Abstract:
BACKGROUND:Hospital governance is broadening its orientation from cost and production controls towards 'improving performance on clinical outcomes'. Given this new focus one might assume that doctors are drawn into hospital management across OECD countries. Hospital performance in terms of patient health, quality of care and efficiency outcomes is supposed to benefit from their involvement. However, international comparative evidence supporting this idea is limited. Just a few studies indicate that there may be a positive relationship between medical doctors being part of hospital boards, and overall hospital performance. More importantly, the assumed relationship between these so-called doctor managers and hospital performance has remained a 'black-box' thus far. However, there is an increasing literature on the implementation of quality management systems in hospitals and their relation with improved performance. It seems therefore fair to assume that the relation between the involvement of doctors in hospital management and improved hospital performance is partly mediated via quality management systems. The threefold aim of this paper is to 1) perform a quick scan of the current situation with regard to doctor managers in hospital management in 19 OECD countries, 2) explore the phenomenon of doctor managers in depth in 7 OECD countries, and 3) investigate whether doctor involvement in hospital management is associated with more advanced implementation of quality management systems. METHODS:This study draws both on a quick scan amongst country coordinators in OECD's Health Care Quality Indicator program, and on the DUQuE project which focused on the implementation of quality management systems in European hospitals. RESULTS:This paper reports two main findings. First, medical doctors fulfil a broad scope of managerial roles at departmental and hospital level but only partly accompanied by formal decision making responsibilities. Second, doctor managers having more formal decision making responsibilities in strategic hospital management areas is positively associated with the level of implementation of quality management systems. CONCLUSIONS:Our findings suggest that doctors are increasingly involved in hospital management in OECD countries, and that this may lead to better implemented quality management systems, when doctors take up managerial roles and are involved in strategic management decision making.
journal_name
BMC Health Serv Resjournal_title
BMC health services researchauthors
Rotar AM,Botje D,Klazinga NS,Lombarts KM,Groene O,Sunol R,Plochg Tdoi
10.1186/s12913-016-1396-4subject
Has Abstractpub_date
2016-05-24 00:00:00pages
160issn
1472-6963pii
10.1186/s12913-016-1396-4journal_volume
16 Suppl 2pub_type
杂志文章abstract:BACKGROUND:The objective of this paper is to identify the key conditions that positively affect the use of e-health services in Central Eastern Europe (CEE) countries. CEE countries after the political and economic transformation in 1989/90 implemented slightly different national health care models. The research questi...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-5034-9
更新日期:2020-03-04 00:00:00
abstract:BACKGROUND:Musculoskeletal disorders are common in the general population and a leading cause for care seeking. Despite the large number of patients with musculoskeletal disorders seeking care, little is known of the clinical course, pathways and predictors of healthcare utilization among these patients. The purposes o...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05100-0
更新日期:2020-03-23 00:00:00
abstract:BACKGROUND:Previous healthy lifestyle interventions based on the Salud para Su Corazón curriculum for Latinos in the United States, and a pilot study in Guatemala, demonstrated improvements in patient knowledge, behavior, and clinical outcomes for adults with hypertension. This article describes the implementation of a...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-1248-7
更新日期:2015-12-28 00:00:00
abstract:BACKGROUND:A Massachusetts regulation implemented in 2007 has required all acute care hospitals to report patients' race, ethnicity and preferred language using standardized methodology based on self-reported information from patients. This study assessed implementation of the regulation and its impact on the use of ra...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-10-352
更新日期:2010-12-31 00:00:00
abstract:BACKGROUND:In France, equality in access to screening has been one of the main thrusts of public policies implemented between 2009 and 2013 (the national cancer plan). Our aim in this study was to analyse the obstacles to and levers for breast, cervical, and colorectal cancer screening uptake and their trends over time...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-465
更新日期:2014-10-04 00:00:00
abstract:BACKGROUND:Older people have higher rates of hospital admission than the general population and higher rates of readmission due to complications and falls. During hospitalisation, older people experience significant functional decline which impairs their future independence and quality of life. Acute hospital services ...
journal_title:BMC health services research
pub_type: 杂志文章,随机对照试验
doi:10.1186/1472-6963-11-202
更新日期:2011-08-23 00:00:00
abstract:BACKGROUND:Concerns have been raised regarding the reasonableness of using personal health responsibility as a principle or criterion for setting priorities in healthcare. While this debate continues, little is known about clinicians' views on the role of patient responsibility in clinical contexts. This paper contribu...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05364-6
更新日期:2020-06-03 00:00:00
abstract:BACKGROUND:The aim of this study was to compare the expressed levels of career satisfaction of three groups of comparable dental healthcare professionals, working in Trinidad, the United Kingdom and New Zealand. METHODS:Three questionnaire surveys were carried out of comparable dental healthcare professionals. Dental ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-6-32
更新日期:2006-03-14 00:00:00
abstract:BACKGROUND:As part of an electronic dashboard operated by Public Health Wales, senior managers at hospitals in Wales report daily "escalation" scores which reflect management opinion on the pressure a hospital is experiencing and ability to meet ongoing demand with respect to unscheduled care. An analysis was undertake...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究
doi:10.1186/s12913-016-1555-7
更新日期:2016-07-26 00:00:00
abstract:BACKGROUND:Business cases are used to provide a structured justification in favour of investing in new projects, services or interventions. Despite the use of business cases in determining how limited resources will be allocated within England's National Health Service (NHS), guidance concerning how to develop and eval...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-019-4269-9
更新日期:2019-06-28 00:00:00
abstract:BACKGROUND:Health systems are expected to serve the population needs in an effective, efficient and equitable manner. Therefore, the importance of strengthening of public, private and community health systems has been emphasized time and again. In most of the developing countries, certain weaknesses and gaps in the gov...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-122
更新日期:2011-05-24 00:00:00
abstract:BACKGROUND:In the last decade, the number of patients supported by informal caregivers has substantially increased. In the Italian healthcare context, informal caregivers' experience of care is a new under-recognized construct, and no assessment tool is available. Measuring caregivers' experience is important since in ...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-017-2317-x
更新日期:2017-07-17 00:00:00
abstract:BACKGROUND:Costs and consumer preference have led to a shift from the long-term institutional care of aged older people to home and community based care. The aim of this review is to evaluate the outcomes of case managed, integrated or consumer directed home and community care services for older persons, including thos...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/1472-6963-11-93
更新日期:2011-05-09 00:00:00
abstract:BACKGROUND:Clinical practice improvements based on quality-register data are influenced by multiple factors. Although there is agreement that information from quality registers is valuable for quality improvement, practical ways of organising register use have been notoriously difficult to realise. The present study so...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-4944-x
更新日期:2020-02-11 00:00:00
abstract:BACKGROUND:In 2010 the 'Polymedication Check' (PMC), a pharmacist-led medication review, was newly introduced to be delivered independently from the prescriber and reimbursed by the Swiss health insurances. This study aimed at evaluating the impact of this new cognitive service focusing on medicines use and patients' a...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s12913-016-1384-8
更新日期:2016-04-23 00:00:00
abstract:BACKGROUND:Maintaining the health and well-being of family carers of people with dementia is vital, given their potential for experiencing burden associated with the role. The study aimed to help dementia carers develop self-efficacy, be less hassled by the caring role and improve their health and well-being with goal-...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1410-x
更新日期:2016-05-04 00:00:00
abstract:BACKGROUND:Healthcare obtained abroad may conflict with care received in the country of residence. A special concern for immigrants has been raised as they may have stronger links to healthcare services abroad. Our objective was to investigate use of healthcare in a foreign country in Turkish immigrants, their descenda...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-390
更新日期:2012-11-13 00:00:00
abstract:BACKGROUND:Enhancing service efficiency and quality has always been one of the most important factors to heighten competitiveness in the health care service industry. Thus, how to utilize information technology to reduce work load for staff and expeditiously improve work efficiency and healthcare service quality is pre...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-8-87
更新日期:2008-04-17 00:00:00
abstract:BACKGROUND:Clinical networks have been established to improve patient outcomes and processes of care by implementing a range of innovations and undertaking projects based on the needs of local health services. Given the significant investment in clinical networks internationally, it is important to assess their effecti...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-1096-5
更新日期:2015-11-05 00:00:00
abstract:BACKGROUND:The phased withdrawal of oral polio vaccine (OPV) and the introduction of inactivated poliovirus vaccine (IPV) is central to the polio 'end-game' strategy. METHODS:We analyzed the cost implications in Chile of a switch from the vaccination scheme consisting of a pentavalent vaccine with whole-cell pertussis...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-020-05115-7
更新日期:2020-04-09 00:00:00
abstract:BACKGROUND:The cost of dialysis in low and middle-Income countries has not been systematically reviewed. The objective of this article is to systematically review peer-reviewed articles on the cost of dialysis across low and middle-income countries. METHODS:PubMed and Embase databases were searched for the year 1998 t...
journal_title:BMC health services research
pub_type: 杂志文章,评审
doi:10.1186/s12913-015-1166-8
更新日期:2015-11-12 00:00:00
abstract:BACKGROUND:Medical devices and in vitro diagnostic tests (IVD) are vital components of health delivery systems but access to these important tools is often limited in Africa. The regulation of health commodities by National Regulatory Authorities is intended to ensure their safety and quality whilst ensuring timely acc...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-014-0524-2
更新日期:2014-10-31 00:00:00
abstract:BACKGROUND:Several approaches to medication optimisation by identifying drug-related problems in older people have been described. Although some interventions have shown reductions in drug-related problems (DRPs), evidence supporting the effectiveness of medication reviews on clinical and economic outcomes is lacking. ...
journal_title:BMC health services research
pub_type: 杂志文章,多中心研究,随机对照试验
doi:10.1186/s12913-020-5056-3
更新日期:2020-03-17 00:00:00
abstract:BACKGROUND:Reablement is a time-limited intervention that aims to support people to regain independence and enable them to resume their daily activities after they return home from an in-patient care setting, or to maintain independence to enable them to remain at home. There is some evidence that reablement can enhanc...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-016-1600-6
更新日期:2016-08-11 00:00:00
abstract:BACKGROUND:To examine the association between rurality and health in Scotland, after adjusting for differences in individual and practice characteristics. METHODS: DESIGN:Mortality and hospital record data linked to two cross sectional health surveys. SETTING:Respondents in the community-based 1995 and 1998 Scottish...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-43
更新日期:2012-02-17 00:00:00
abstract:BACKGROUND:This study examined the daily surgical scheduling problem in a teaching hospital. This problem relates to the use of multiple operating rooms and different types of surgeons in a typical surgical day with deterministic operation durations (preincision, incision, and postincision times). Teaching hospitals pl...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-464
更新日期:2014-10-15 00:00:00
abstract:BACKGROUND:Despite widespread documentation of racial/ethnic disparities in care (predominantly under-use of needed care), differences in population-wide attitudes or experiences about under- or overuse (care where harms may outweigh potential benefits) of care are not well understood. We examined whether race/ethnicit...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/s12913-015-1106-7
更新日期:2015-10-01 00:00:00
abstract:BACKGROUND:Clinicians informally assess changes in patients' status over time to prognosticate their outcomes. The incorporation of trends in patient status into regression models could improve their ability to predict outcomes. In this study, we used a unique approach to measure trends in patient hospital death risk a...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-11-171
更新日期:2011-07-21 00:00:00
abstract:BACKGROUND:The General Medical Services primary care contract for the United Kingdom financially rewards performance in 19 clinical areas, through the Quality and Outcomes Framework. Little is known about how best to determine the size of financial incentives in pay for performance schemes. Our aim was to test the hypo...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-12-94
更新日期:2012-04-16 00:00:00
abstract:BACKGROUND:Drug costs increasingly pose a burden upon the otherwise inadequate health care resources and rational drug utilization is an important segment of every national health policy. Optimal patient care should be the goal of rational pharmacotherapy, whereby the economic burden of treatment is just one of the ele...
journal_title:BMC health services research
pub_type: 杂志文章
doi:10.1186/1472-6963-14-343
更新日期:2014-08-15 00:00:00