Autonomy of health care facilities: it is more an ideal than an institutional reality

The issue of hospital autonomy has aroused considerable international interest since the mid-1990's, especially with regard to its linkage to governmental decentralization processes and reform of the health field. Non-profit hospitals have increasingly been obliged to become more autonomous as th...

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Main Authors: Gloria Molina M (Author), Martha Liliana Hernández (Author), César Augusto Carrioni (Author)
Format: Book
Published: Universidad de Antioquia, 2007-08-01T00:00:00Z.
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100 1 0 |a Gloria Molina M  |e author 
700 1 0 |a Martha Liliana Hernández  |e author 
700 1 0 |a César Augusto Carrioni  |e author 
245 0 0 |a Autonomy of health care facilities: it is more an ideal than an institutional reality 
260 |b Universidad de Antioquia,   |c 2007-08-01T00:00:00Z. 
500 |a 0120-386X 
520 |a The issue of hospital autonomy has aroused considerable international interest since the mid-1990's, especially with regard to its linkage to governmental decentralization processes and reform of the health field. Non-profit hospitals have increasingly been obliged to become more autonomous as they compete for funding with private institutions. Objective: to understand how autonomy expresses itself through key management processes in non-profit and for-profit hospitals both in Medellín, the second largest city of Colombia, and its metropolitan area. Different institutional factors-political, administrative and economic-influencing autonomy are examined. Methods: a grounded theory method was used, consisting of semi-structured interviews with managers in six hospitals. Results: findings suggest that autonomy is perceived more as an ideal to aspire to, which would enable the hospital management to make free decisions, providing services in a manner that ensures financial sustainability. In practical terms, however, the degree of administrative and financial autonomy is circumscribed by both internal organizational factors associated with hospitals characteristics and external factors associated with institutional environment. 
546 |a ES 
690 |a autonomy 
690 |a administration 
690 |a administration processes 
690 |a development 
690 |a Public aspects of medicine 
690 |a RA1-1270 
655 7 |a article  |2 local 
786 0 |n Revista Facultad Nacional de Salud Pública, Vol 25, Iss 2, Pp 75-84 (2007) 
787 0 |n http://aprendeenlinea.udea.edu.co/revistas/index.php/fnsp/article/view/84/101 
787 0 |n https://doaj.org/toc/0120-386X 
856 4 1 |u https://doaj.org/article/652e7fa48e8c437cb2f6fc2f5f6e7d6b  |z Connect to this object online.