutions holds out great attraction. This text explores the capacity and impact of decentralization within European health care systems. It examines both the theoretical underpinnings as well as recent practical experiences, drawing upon both published literature and evidence collected directly from the field. The book also assesses the appropriateness of management processes within health systems for implementing a successful decentralization strategy. Decentralization in Health Care will appeal to health policy makers, postgraduates taking courses in health services management, HR, health policy and health economics, and human resource professionals. ·What are the characteristics that define a Social Health Insurance system? ·How is success measured in SHI systems? ·How are SHI systems developing in response to external pressures? Using the seven Social Health Insurance countries in western Europe - Austria, Belgium, France, Germany, Luxembourg, the Netherlands and Switzerland - as well as Israel, this important book reviews core structural and organizational dimensions, as well as recent reforms and innovations. Covering a wide range of policy issues, the book: ·Explores the pressures these health systems confront to be more efficient, more effective, and more responsive ·Reviews their success in addressing these pressures ·Examines the implications of change on the structure of SHI’s as they are currently defined ·Draws out policy lessons about past experience and likely future developments in SHI systems in a manner useful to policymakers in Europe and elsewhere Social Health Insurance Systems in Western Europe will be of interest to students of health policy and management as well as health managers and policy-makers. Contributors: Helmut Brand, Jan Bultman, Reinhard Busse, Laurent Chambaud, David Chinitz, Diana M.J. Delnoij, André P. den Exter, Aad A. de Roo, Anna Dixon, Isabelle Durand-Zaleski, Hans F.W. Dubois, Josep Figueras, Bernhard Gibis, Stefan Greß, Bernhard J. Güntert, Jean Hermesse, Maria M. Hofmarcher, Martin McKee, Pedro W. Koch-Wulkan, Claude Le Pen, Kieke G.H. Okma, Martin Pfaff, Richard B. Saltman, Wendy G.M. van der Kraan, Jürgen Wasem, Manfred Wildner, Matthias Wismar. Decentralization has become a popular managenment strategy in many European health care systems. The term describes a wide variety of power transfer arrangements and accountability systems. The logic of decentralization is grounded in an intrinsically powerful idea: that smaller organizations, properly structured and steered, are inherently more agile and accountable than larger organizations. In a world where large organizations control wide swathes of both public and private sector activity, the possibility of establishing more locally operated, locally responsible institutions holds out great attraction. This text explores the capacity and impact of decentralization within European health care systems. It examines both the theoretical underpinnings as well as recent practical experiences, drawing upon both publishes litterature and evidence collected directly from the field. The book also assesses the appropriateness of management processes within health systems for implementing a successful decentralization strategy Decentralization has become a management strategy in many European health care systems. This text explores the capacity and impact of decentralization within European health care systems. It examines both the theoretical underpinnings and practical experiences, drawing upon both published literature and evidence collected directly from the field Exploring the capacity and impact of decentralization within European health care systems, this book examines both the theoretical underpinnings as well as practical experience with decentralization