Volume 18, Issue 4 (1-2020)
jhosp 2020, 18(4): 63-73 |
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Etemadian M, Shahrokh H, Aryankhesal A. A case study on the establishment of nongovernmental hospitals in the public sector; providing a model for the development of the nongovernmental sector of health system. jhosp 2020; 18 (4) :63-73
URL: http://jhosp.tums.ac.ir/article-1-6163-en.html
URL: http://jhosp.tums.ac.ir/article-1-6163-en.html
1- Associate Professor of Hospital Management Research Center, Iran University of Medical Sciences, Tehran, Iran.
2- Assistant Professor of Urology Department, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran.
3- Associate Professor of Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. (Corresponding author) Corresponding author’s address: School of Health Management and Information Sciences, Rashid Yasemi St., Vali Asr Ave., Tehran, Iran. Email: aryankhesal.a@iums.ac.ir
2- Assistant Professor of Urology Department, Hasheminejad Kidney Center, Iran University of Medical Sciences, Tehran, Iran.
3- Associate Professor of Department of Health Services Management, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran. (Corresponding author) Corresponding author’s address: School of Health Management and Information Sciences, Rashid Yasemi St., Vali Asr Ave., Tehran, Iran. Email: aryankhesal.a@iums.ac.ir
Abstract: (2783 Views)
Background: This study aimed to explore the process of establishing a non-governmental and nonprofit hospital, as a corporate infantry, and a model for the establishment of autonomous and corporate hospitals.
Materials and Methods: This was a qualitative case study. The data were collected by interviewing the founders of Moheb Mehr Hospital, staff and some university officials and charity organizations. The data analysis was conducted based on grounded theory principles and data were coded in three stages of open, axial and selective coding.
Results: The primary factors behind the establishment of Moheb Hospital were the low level of physicians' fees and the physicians’ dual practice in the public and private sectors. The existence of unused spaces at Hashemi-Nejad Hospital and the possibility of contracting supplementary insurance were the secondary factors. The reaction included welcoming from hospital physicians and opposition from the government and the Ministry of Health. A good patient access was created due to the lower charges, in comparison to the private sector, and having contract with the supplementary insurance. The negative comments from the government and the Ministry were gradually adjusted.
Conclusion: The decentralization initiatives of the public sector in hospitals should be considered as a bottom-up process. Instead of turning government hospitals into independent or corporate, it is better to re-establish them in an autonomous or corporate form. Also, before any decentralization action, financial and managerial stability must be created in the organizations. Morevoer, employee benefits must be preserved. Instead of receiving government funding, it is better to use the capacity of the endowment and receive bank loans.
Materials and Methods: This was a qualitative case study. The data were collected by interviewing the founders of Moheb Mehr Hospital, staff and some university officials and charity organizations. The data analysis was conducted based on grounded theory principles and data were coded in three stages of open, axial and selective coding.
Results: The primary factors behind the establishment of Moheb Hospital were the low level of physicians' fees and the physicians’ dual practice in the public and private sectors. The existence of unused spaces at Hashemi-Nejad Hospital and the possibility of contracting supplementary insurance were the secondary factors. The reaction included welcoming from hospital physicians and opposition from the government and the Ministry of Health. A good patient access was created due to the lower charges, in comparison to the private sector, and having contract with the supplementary insurance. The negative comments from the government and the Ministry were gradually adjusted.
Conclusion: The decentralization initiatives of the public sector in hospitals should be considered as a bottom-up process. Instead of turning government hospitals into independent or corporate, it is better to re-establish them in an autonomous or corporate form. Also, before any decentralization action, financial and managerial stability must be created in the organizations. Morevoer, employee benefits must be preserved. Instead of receiving government funding, it is better to use the capacity of the endowment and receive bank loans.
Keywords: Hospital administration, Autonomous hospital, Corporate hospital, Nonprofit hospital, Hospital establishment, NGO Development, Public-private partnership, Decentralization.
Type of Study: Original Article |
Subject:
سیاست گذاری ، برنامه ریزی و رهبری و مدیریت در بیمارستان
Received: 2019/05/29 | Accepted: 2020/03/9 | Published: 2020/03/12
Received: 2019/05/29 | Accepted: 2020/03/9 | Published: 2020/03/12
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