Document Type : Original Article
Authors
Department of Health Policy and Management, School of Management and Medical Informatics, Tabriz University of Medical Sciences, Tabriz, Iran
Abstract
In recent years, many reforms have been made on the structure of hospital administration, most
of which are proposed by Parker–Harding models. Therefore, the purpose of this study is to
systematically review global relevant experiences in reforming the hospital governance structure
with emphasis on the Parker–Harding model. Required information was collected using keywords
autonomization, corporatization, privatization, decentralization, reform, hospital autonomy, governance
model, and structural reform in databases such as EMBASE, PubMed, Scopus, SID, MagIran, and
other resources. Information on the subjects under study was collected from 1990 to 2020. The
content extraction method was used for data extraction and data analysis. Thirty‑nine sources were
included in the study. Results of searching for relevant evidence on a variety of hospital governance
models (government, board, corporate, and private) based on the Parker–Harding model in four
categories including strengths (31), weaknesses (30), outcomes (26), and interventions (21) are
outlined. In this study, strengths, weaknesses, outcomes, and corrective interventions were presented
for different models of hospital administration that could be used by healthcare policymakers. Also,
According to the results of this study, governmental model less recommended.
Keywords
1. MosadeghradA. Handbook of Hospital Professional Organization
and Management. Tehran, Iran: Dibagran Tehran; 2004.
2. Lebni JY, Toghroli R, Abbas J, Kianipour N, NeJhaddadgar N,
Salahshoor MR, et al. Nurses’ work‑related quality of life and its
influencing demographic factors at a public hospital in Western
Iran: A cross‑sectional study. Int Q Community Health Educ
2020;12:272684X20972838.
3. Erwin CO, Landry AY, Livingston AC, Dias A. Effective
governance and hospital boards revisited: Reflections on 25 years
of research. Med Care Res Rev 2019;76:131‑166.
4. Fiorio CV, Gorli M, Verzillo S. Evaluating organizational change
in health care: The patient‑centered hospital model. BMC Health
Serv Res 2018;18:95.
5. Mercille J. Privatization in the Irish hospital sector since 1980.
J Public Health (Oxf) 2018;40:863‑70.
6. Schroeder GD, Kurd MF, Kepler CK, Radcliff KE, Maltenfort MG,
Murphy H, et al. The effect of hospital ownership on health care
utilization in orthopedic surgery. Clin Spine Surg 2018;31:73‑9.
7. Nouri M, Ghaffarifar S, Sadeghi‑Bazargani H. Development of
the Persian patient satisfaction questionnaire. Int J Health Care
Qual Assur 2018;31:988‑99.
8. Moradi F, Toghroli R, Abbas J, Ziapour A, Lebni JY, Aghili A,
et al. Hospital managers’ skills required and onward challenges:
A qualitative study. J Educ Health Promot 2020;9:228.
9. Mohammadi M, Ziapoor A, Mahboubi M, Faroukhi A, Amani N,
Hydarpour, F, et al. Performance evaluation of hospitals under the
supervision of Kermanshah Medical Sciences using pabonlasoty
diagram of a five‑year period (2008‑2012). Life Sci J 2014;11:77‑81.
10. Lebni JY, Azar F, Sharma M, Zangeneh A, Kianipour N,
Azizi S, et al. Factors affecting occupational hazards among
operating room personnel at hospitals affiliatedin in Western
Iran: A cross‑sectional study. J Public Health 2020;1:1‑8.
11. Nouri M, Ghaffarifar S, Sadeghi Bazargani H, Ghaffari R. Patients’
satisfaction with medical residents’ communication skills at the
largest teaching and treatment center in North West Iran in 2016.
Shiraz Emed J 2017;18:4.
12. Roggenkamp SD, White KR, Bazzoli GS. Adoption of hospital
case management: Economic and institutional influences. Soc Sci
Med 2005;60:2489‑500.
13. Parker D, Kirkpatrick C. Privatisation in developing countries:
A review of the evidence and the policy lessons. J Dev Stud
2005;41:513‑41.
14. Logan IB, Mengisteab K. IMF‑World Bank adjustment and
structural transformation in sub‑Saharan Africa. Econ Geogr
1993;69:1‑24.
15. Maharani A, Femina D, Tampubolon G. Decentralization in
Indonesia: Lessons from cost recovery rate of district hospitals.
Health Policy Plan 2015;30:718‑27.
16. Grimshaw D, Jaehrling K, Van Der Meer M, Méhaut P, Shimron N.
Convergent and divergent country trends in coordinated wage
setting and collective bargaining in the public hospitals’ sector.
Ind Relat J 2007;38:591‑613.
17. Duncan C. The impact of two decades of reform of British public
sector industrial relations. Public Money Manage 2001;21:27‑34.
18. Schulten T, Brandt T, Hermann C. Liberalisation and privatisation
of public services and strategic options for European trade unions.
Transf Eur Rev Labour Res 2008;14:295‑311.
19. Galetto M, Marginson P, Spieser C. Collective Bargaining and the
Changing Governance of Hospitals: A Comparison between the
United Kingdom, Italy, and France. In SASE Conference, MIT;
June, 2012.
20. Bordogna L, Hazard M. Transaction costs and the reform of public
service employment relations. Eur J Ind Relat 2008;14:381‑400.
21. Preker AS, Harding A. Innovations in Health Service Delivery:
The Corporatization of Public Hospitals. Washington, D.C.: The
World Bank; 2003.
22. Khan K, Kunz R, Kleijnen J, Antes G . Systematic Reviews to
Support Evidence‑Based Medicine. United States: CRC Press;
2011.
23. Jafari M, Rashidian A, Abolhasani F, Mohammad K, Yazdani S,
Parkerton P, et al. Space or no space for managing public hospitals;
A qualitative study of hospital autonomy in Iran. Int J Health
Plann Manage 2011;26:e121‑37.
24. Poorolajal J, Tajik P, Yazdizadeh B, Sehat M, Salehi AR, Rezaei M
and et al. Quality assessment of the reporting of cohort studies
before STROBE statement. Iran J Epidemiol 2009;5:17‑26.
25. Von Elm E, Altman D, Egger M, Pocock S, Gøtzsche P,
Vandenbroucke J.The Strengthening the Reporting of
Observational Studies in Epidemiology (STROBE) statement:
Guidelines for reporting observational studies. Ann Intern Med
2007;147:573‑7.
26. Vandenbroucke JP, von Elm E, Altman D, Gøtzsche PC,
Mulrow CD, Pocock SJ and et al. Strengthening the Reporting of
Observational Studies in Epidemiology (STROBE): Explanation
and elaboration. Int J Surg 2014;12:1500‑24.
27. Arndt M, Bigelow B. Benefits and disadvantages of corporate
restructuring – The hospital view. Hosp Top 1996;74:21‑5.
28. Bryan YE, Hitchings KS, Fox MA, Kinneman MT, Young MJ. The evaluation of hospital restructuring efforts: Satisfaction, quality,
and costs. Qual Manag Health Care 1998;6:22‑34.
29. Eeckloo K, Van Herck G, Van Hulle C, Vleugels A. From corporate
governance to hospital governance. Authority, transparency
and accountability of Belgian non‑profit hospitals’ board and
management. Health Policy 2004;68:1‑5.
30. Abdullah MT, Shaw J. A review of the experience of
hospital autonomy in Pakistan. Int J Health Plann Manage
2007;22:45‑62.
31. Hartwig, K, et al. Erratum: Hospital management in the context of
health sector reform: A planning model in Ethiopia. Int J Health
Plann Manage 2009;24:187‑90.
32. Eggleston K, Shen YC, Lau J, Schmid CH, Chan J. Hospital
ownership and quality of care: What explains the different results
in the literature? Health Econ 2008;17:1345‑62.
33. Herr A. Cost and technical efficiency of German hospitals: Does
ownership matter? Health Econ 2008;17:1057‑71.
34. Tjerbo T. The politics of local hospital reform: A case study of
hospital reorganization following the 2002 Norwegian hospital
reform. BMC Health Serv Res 2009;9:212.
35. Aksan HA, Ergin I, Ocek Z. The change in capacity and service
delivery at public and private hospitals in Turkey: A closer look
at regional differences. BMC Health Serv Res 2010;10:300.
36. Rego G, Nunes R, Costa J. The challenge of corporatisation: The
experience of Portuguese public hospitals. Eur J Health Econ
2010;11:367‑81.
37. Braithwaite J, Travaglia JF, Corbett A. Can questions of the
privatization and corporatization, and the autonomy and
accountability of public hospitals, ever be resolved? Health Care
Anal 2011;19:133‑53.
38. Tiemann O, Schreyögg J, Busse R. Hospital ownership and
efficiency: A review of studies with particular focus on Germany.
Health Policy 2012;104:163‑71.
39. Gholipour K, Delgoshai B, Masudi‑Asl I, Hajinabi K, Iezadi S.
Comparing performance of Tabriz obstetrics and gynaecology
hospitals managed as autonomous and budgetary units using
Pabon Lasso method. Australas Med J 2013;6:701‑7.
40. Mousazadeh Y, Jannati A, Beiramy HJ, AsghariJafarabadi M and
Ebadi A. Advantages and disadvantages of different methods
of hospitals’ downsizing: A narrative systematic review. Health
Promot Perspect 2013;3:276.
41. Czypionka T, Kraus M, Mayer S, Röhrling G. Efficiency,
ownership, and financing of hospitals: The case of Austria. Health
Care Manag Sci 2014;17:331‑47.
42. Jehu‑Appiah C, Sekidde S, Adjuik M, Akazili J, Almeida SD,
Nyonator F, et al. Ownership and technical efficiency of hospitals:
Evidence from Ghana using data envelopment analysis. Cost Eff
Resour Alloc 2014;12:9.
43. Markazi‑Moghaddam N, Aryankhesal A, Arab M. The first
stages of liberalization of public hospitals in Iran: Establishment
of autonomous hospitals and the barriers. Iran J Public Health
2014;43:1640‑50.
44. Shwekerela B. The effects of hospital reforms on the management
of public hospitals in Tanzania: Challenges and lessons learnt.
World Hosp Health Serv 2014;50:23‑6.
45. Farrow G. Can organisational restructuring of hospitals improve
quality and safety? the experience at sydney children’s hospitals
network.London: BMJ Publishing Group Ltd; 2015.
46. Ferreira D, Marques RC. Did the corporatization of Portuguese
hospitals significantly change their productivity? Eur J Health
Econ 2015;16:289‑303.
47. Kahancová M, Szabó IG. Hospital bargaining in the wake of
management reforms: Hungary and Slovakia compared. Eur J
Ind Relat 2015;21:335‑52.
48. Lindlbauer I, Winter V, Schreyögg J. Antecedents and
consequences of corporatization: An empirical analysis of German
public hospitals. J Public Adm Res Theory 2016;26:309‑26.
49. Pan J, Qin X, Hsieh CR. Is the pro‑competition policy an effective
solution for China’s public hospital reform. Health Econ Policy
Law 2016;11:337.
50. Pesheva P, Georgieva E, Hristov N, Zahariev V and Dimitrova V.
The hospital sector reform in BulgariaNikolai Hristov. Eur J Public
Health 2017;27 Suppl 3:56‑78.
51. De Geyndt W. Does autonomy for public hospitals in developing
countries increase performance? Evidence‑based case studies. Soc
Sci Med 2017;179:74‑80.
52. Fu H, Li L, Li M, Yang C, Hsiao W. An evaluation of systemic
reforms of public hospitals: The Sanming model in China. Health
Policy Plan 2017;32:1135‑45.
53. Sajadi HS, Sajadi ZS, Sajadi FA, Hadi M and Zahmatkesh M.
The comparison of hospitals’ performance indicators before and
after the Iran’s hospital care transformations plan. J Educ Health
Promot 2017;6:44‑76.
54. Thiel A, Winter V, Büchner VA. Board characteristics, governance
objectives, and hospital performance: An empirical analysis of
German hospitals. Health Care Manage Rev 2018;43:282‑92.
55. Jones L, Pomeroy L, Robert G, Burnett S, Anderson JE, Fulop NJ.
How do hospital boards govern for quality improvement? A
mixed methods study of 15 organisations in England. BMJ Qual
Saf 2017;26:978‑86.
56. Verzulli R, Jacobs R, Goddard M. Autonomy and performance in
the public sector: The experience of English NHS hospitals. Eur J
Health Econ 2018;19:607‑26.
57. Jafari M, Habibirad A, Pourtaleb A, Salarianzadeh MH. Health
system organizational reform in governing Iranian public
hospitals: A content analysis to comprehend the barriers in Board
of Trustees’ hospitals. Int J Health Plann Manage 2018;33:e612‑20.
58. Zhao D, Zhang Z. Qualitative analysis of direction of public
hospital reforms in China. Front Med 2018;12:218‑23.
59. Govindaraj R, Chawla M. Recent experiences with hospital
autonomy in developing countries: What can we learn? Boston,
MA: Harvard School of Public Health; 1996.
60. Tao D, Hawkins L, Wang H, Langenbrunner J, Zhang S,
Dredge R. Fixing the public hospital system in China. Volume
2010;2:8‑20.
61. Mordelet P. The future of public hospitals in a globalized world:
Corporate governance, corporatization or privatization? World
Hosp Health Serv 2008;44:23‑5.
62. Hartwig K, Pashman J, Cherlin E, Dale M, Callaway M,
Czaplinski C and et al. Hospital management in the context of
health sector reform: A planning model in Ethiopia. Int J Health
Plann Manage 2008;23:203‑18.
63. Bazzoli GJ. The corporatization of American hospitals. J Health
Polit Policy Law 2004;29:885‑905.
64. McKee M, Edwards N, Atun R. Public‑private partnerships for
hospitals. Bull World Health Organ 2006;84:890‑6.
65. Nurunnabi M, Islam SK. Accountability in the Bangladeshi
accountability in healthcare privatized healthcare sector. Int J
Health Care Qual Assur 2012;25:625‑44.
66. Tiemann O, Schreyögg J. Changes in hospital efficiency after
privatization. Health Care Manage Sci 2012;15:310‑26.
67. Kahancová M, Szabó IG. Acting on the Edge of the Public Sector:
Hospital Corporatization and Collective Bargaining in Hungary
and Slovakia; 2012.
68. Collins D, Njeru G, Meme J, Newbrander W. Hospital autonomy:
The experience of Kenyatta National Hospital. Int J Health Plann
Manage 1999;14:129‑53.
69. Filerman GL. Book Review: Innovations in Health Services
Delivery: The Corporatization of Public Hospitals. Los Angeles,
CA: SAGE Publications; 2004.
70. Jackson R, Kartoglu I, Stringer C, Gorrell G, Roberts A, Song X,
et al. CogStack‑experiences of deploying integrated information
retrieval and extraction services in a large National Health
Service Foundation Trust hospital. BMC Med Inform Decis Mak 2018;18:47.
71. Villa S, Kane N. Assessing the impact of privatizing public
hospitals in three American states: Implications for universal
health coverage. Value Health 2013;16:S24‑33.
72. Grover C. Privatizing employment services in Britain. Crit Soc
Policy 2009;29:487‑509.
73. Roemer MI. Foreign privatization of national health systems. Am
J Public Health 1987;77:1271‑2.
74. Spackman M. Public‑private partnerships: Lessons from the
British approach. Econ Syst 2002;26:283‑301.
75. Albreht T. Privatization processes in health care in Europe – A
move in the right direction, a ‘trendy’ option, or a step back? Eur
J Public Health 2009;19:448‑50.
and Management. Tehran, Iran: Dibagran Tehran; 2004.
2. Lebni JY, Toghroli R, Abbas J, Kianipour N, NeJhaddadgar N,
Salahshoor MR, et al. Nurses’ work‑related quality of life and its
influencing demographic factors at a public hospital in Western
Iran: A cross‑sectional study. Int Q Community Health Educ
2020;12:272684X20972838.
3. Erwin CO, Landry AY, Livingston AC, Dias A. Effective
governance and hospital boards revisited: Reflections on 25 years
of research. Med Care Res Rev 2019;76:131‑166.
4. Fiorio CV, Gorli M, Verzillo S. Evaluating organizational change
in health care: The patient‑centered hospital model. BMC Health
Serv Res 2018;18:95.
5. Mercille J. Privatization in the Irish hospital sector since 1980.
J Public Health (Oxf) 2018;40:863‑70.
6. Schroeder GD, Kurd MF, Kepler CK, Radcliff KE, Maltenfort MG,
Murphy H, et al. The effect of hospital ownership on health care
utilization in orthopedic surgery. Clin Spine Surg 2018;31:73‑9.
7. Nouri M, Ghaffarifar S, Sadeghi‑Bazargani H. Development of
the Persian patient satisfaction questionnaire. Int J Health Care
Qual Assur 2018;31:988‑99.
8. Moradi F, Toghroli R, Abbas J, Ziapour A, Lebni JY, Aghili A,
et al. Hospital managers’ skills required and onward challenges:
A qualitative study. J Educ Health Promot 2020;9:228.
9. Mohammadi M, Ziapoor A, Mahboubi M, Faroukhi A, Amani N,
Hydarpour, F, et al. Performance evaluation of hospitals under the
supervision of Kermanshah Medical Sciences using pabonlasoty
diagram of a five‑year period (2008‑2012). Life Sci J 2014;11:77‑81.
10. Lebni JY, Azar F, Sharma M, Zangeneh A, Kianipour N,
Azizi S, et al. Factors affecting occupational hazards among
operating room personnel at hospitals affiliatedin in Western
Iran: A cross‑sectional study. J Public Health 2020;1:1‑8.
11. Nouri M, Ghaffarifar S, Sadeghi Bazargani H, Ghaffari R. Patients’
satisfaction with medical residents’ communication skills at the
largest teaching and treatment center in North West Iran in 2016.
Shiraz Emed J 2017;18:4.
12. Roggenkamp SD, White KR, Bazzoli GS. Adoption of hospital
case management: Economic and institutional influences. Soc Sci
Med 2005;60:2489‑500.
13. Parker D, Kirkpatrick C. Privatisation in developing countries:
A review of the evidence and the policy lessons. J Dev Stud
2005;41:513‑41.
14. Logan IB, Mengisteab K. IMF‑World Bank adjustment and
structural transformation in sub‑Saharan Africa. Econ Geogr
1993;69:1‑24.
15. Maharani A, Femina D, Tampubolon G. Decentralization in
Indonesia: Lessons from cost recovery rate of district hospitals.
Health Policy Plan 2015;30:718‑27.
16. Grimshaw D, Jaehrling K, Van Der Meer M, Méhaut P, Shimron N.
Convergent and divergent country trends in coordinated wage
setting and collective bargaining in the public hospitals’ sector.
Ind Relat J 2007;38:591‑613.
17. Duncan C. The impact of two decades of reform of British public
sector industrial relations. Public Money Manage 2001;21:27‑34.
18. Schulten T, Brandt T, Hermann C. Liberalisation and privatisation
of public services and strategic options for European trade unions.
Transf Eur Rev Labour Res 2008;14:295‑311.
19. Galetto M, Marginson P, Spieser C. Collective Bargaining and the
Changing Governance of Hospitals: A Comparison between the
United Kingdom, Italy, and France. In SASE Conference, MIT;
June, 2012.
20. Bordogna L, Hazard M. Transaction costs and the reform of public
service employment relations. Eur J Ind Relat 2008;14:381‑400.
21. Preker AS, Harding A. Innovations in Health Service Delivery:
The Corporatization of Public Hospitals. Washington, D.C.: The
World Bank; 2003.
22. Khan K, Kunz R, Kleijnen J, Antes G . Systematic Reviews to
Support Evidence‑Based Medicine. United States: CRC Press;
2011.
23. Jafari M, Rashidian A, Abolhasani F, Mohammad K, Yazdani S,
Parkerton P, et al. Space or no space for managing public hospitals;
A qualitative study of hospital autonomy in Iran. Int J Health
Plann Manage 2011;26:e121‑37.
24. Poorolajal J, Tajik P, Yazdizadeh B, Sehat M, Salehi AR, Rezaei M
and et al. Quality assessment of the reporting of cohort studies
before STROBE statement. Iran J Epidemiol 2009;5:17‑26.
25. Von Elm E, Altman D, Egger M, Pocock S, Gøtzsche P,
Vandenbroucke J.The Strengthening the Reporting of
Observational Studies in Epidemiology (STROBE) statement:
Guidelines for reporting observational studies. Ann Intern Med
2007;147:573‑7.
26. Vandenbroucke JP, von Elm E, Altman D, Gøtzsche PC,
Mulrow CD, Pocock SJ and et al. Strengthening the Reporting of
Observational Studies in Epidemiology (STROBE): Explanation
and elaboration. Int J Surg 2014;12:1500‑24.
27. Arndt M, Bigelow B. Benefits and disadvantages of corporate
restructuring – The hospital view. Hosp Top 1996;74:21‑5.
28. Bryan YE, Hitchings KS, Fox MA, Kinneman MT, Young MJ. The evaluation of hospital restructuring efforts: Satisfaction, quality,
and costs. Qual Manag Health Care 1998;6:22‑34.
29. Eeckloo K, Van Herck G, Van Hulle C, Vleugels A. From corporate
governance to hospital governance. Authority, transparency
and accountability of Belgian non‑profit hospitals’ board and
management. Health Policy 2004;68:1‑5.
30. Abdullah MT, Shaw J. A review of the experience of
hospital autonomy in Pakistan. Int J Health Plann Manage
2007;22:45‑62.
31. Hartwig, K, et al. Erratum: Hospital management in the context of
health sector reform: A planning model in Ethiopia. Int J Health
Plann Manage 2009;24:187‑90.
32. Eggleston K, Shen YC, Lau J, Schmid CH, Chan J. Hospital
ownership and quality of care: What explains the different results
in the literature? Health Econ 2008;17:1345‑62.
33. Herr A. Cost and technical efficiency of German hospitals: Does
ownership matter? Health Econ 2008;17:1057‑71.
34. Tjerbo T. The politics of local hospital reform: A case study of
hospital reorganization following the 2002 Norwegian hospital
reform. BMC Health Serv Res 2009;9:212.
35. Aksan HA, Ergin I, Ocek Z. The change in capacity and service
delivery at public and private hospitals in Turkey: A closer look
at regional differences. BMC Health Serv Res 2010;10:300.
36. Rego G, Nunes R, Costa J. The challenge of corporatisation: The
experience of Portuguese public hospitals. Eur J Health Econ
2010;11:367‑81.
37. Braithwaite J, Travaglia JF, Corbett A. Can questions of the
privatization and corporatization, and the autonomy and
accountability of public hospitals, ever be resolved? Health Care
Anal 2011;19:133‑53.
38. Tiemann O, Schreyögg J, Busse R. Hospital ownership and
efficiency: A review of studies with particular focus on Germany.
Health Policy 2012;104:163‑71.
39. Gholipour K, Delgoshai B, Masudi‑Asl I, Hajinabi K, Iezadi S.
Comparing performance of Tabriz obstetrics and gynaecology
hospitals managed as autonomous and budgetary units using
Pabon Lasso method. Australas Med J 2013;6:701‑7.
40. Mousazadeh Y, Jannati A, Beiramy HJ, AsghariJafarabadi M and
Ebadi A. Advantages and disadvantages of different methods
of hospitals’ downsizing: A narrative systematic review. Health
Promot Perspect 2013;3:276.
41. Czypionka T, Kraus M, Mayer S, Röhrling G. Efficiency,
ownership, and financing of hospitals: The case of Austria. Health
Care Manag Sci 2014;17:331‑47.
42. Jehu‑Appiah C, Sekidde S, Adjuik M, Akazili J, Almeida SD,
Nyonator F, et al. Ownership and technical efficiency of hospitals:
Evidence from Ghana using data envelopment analysis. Cost Eff
Resour Alloc 2014;12:9.
43. Markazi‑Moghaddam N, Aryankhesal A, Arab M. The first
stages of liberalization of public hospitals in Iran: Establishment
of autonomous hospitals and the barriers. Iran J Public Health
2014;43:1640‑50.
44. Shwekerela B. The effects of hospital reforms on the management
of public hospitals in Tanzania: Challenges and lessons learnt.
World Hosp Health Serv 2014;50:23‑6.
45. Farrow G. Can organisational restructuring of hospitals improve
quality and safety? the experience at sydney children’s hospitals
network.London: BMJ Publishing Group Ltd; 2015.
46. Ferreira D, Marques RC. Did the corporatization of Portuguese
hospitals significantly change their productivity? Eur J Health
Econ 2015;16:289‑303.
47. Kahancová M, Szabó IG. Hospital bargaining in the wake of
management reforms: Hungary and Slovakia compared. Eur J
Ind Relat 2015;21:335‑52.
48. Lindlbauer I, Winter V, Schreyögg J. Antecedents and
consequences of corporatization: An empirical analysis of German
public hospitals. J Public Adm Res Theory 2016;26:309‑26.
49. Pan J, Qin X, Hsieh CR. Is the pro‑competition policy an effective
solution for China’s public hospital reform. Health Econ Policy
Law 2016;11:337.
50. Pesheva P, Georgieva E, Hristov N, Zahariev V and Dimitrova V.
The hospital sector reform in BulgariaNikolai Hristov. Eur J Public
Health 2017;27 Suppl 3:56‑78.
51. De Geyndt W. Does autonomy for public hospitals in developing
countries increase performance? Evidence‑based case studies. Soc
Sci Med 2017;179:74‑80.
52. Fu H, Li L, Li M, Yang C, Hsiao W. An evaluation of systemic
reforms of public hospitals: The Sanming model in China. Health
Policy Plan 2017;32:1135‑45.
53. Sajadi HS, Sajadi ZS, Sajadi FA, Hadi M and Zahmatkesh M.
The comparison of hospitals’ performance indicators before and
after the Iran’s hospital care transformations plan. J Educ Health
Promot 2017;6:44‑76.
54. Thiel A, Winter V, Büchner VA. Board characteristics, governance
objectives, and hospital performance: An empirical analysis of
German hospitals. Health Care Manage Rev 2018;43:282‑92.
55. Jones L, Pomeroy L, Robert G, Burnett S, Anderson JE, Fulop NJ.
How do hospital boards govern for quality improvement? A
mixed methods study of 15 organisations in England. BMJ Qual
Saf 2017;26:978‑86.
56. Verzulli R, Jacobs R, Goddard M. Autonomy and performance in
the public sector: The experience of English NHS hospitals. Eur J
Health Econ 2018;19:607‑26.
57. Jafari M, Habibirad A, Pourtaleb A, Salarianzadeh MH. Health
system organizational reform in governing Iranian public
hospitals: A content analysis to comprehend the barriers in Board
of Trustees’ hospitals. Int J Health Plann Manage 2018;33:e612‑20.
58. Zhao D, Zhang Z. Qualitative analysis of direction of public
hospital reforms in China. Front Med 2018;12:218‑23.
59. Govindaraj R, Chawla M. Recent experiences with hospital
autonomy in developing countries: What can we learn? Boston,
MA: Harvard School of Public Health; 1996.
60. Tao D, Hawkins L, Wang H, Langenbrunner J, Zhang S,
Dredge R. Fixing the public hospital system in China. Volume
2010;2:8‑20.
61. Mordelet P. The future of public hospitals in a globalized world:
Corporate governance, corporatization or privatization? World
Hosp Health Serv 2008;44:23‑5.
62. Hartwig K, Pashman J, Cherlin E, Dale M, Callaway M,
Czaplinski C and et al. Hospital management in the context of
health sector reform: A planning model in Ethiopia. Int J Health
Plann Manage 2008;23:203‑18.
63. Bazzoli GJ. The corporatization of American hospitals. J Health
Polit Policy Law 2004;29:885‑905.
64. McKee M, Edwards N, Atun R. Public‑private partnerships for
hospitals. Bull World Health Organ 2006;84:890‑6.
65. Nurunnabi M, Islam SK. Accountability in the Bangladeshi
accountability in healthcare privatized healthcare sector. Int J
Health Care Qual Assur 2012;25:625‑44.
66. Tiemann O, Schreyögg J. Changes in hospital efficiency after
privatization. Health Care Manage Sci 2012;15:310‑26.
67. Kahancová M, Szabó IG. Acting on the Edge of the Public Sector:
Hospital Corporatization and Collective Bargaining in Hungary
and Slovakia; 2012.
68. Collins D, Njeru G, Meme J, Newbrander W. Hospital autonomy:
The experience of Kenyatta National Hospital. Int J Health Plann
Manage 1999;14:129‑53.
69. Filerman GL. Book Review: Innovations in Health Services
Delivery: The Corporatization of Public Hospitals. Los Angeles,
CA: SAGE Publications; 2004.
70. Jackson R, Kartoglu I, Stringer C, Gorrell G, Roberts A, Song X,
et al. CogStack‑experiences of deploying integrated information
retrieval and extraction services in a large National Health
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