Decentralization In Hospital

The growth of healthcare expenditures in the modern era, demands the expansion of hospitals, thereby increases the complexity of their organizational structure. This creates a propensity towards a hierarchical structure divided into departments based on clinical specialties. This interdependent system of superiors and subordinates to a certain extent cultivates a culture that involves employees ' lack of engagement, attrition, and distrust. To combat this issue the first article titled “Organizational Change: Decentralization in Hospitals” by I. H. Monrad (1997) emphasizes the need for decentralization in hospitals in hopes of promoting positive changes in its organizational structure. The second article titled “Effects of health care decentralization

This is accomplished using survey data from the Spanish Health Barometer. The results of this study display the difficulty in quantifying the effect of decentralization in hospitals and the satisfaction of the general public in Spain. Antón states in the conclusion that “no: we have not been able to find any major impact of the process of devolution on subjective satisfaction” (p.428). Depending on the perspective of the individual the results of this study can be interpreted positively or negatively. In the book, Komives and Wagner acknowledge that “Change is not neutral, people will be better or worse because of it” (p.102). In other words, the decentralization of hospitals is capable of generating advantages and disadvantages for the network of citizens that it is connected to. For example, a positive impact of moving the decision-making process closer to citizens is the increased accountability that it is associated with. However, at the same time, it might “facilitate the capture of the decision maker by local power groups”(Antón, 2014, p. 412). Although an example of this is not given, it is not uncommon to see local power groups trying to seize and capitalizes on situation where hospitals funded by the government are undergoing new management and or, transitions of power. From a leadership perspective, healthcare providers have committed to providing, to the best of their abilities, care for their patients and ensuring their satisfaction. This common purpose could continue to aid in the examination of whether or not the decentralization of hospitals is beneficial and, or in the best interest of citizens and patients. The main weakness in this article lies in the dependency on survey data which is low in external validity, meaning the results cannot be