Why Is It So Hard To Manage Healthcare: Theoretical Discussions

Abstract

Public health service organizations have distinctive and unique characteristics. They require a wide range of resources, from healthcare workers with professional background and medical technology, to the basic consumables, and robotic medical devices. Continued high labor intensity and capital-intensive technology are specific to healthcare services. Moreover, interdisciplinary team work is increasingly prevalent, and there has been a great deal of challenge supported by organizational and professional boundaries.  The aim of this study is to summarize the theoretical and current discussions concerning management of health care organizations different from general management perspectives of the other sectors.

Keywords

• Health Services,Healthcare Organizations,Health Administration

Sağlık Hizmetlerini Yönetmek Neden Zordur?: Teorik Tartışmalar

Abstract

Kamuda sağlık hizmeti sunan kuruluşlar, diğer kamu kuruluşlarından farklı olarak kendine münhasır, spesifik özelliklere sahiptir. Sağlık hizmeti sunan kuruluşlar, hizmeti sunabilmek için farklı mesleklerden uzmanların işgücüne ve tıp teknolojisine, basit sarf malzemeden robotik özellikli tıbbi cihazlara kadar geniş perspektifte maddi kaynağa ihtiyaç duyarlar. Yoğun emek ve yüksek teknoloji kullanılan sağlık kurumları, karmaşık bir yapıya sahip olma ile beraber farklı mesleklerden sağlık çalışanlarının ekip halinde, disiplinler arası uyum içinde çalışmalarının sağlanmasının önünde profesyonel ve organizasyonel zorlukların bulunduğu örgütlerdir. Bu çalışmada, sağlık kurumlarını yönetmenin diğer sektörlere özgü yönetim anlayışından hangi perspektiflerde ayrıldığı konusunda teorik ve güncel tartışmalar özetlenmektir.  

Keywords

• Sağlık Hizmeti,Sağlık Kurumları,Sağlık Yönetimi

References

1. Bate, P. (2000). Changing the Culture of a Hospital: From Hierarchy to Networked Community. Public Administration, 78 (3), 485-512.
2. Camgöz-Akdağ, H., Tarım, M., Subash, L., & Yatkın, A. (2013). QFD Application Using SERVQUAL for Private Hospitals: A Case Study. Leadership in Health Services, 26(3), 175-183.
3. Çakmak, B.M. (2016). Sağlık Bakanlığı Hastanelerinde Hekim Yöneticilerin Yönetsel Beceri ve Rollerinin Incelenmesi. Doktora Tezi, Ankara: Hacettepe Üniversitesi.
4. Cronin, J.J., & Taylor, A.S. (1992). Measuring Service Quality: A Reexamination and Extension. Journal of Marketing, 56(3), 55-68.
5. Degeling, P., Maxwell, S., Kennedy, J., & Coyle, B. (2003). Medicine, Management and Modernization: ‘A Dance Macabre’. British Medical Journal, 326(7390), 649-652.
6. Dickinson, H., & Ham, C. (2008). Engaging Doctors in Leadership: Review of Literature. University of Birmingham NHS Institute for Innovation and Improvement Coventry.
7. Drucker P.F. (1980). Fırtınalı Dönemlerde Yönetim. Bülent Toksöz (Çev.). İstanbul: İnkılap Yayınevi.
8. Edmonstone, J. D. (1986). If You're Not the Woodcutter, What Are You Doing with That Axe?: Problems of Managing the NHS. Health Services Manpower Review, 12(3), 8-12.

9. Fişek, N.H. (1985). Halk Sağlığına Giriş. Ankara: Hacettepe Üniversitesi Dünya Sağlık Örgütü Hizmet Araştırma ve Araştırıcı Yetiştirici Merkezi.
10. Galbraith, J.K. (1967). The New Industrial State. Boston: Houghton Mifflin Company. (Erişim Tarihi: 20.09.2018),http://www.ebbemunk.dk/technostructure/technostructurep3.html
11. Gemlik, N., Manioğlu, Y., & Çatar, Ö. (2015). Geert Hofstede’in Örgüt Kültürü Modeline Göre Sağlık Meslek Gruplarının Incelenmesi ve Kamu Özel Hastanelerinde Karşılaştırmalı Bir Araştırma. Hacettepe Üniversitesi Sağlık Bilimleri Fakültesi, Vol 1, 1-14.
12. Ginter, P.M., Duncan, W.J., & Swayne, L.E. (2018). The Strategic Management of Health Care Organizations. Eight Edition, Hoboken, New Jersey: John Wiley & Sons Inc.
13. Jemal, H., Kechaou, Z., Ayed M.B., & Alimi A.M. (2015). A Multi Agent System for Hospital Organization. International Journal of Machine Learning and Computing, 5(1), 51-56.
14. Kavuncubaşı, Ş. (2000). Hastane ve Sağlık Örgütleri Yönetimi, Ankara: Siyasal Yayınevi.
15. Kılıç, M., Arslan, M., Leblebici, D.N., Aydın, M.D., & Öktem, M.K. (2008). Managerial Control vs Professional Autonomy: An Empirical Study on Perceptions of Physicians at Teaching Hospitals in Turkey, Journal of Medical Systems, 32(2), 157-165.
16. Kouzes, J.M., & Mico, P.R. (1979). Domain Theory: An Introduction to Organizational Behavior in Human Service Organizations. Journal of Applied Behavioral Science October, 15 (4), 449-469.
17. Kuntz, L., & Vera, A. (2007). Modular Organization and Hospital Performance. Health Services Management Research, 20, 48-58.
18. Kuntz, L., & Vera, A. (2010). Transfer Pricing in Hospitals and Efficiency of Phycisians: The Case of Anesthesia Services. İçinde: A. Vera (Ed.), Krankenhausmanagement in einem wettbewerbsorientierten Umfeld. Köln: Josef Eul Verlag GmbH.
19. Leggat, S.G. (2007). Effective Healthcare Teams Require Effective Team Members: Defining Teamwork Competencies. BMC Health Services Research, 7-17.
20. Leggat, S., Stanton, P., & Bamber, G.J. (2018). New Development: 4P Recommendations for Implementing Change, From Research in Hospitals. Journal of Public Money & Management, 38(1), 45-50.
21. Loh, E. (2013). How and Why Doctors Transition from Clinical Practice to Senior Hospital Management: A Case Research Study from Victory, Australia. International Journal of Clinical Leadership, 22(4), 235-244.
22. Medgadget (2017). University of Minnesota Researches Develop a Better 3D-Printed Organ Model. (Erişim: 07.12.2018),https://www.medgadget.com/2017/12/university-minnesota-researchers-develop-better-3d-printed-organ-model.html
23. Mintzberg, H. (1980). Structure in 5’s: A Synthesis of the Research on Organization Design. Management Science, 26(3), 322-341.
24. Mintzberg, H. (2002). Managing Care and Cure-up and down, in and out. Health Services Management Research, 15, 193-206.
25. Montgomery, K. (1990). A Prospective Look at the Specialty of Medical Management. Work and Occupation, 17, 178-198.
26. Olden, P.C. (2016). Contingency Management of Health Care Organizations: It Depends. The Health Care Manager, 35(1), 28-36.
27. Parasuraman, A.P., Zeithaml, A.V., & Berry L.L. (1988). SERVQUAL: A Multiple-item Scale for Measuring Consumer Perceptions of Service Quality. Journal of Retailing, 64(1), 12-40.
28. Pillay, R. (2018). Healthcare 3.0 How Technology is Driving the Transition to Prosumers, Platforms and Outsurance. Xlibris Corp.
29. Raelin, J.A. (1999). Kültürlerin Çatışması Yönetenler-Yönetilenler. Kamuran Tuncay, Mürşit Balanlılar, Ahmet Buğdaycı (Çev.). İstanbul: Türkiye İş Bankası Kültür Yayınları.
30. Romero, L.M.R., Tosina, L.J.R., Valderrama, M.A.E., Arbizu, J.C., & Martinez, I.R. (2011). A Comprehensive View of the Technologies Involved in Pervasive Care. İçinde: L. Bos, L.K. Carroll, A. Marsch & L.M. Roa (Ed.), Future Visions on Biomedicine and Bioinformatics 1 (s.3-21). Berlin Heidelberg: Springer- Verlag.
31. Sağlık Bakanlığı (2018). Sağlık İstatistikleri Yıllığı 2017.
32. Scott, R.W. (1982). Managing Professional Work: Three Models of Control for Health Organizations. Health Services Research, 17 3), 213-240.
33. Şahin, B. (1999). Sağlıkta Yönetim Zorluğu Hekim Otonomisinin Sonu Olabilir mi? Hacettepe Sağlık İdaresi Dergisi, 4(1), 27-42.
34. Thorne, M.L. (2002). Colonizing the New World of NHS Management: The Shifting Power of Professionals. Health Services Management Resources, 15(1), 14-26.
35. Unger, P., Macq, J., Bredo, F., & Boelaert, M. (2000). Through Mintzberg’s Glasses: A Fresh Look at the Organization of Ministries of Health. Bulletin of the World Health Organization, 78(8), 1005-1014.
36. Williams, J.M., Griffiths, A.J., Jones, D., & Eaton, P.N. (1995). Energy Consumption in Large Acute Hospitals. Energy&Environment, 6(2), 119-134.
37. Zeckhauser, R., & Sommers, B. (2013). Consumerism in Health Care: Challenges and Opportunities. Virtual Mentor, 15(11): 988-992.