* What roles do hospitals play in the health care system and how are these roles changing? * If hospitals are to optimize health gains and respond to public expectations, how should they be configured, managed, and sustained? * What lessons emerge from experiences of changing hospital systems across Europe? Hospitals of the future will confront difficult challenges: new patterns of disease, rapidly evolving medical technologies, ageing populations, and continuing budget constraints. This book explores the competing pressures facing policymakers across Europe as they struggle to respond to these complex challenges. It argues that hospitals, as part of a larger health system, should focus on enhancing health outcomes while also responding to public expectations. Adopting a cross-national, cross-disciplinary perspective, the study assesses recent evidence on the factors driving hospital reform and the strategies used to improve organizational performance. It reviews the evidence from eastern as well as western Europe and combines academic research with real-world policy experience. It looks at the role of hospitals in enhancing health rather than simply processing patients. The book concludes that hospitals cannot be managed in isolation from society and the wider health system, and that policymakers have a responsibility to define the broader health care goals that hospitals should strive to meet. Hospitals in a Changing Europe synthesizes current evidence in a readable and accessible form for all practitioners, policy-makers, academics and graduate level students concerned with health reform.

A team of world-leading policy experts and clinicians analyse the changing role of the hospital across Europe.

While there may be consensus on the broader issues of the core objectives of the health care system, expectations differ between EU countries, and European national policy-makers. This book seeks firstly to assess the impact of the enlargement process and then to analyse the challenges that lie ahead in the field of health and health policy.

For many citizens primary health care is the first point of contact with their health care system, where most of their health needs are satisfied but also acting as the gate to the rest of the system. In that respect primary care plays a crucial role in how patients value health systems as responsive to their needs and expectations. This volume analyses the way how primary are is organized and delivered across European countries, looking at governance, financing and workforce aspects and the breadth of the service profiles. It describes wide national variations in terms of accessibility, continuity and coordination. Relating these differences to health system outcomes the authors suggest some priority areas for reducing the gap between the ideal and current realities.

“This timely book provides insight into the changing role of the ‘hospital’ in the face of technological, organizational innovation and ever-tightening health budgets.”James Barlow, Imperial College Business School, UK “This book covers various relevant aspects of the hospital in different states and contexts. Underlining the importance of business models for future hospitals, this publication presents models of care from a historic and a current perspective. All authors possess a deep insight into different health care systems, not only as scholars but as experts working for world-renowned health policy institutions such as the World Health Organization, the World Bank or the European Observatory for Health Systems.”Siegfried Walch, Management Center Innsbruck, Austria “For an organisation like mine, representing those involved in the strategic planning of healthcare infrastructure, this book provides invaluable insights into what really matters – now and for the future – in the complex and contentious field of hospital development.”Jonathan Erskine, European Health Property Network, Netherlands This book seeks to reframe current policy discussions on hospitals. Healthcare services turn expensive economic resources—people, capital, pharmaceuticals, energy, materials—into care and cure. Hospitals concentrate the use and the cost of these resources, particularly highly-trained people, expensive capital, and embedded technologies. But other areas of health, such as public health and primary care, seem to attract more attention and affection, at least within the health policy community. How to make sense of this paradox? Hospitals choose, or are assigned, to deliver certain parts of care packages. They are organised to do this via “business models”. These necessarily incorporate models of care – the processes of dealing with patients. The activity needs to be governed, in the widest senses. Rational decisions need to be taken about both the care and the resources to be used. This book pulls these elements together, to stimulate a debate.

Das Krankenhaus unterlag als Bautyp in den letzten Jahren großen Veränderungen: Der Wandel im Gesundheitswesen, die evidenzbasierte Medizin sowie Fragen der Gesundheitsökonomie (wie die Bündelung bestimmter Verfahren in Fachkliniken) stellen neue Anforderungen an die Planung. Private Gesundheitseinrichtungen treiben den Paradigmenwechsel vom funktionalen Technikbauwerk zum design-affinen Gesundheitsbau mit Hotelcharakter voran. Dieses Buch stellt in einem breiten systematischen Teil die Voraussetzungen für Entwurf und Planung von Krankenhäusern dar. Der Beispielteil dokumentiert in sechs Kategorien – Allgemeinkrankenhäuser, Kinderkliniken, Universitätskliniken, Fachkrankenhäuser, Ambulanzen und Polikliniken sowie Reha- und Nachsorgeeinrichtungen – ca. 40 internationale Projekte.

People have always travelled within Europe for work and leisure, although never before with the current intensity. Now, however, they are travelling for many other reasons, including the quest for key services such as health care. Whatever the reason for travelling, one question they ask is "If I fall ill, will the health care I receive be of a high standard?" This book examines, for the first time, the systems that have been put in place in all of the European Union's 27 Member States. The picture it paints is mixed. Some have well developed systems, setting standards based on the best available evidence, monitoring the care provided, and taking action where it falls short. Others need to overcome significant obstacles.

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.

Despite considerable investments in health facilities worldwide, little systematic evidence is available on how to plan, design and build new facilities that maximize health gain and ensure that services are responsive to the legitimate expectations of users. This book brings together current knowledge about key dimensions of capital investment in the health sector.

This volume, developed by the Observatory together with OECD, provides an overall conceptual framework for understanding and applying strategies aimed at improving quality of care. Crucially, it summarizes available evidence on different quality strategies and provides recommendations for their implementation. This book is intended to help policy-makers to understand concepts of quality and to support them to evaluate single strategies and combinations of strategies.