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Organizational change: decentralization in hospitals
Author(s) -
Aas I. H. Monrad
Publication year - 1997
Publication title -
the international journal of health planning and management
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.672
H-Index - 41
eISSN - 1099-1751
pISSN - 0749-6753
DOI - 10.1002/(sici)1099-1751(199704)12:2<103::aid-hpm461>3.0.co;2-5
Subject(s) - decentralization , delegation , hierarchy , business , economic system , economics , management , market economy
Decentralization may be defined as the spread of power from higher to lower levels in a hierarchy. For hospitals, decentralization in an organizational change of especial importance. Decentralization in hospitals may be accomplished through decentralization to departments; more general changes in organizational structure (reduction in the number of hierarchical levels and divisionalization); and, delegation of tasks. A framework for an analysis of decentralization status in hospitals is proposed in four main points: its starting point; the need for change in decentralization status; decentralization solutions; and, the need for review before a decentralization proposal is put into practice. Positive effects of decentralization may be obtained; but, to date, empirical investigations on the impact of decentralization in hospitals are few. © 1997 John Wiley & Sons, Ltd.