THE ROLE OF HOSPITALS IN

HEALTH SYSTEM REFORMS

Assistant Danka Sinadinovi

SCHOOL OF MEDICINE,
UNIVERSITY OF BELGRADE

HOSPITALS AND HEALTH

SYSTEM REFORMS
1. HOSPITALS (their changed role, what
they are, types, hospital medical and
allied staff)
2. RESTRUCTURING OF HOSPITAL SERVICES
3. HOSPITAL DECENTRALIZATION
4. IMPROVING QUALITY OF HOSPITAL CARE
THE ROLE OF HOSPITALS IN HEALTH SYSTEM REFORMS

HOSPITALS
hospital = inpatients; hospitalize
(send to hospital, admit to hospital),
hospitalization or hospital admission
it consists of departments/wards/units
(ICU);
a ward round; a waiting/operating room
(theater); visiting hours
opposite terms: ambulatory care,
outpatients; discharge/release from
hospital; a discharge summary
THE ROLE OF HOSPITALS IN HEALTH SYSTEM REFORMS

TYPES OF HOSPITALS AND

ADMISSIONS
hospital types: teaching hospital;
general hospital; maternity hospital,
ophthalmic hospital etc.; day hospital
hospital admissions:
1. ARRANGED ADMISSION: recommended, a
waiting-list, a letter, an admission card (p. 38)
2. EMERGENCY ADMISSION: a patient (e.g.
after an accident) is taken to ER (emergency
room) by ambulance
THE ROLE OF HOSPITALS IN HEALTH SYSTEM REFORMS

HOSPITAL MEDICAL STAFF

medical and nursing staff/personnel:

a doctor/physician; UK and US hospital grades
(p. 39) (a resident, an intern)
a nurse (a senior/charge nurse), a sister
(a ward/theater sister)

paramedical staff/personnel
(paramedics):
orderlies, nursing auxiliaries/assistants,
ambulance drivers
THE ROLE OF HOSPITALS IN HEALTH SYSTEM REFORMS

RESTRUCTURING HOSPITAL SERVICES

hospital capacity: a number of hospital beds

three trends across Europe:

1. fewer hospital beds and their closure, shorter

length of stay, increase of day-care
interventions (high hospital cost)
2. hospital closures and mergers (hospitals
grouped under one hospital management)
(Ireland, UK) (lower cost)
3. restructured hospitals and construction of new
facilities (accommodation): ambulatory care
(France, Norway, Spain)
THE ROLE OF HOSPITALS IN HEALTH SYSTEM REFORMS

HOSPITAL DECENTRALIZATION

reforms triggered by the purchaser-provider

split:
1. autonomous (self-governing) hospitals
2. an increase of private-sector provision together
with public-sector hospitals (the developed
world)
3. public-sector hospitals still predominate
(the developing world)
THE ROLE OF HOSPITALS IN HEALTH SYSTEM REFORMS

IMPROVING QUALITY OF HOSPITAL CARE

improved performance (way of work)

within
the hospital structure:
1. optimizing (making the best) clinical
performance
2. changes in payment mechanism
3. changes in organizational environment
THE ROLE OF HOSPITALS IN HEALTH SYSTEM REFORMS

CLINICAL PERFORMANCE

clinical quality assurance and

clinical audit (examination of
accounts)
assessing service performance
clinical governance (control,
management, running)
THE ROLE OF HOSPITALS IN HEALTH SYSTEM REFORMS

PAYMENT MECHANISM

new financial incentives

(encouragements),
new paying methods
global budgeting (the developed
world)
from input-based funding to more
performance-oriented approaches (the
developing world)
THE ROLE OF HOSPITALS IN HEALTH SYSTEM REFORMS

ORGANIZATIONAL ENVIRONMENT

the relationship between organizational culture and

quality of care
Book, p. 40/41, Check your vocabulary, ex. A & B

THE ROLE OF HOSPITALS IN HEALTH SYSTEM REFORMS

SUFFIXES IN MEDICINE

THE ROLE OF HOSPITALS IN HEALTH SYSTEM REFORMS

MEDICAL SUFFIXES (1)

-logy (science), e.g. biology

-iatrics (specialty), e.g. pediatrics
-sis (process/action), e.g. dialysis
-asis/ism (condition/state), e.g.
homeostasis
-emia (condition in blood), e.g. lipemia
THE ROLE OF HOSPITALS IN HEALTH SYSTEM REFORMS

MEDICAL SUFFIXES (2)

-pathy (disease, abnormality), e.g.

neuropathy
-itis (inflammation), e.g. meningitis
-algia (pain), e.g. neuralgia
-oma (tumor), e.g. lymphoma

THE ROLE OF HOSPITALS IN HEALTH SYSTEM REFORMS

MEDICAL SUFFIXES (3)

-graph/-scope (instrument), e.g. electrocardiograph

-gram (record), e.g. electroencephalogram
surgical techniques:
-stomy (opening), e.g. tracheostomy
-tomy (cutting), e.g. appendectomy
-ectomy (removal), e.g. tonsillectomy
-plasty (reconstruction), e.g. rhinoplasty
Book, p. 41, ex. 1

THE ROLE OF HOSPITALS IN HEALTH SYSTEM REFORMS