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Health systems management or health care systems management describes the leadership and general management of hospitals, hospital networks, and/or health care systems. In international use, the term refers to management at all levels. In the United States, management of a single institution (e.g. a hospital) is also referred to as "medical and health services management", "healthcare management", or "health administration".
Health systems management ensures that specific outcomes are attained, that departments within a health facility are running smoothly, that the right people are in the right jobs, that people know what is expected of them, that resources are used efficiently and that all departments are working towards a common goal.
Hospital administrators are individuals or groups of people who act as the central point of control within hospitals. These individuals may be previous or current clinicians, or individuals with other backgrounds. There are two types of administrators, generalists and specialists. Generalists are individuals who are responsible for managing or helping to manage an entire facility. Specialists are individuals who are responsible for the efficient operations of a specific department such as policy analysis, finance, accounting, budgeting, human resources, or marketing.
It was reported in September 2014, that the United States spends roughly $218 billion per year on hospital's administration costs, which is equivalent to 1.43 percent of the total U.S. economy. Hospital administration has grown as a percent of the U.S. economy from .9 percent in 2000 to 1.43 percent in 2012, according to Health Affairs. In 11 different countries, hospitals allocate approximately 12 percent of their budget toward administrative costs. In the United States, hospitals spend 25 percent on administrative costs.
Training and organizations
Although many colleges and universities are offering a bachelor's degree in healthcare administration or human resources, a master's degree is considered the "standard credential" for most health administrators in the United States. Research and academic-based doctorate level degrees, such as the Doctor of Philosophy (PhD) in Health Administration and the Doctor of Health Administration (DHA) degree, prepare health care professionals to turn their clinical or administrative experiences into opportunities to develop new knowledge and practice, teach, shape public policy and/or lead complex organizations. There are multiple recognized degree types that are considered equivalent from the perspective of professional preparation.
The Commission on the Accreditation of Healthcare Management Education (CAHME) is the accrediting body overseeing master's-level programs in the United States and Canada on behalf of the United States Department of Education. It accredits several degree program types, including Master of Hospital Administration (MHA), Master of Health Services Administration (MHSA), Master of Business Administration in Hospital Management (MBA-HM), Master of Health Administration (MHA), Master of Public Health (MPH, MSPH, MSHPM), Master of Science (MS-HSM, MS-HA), and Master of Public Administration (MPA).
There are a variety of different professional associations related to health systems management, which can be subcategorized as either personal or institutional membership groups. Personal membership groups are joined by individuals, and typically have individual skills and career development as their focus. Larger personal membership groups include the American College of Healthcare Executives, the Healthcare Financial Management Association, and the Healthcare Information and Management Systems Society. Institutional membership groups are joined by organizations; whereas they typically focus on organizational effectiveness, and may also include data-sharing agreements and other medical related or administrative practice sharing vehicles for member organizations. Prominent examples include the American Hospital Association and the University Healthsystems Consortium.
Early hospital administrators were called patient directors or superintendents. At the time, many were nurses who had taken on administrative responsibilities. Over half of the members of the American Hospital Association were graduate nurses in 1916. Other superintendents were medical doctors, laymen and members of the clergy. In the United States, the first degree granting program in the United States was established at Marquette University in Milwaukee, Wisconsin. By 1927, the first two students received their degrees. The original idea is credited to Father Moulinier, associated with the Catholic Hospital Association. The first modern health systems management program was established in 1934 at the University of Chicago. At the time, programs were completed in two years – one year of formal graduate study and one year of practicing internship. In 1958, the Sloan program at Cornell University began offering a special program requiring two years of formal study, which remains the dominant structure in the United States and Canada today (see also "Academic Preparation").
Health systems management has been described as a "hidden" health profession because of the relatively low-profile role managers take in health systems, in comparison to direct-care professions such as nursing and medicine. However the visibility of the management profession within healthcare has been rising in recent years, due largely to the widespread problems developed countries are having in balancing cost, access, and quality in their hospitals and health systems.
- Jill Barr & Lesley Dowding; Leadership in Health Care, 2012; Sage Publications Ltd; ISBN 1446207633.
- "World Health Organization - Management".
- "Bureau of Labor Statistics".
- "Health Care Administrator". Retrieved 11 September 2012.
- Kliff, Sarah. "$1.43 of every $100 in America goes toward hospital administration". Vox. Retrieved 16 September 2014.
- "Bachelor's Degree in Healthcare Administration" New England College
- "healthcare management"
- "Bureau of Labor Statistics - Occupational Outlook Handbook entry".
- Haddock, Cynthia Carter "A Brief History of Healthcare Management", 2002.
- "University of Chicago - Graduate Program in Health Administration and Policy".
- Stevens, R. (1999). "In sickness and in wealth: American hospitals in the twentieth century." Baltimore: The Johns Hopkins University Press.
- Haddock, C. C., & McLean, R. D. (2002). "Careers in Healthcare Management: How to Find your Path and Follow It." Chicago: Health Administration Press.
- Organisation for Economic Co-operation and Development (2006). "Rising health costs put pressure on public finances, finds OECD." Retrieved January 20, 2009 from the OECD Web site: http://www.oecd.org/document/37/0,3343,en_2649_201185_36986213_1_1_1_1,00.html
- American College of Healthcare Executives
- Healthcare Financial Management Association
- Healthcare Information and Management Systems Society
- Healthcare Leadership Alliance
- Home Economics Archive: Tradition, Research, History (HEARTH)
An e-book collection of over 1,000 books spanning 1850 to 1950, created by Cornell University's Mann Library. Includes several hundred works on hospital administration—particularly hospital nutrition—in this period, itemized in a specific bibliography.
- Journal of Health Administration Education
- MHA Guide - Directory of Health Administration Programs
- Organisation for Economic Co-operation and Development - Reviews of health systems
- World Health Organization - 'Making Health Systems Work' series