Incorporation of public hospitals: a "silver bullet" against overcapacity, managerial bottlenecks and resource constraints? Case studies from Austria and Estonia.

摘要: This paper presents a new approach for incorporating public hospitals by contrasting the experience from an "old" EU country (Austria) with member state (Estonia). In (including states) hospital overcapacity is serious problem, technical, fiscal and political perspective. Few countries have succeeded in establishing appropriate framework resource management guaranteeing long-term financial viability of their network. Many are search effective policies improved more cost-effective use health sector. Over past decade, experiences Austria Estonia emerged as innovative examples which may provide lessons other beyond. describes evolution budgetary units to incorporated autonomous organizations under private corporate law, resulting contractual relationship between (public) owners management. Outdated inefficient sector structures were replaced agile The arrangement allows investments, operating costs budgeting according strategic business goals opposed "fiat". Shielding local influence important aspect this concept. Horizontal integration through networking introducing helps create culture, allowing flexibility achieve efficiencies downsizing economies scale. Based on contracts balance ownership managerial functions strong incentives business-like, results-oriented consumer-friendly was achieved both politically sensitive way, adopting vision protecting interests staff.