Hospitals in Europe face many challenges, including cost pressures, technological changes, an evolving burden of disease, growing patient expectations, political pressure on public authorities to restructure traditional governance models and, in some countries, increasing competition from the private sector

Hospital governance has received particular attention, reflecting the growing number of political, financial and technical, as well as social and professional, factors that affect decision-making in the hospital sector. Reforms have introduced different models of hospital governance in different European countries.

This policy brief provides an overview of 10 case studies from Western Europe on macro-level arrangements in hospital governance – the structural, organizational and operational architecture of the health system. The aim is to compare the experience of decentralized hospital governance to inform policy-making as there have been concerns about the tradeoffs involved.

The concept of hospital governance represents a relatively new approach to hospital-related policy and health policy analysis. Its emergence since the early 2000s reflects the growing number of political, financial and technical, as well as social and professional, factors that affect hospital sector decision-making. Reforms have introduced different models of hospital governance in different European countries.

Hospital governance conceptually encompasses three increasingly blurred levels of hospital-related decision-making, in the context of each health system. The main "entry point" for this policy brief is the macro-level, mostly government-based, aspect of governance rather than the day-to-day operational management of the micro-level or institutional decision-making at the meso-level. One of the key processes has been an increasing decentralization of the macro-governance of public hospitals, and the role of the private sector has also increased in many countries.

Read more: What is the experience of decentralized hospital governance in Europe?

Taking the patients' perspective and putting their needs at the center sets the stage for a shift in health care delivery and even a redefinition of what falls under the purview of health care. Physicians and other clinicians will have to embrace new ways of working together, integrating the role of technology and teamwork in delivering multidisciplinary, data-informed care. Technology partners play a key role in supporting and innovating to improve access to effective, affordable care. Working cooperatively with patients on their needs, preferences and goals will result in a health care system that can deliver affordable care and optimal outcomes for patients' evolving needs.

The American Hospital Association invited hospital administrators and health care leaders to this event sponsored by Siemens Healthineers to learn innovative strategies and technologies that put patients at the center, break down barriers and bring care closer to home.

Access the whole document Transforming Health Care Delivery

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