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2013 | t. 14, z. 10, cz. 1 Współczesne problemy zarządzania w ochronie zdrowia z perspektywy systemu i organizacji | 215--227
Tytuł artykułu

Perspective of Control in the Light of Professional and Managerial Role within Health Care Organisations

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EN
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EN
The medical profession has always a high degree of autonomy. However, the rapid growth of health care costs that has started in the second half of the last century, has forced governments to tighten the control over medical practice and introduce managers into medical organizations, and also to induce competitive forces in health care systems. However, there is no conclusive evidence that the juxtaposition of bureaucratic and market control mechanisms with the autonomy of the medical profession has led to cost reduction. These actions strengthened, however, the conflict between the role of a manager focused on cost control and the role of a doctor directed towards quality control. One of the key area where the control mechanisms have low efficacy, is treatment of patients with multi chronic conditions, as in this case, the coordination of the therapeutic process must include the alignment of actions of various specialties. At the organization level bureaucratic mechanisms of coordination dominated, at the specialty/ward level clan mechanisms within the therapeutic team are functioning. However, in the spaces between autonomous teams of specialists neither bureaucratic mechanism nor clan mechanism of control is effective. From the literature review appears, that the medical profession response to tighter control is a combination of defensive mechanisms. Therefore, it seems that the chance of improving health care effectiveness is not the strengthening of control, but the cultural changes within medical profession resulting affirmation of cost control behaviour. (original abstract)
Twórcy
  • Wojewódzki Szpital Rehabilitacyjny dla Dzieci w Ameryce
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