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Health administration, healthcare administration, healthcare management or hospital management is the field relating to leadership, management, and administration of
public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the det ...
systems,
health care systems Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
,
hospital A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emerge ...
s, and
hospital network A hospital network is a public, non-profit or for-profit company or organization that provides two or more hospitals and other broad healthcare facilities and services. A hospital network may include hospitals in one or more regions within one o ...
s in all the primary, secondary, and tertiary sectors.


Terminology

Health systems management or health care systems management describes the leadership and
general management A general manager (GM) is an executive who has overall responsibility for managing both the revenue and cost elements of a company's income statement, known as profit & loss (P&L) responsibility. A general manager usually oversees most or all of ...
of
hospitals A hospital is a health care institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emerge ...
,
hospital network A hospital network is a public, non-profit or for-profit company or organization that provides two or more hospitals and other broad healthcare facilities and services. A hospital network may include hospitals in one or more regions within one o ...
s, and/or
health care systems Health, according to the World Health Organization, is "a state of complete physical, mental and social well-being and not merely the absence of disease and infirmity".World Health Organization. (2006)''Constitution of the World Health Organiza ...
. 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 for mutual development and growth


Hospital administrators

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
clinician A clinician is a health care professional typically employed at a skilled nursing facility or clinic. Clinicians work directly with patients rather than in a laboratory or as a researcher. A clinician may diagnose, treat, and otherwise care for pa ...
s, or individuals with other healthcare 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 and effective 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 The United States is a highly developed mixed-market economy and has the world's largest nominal GDP and net wealth. It has the second-largest by purchasing power parity (PPP) behind China. It has the world's seventh-highest per capita GDP ...
. 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 countries, hospitals allocate approximately 12 percent of their budget toward administrative costs. In the United States, hospitals spend 25 percent on administrative costs.


Competencies

NCHL competencies that require to engage with credibility, creativity, and motivation in complex and dynamic health care environments. * Accountability * Achievement orientation * Change leadership * Collaboration * Communication skills * Financial Skills * Impact and influence * Innovative thinking * Organizational awareness * Professionalism * Self-confidence * Strategic orientation * Talent development * Team leadership


Training and organizations


Associated qualifications

Health care management is usually studied through healthcare administration"Bachelor's Degree in Healthcare Administration"
''
New England College New England College (NEC) is a private liberal arts college in Henniker, New Hampshire. As of Fall 2020 New England College's enrollment was 4,327 students (1,776 undergraduate and 2,551 graduate). The college is regionally accredited by the Ne ...
''
or healthcare management programs in a business school or, in some institutions, in a school of public health.


North America

Although many colleges and universities are offering a
bachelor's degree A bachelor's degree (from Middle Latin ''baccalaureus'') or baccalaureate (from Modern Latin ''baccalaureatus'') is an undergraduate academic degree awarded by colleges and universities upon completion of a course of study lasting three to six ...
in healthcare administration or human resources, a
master's degree A master's degree (from Latin ) is an academic degree awarded by universities or colleges upon completion of a course of study demonstrating mastery or a high-order overview of a specific field of study or area of professional practice.
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 The Commission on Accreditation of Healthcare Management Education (CAHME) is the accrediting body for graduate programs in healthcare management in the United States and Canada. It is based in Spring House, Pennsylvania and is a 501(c)(3) non-p ...
(CAHME) is the
accrediting body Accreditation is the independent, third-party evaluation of a conformity assessment body (such as certification body, inspection body or laboratory) against recognised standards, conveying formal demonstration of its impartiality and competence to ...
overseeing master's-level programs in the
United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...
and
Canada Canada is a country in North America. Its ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, covering over , making it the world's second-largest country by tot ...
on behalf of the
United States Department of Education The United States Department of Education is a Cabinet-level department of the United States government. It began operating on May 4, 1980, having been created after the Department of Health, Education, and Welfare was split into the Department ...
. 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 The Master of Health Administration, Master of Healthcare Administration (MHA), or Master of Health Management (MHM), is a Master's degree, master's-level professional degree granted to students who complete a course of study in the knowledge and c ...
(MHA),
Master of Public Health The Master of Public Health or Master of Philosophy in Public Health (M.P.H.), Master of Science in Public Health (MSPH), Master of Medical Science in Public Health (MMSPH) and the Doctor of Public Health (Dr.P.H.), International Masters for Healt ...
(MPH, MSPH, MSHPM),
Master of Science A Master of Science ( la, Magisterii Scientiae; abbreviated MS, M.S., MSc, M.Sc., SM, S.M., ScM or Sc.M.) is a master's degree in the field of science awarded by universities in many countries or a person holding such a degree. In contrast to ...
(MS-HSM, MS-HA), and
Master of Public Administration The Master of Public Administration (M.P.Adm., M.P.A., or MPA) is a specialized higher professional post graduate degree in public administration, similar/ equivalent to the Master of Business Administration but with an emphasis on the issues of ...
(MPA).(Master of Hospital Management) (MHM)


Professional organizations

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
Healthcare Financial Management Association The Healthcare Financial Management Association is a professional membership organization that helps healthcare finance management executives and professionals navigate the complexities of the healthcare industry. It is based in Downers Grove, D ...
and the
Healthcare Information and Management Systems Society The Healthcare Information and Management Systems Society (HIMSS) is an American not-for-profit organization dedicated to improving health care in quality, safety, cost-effectiveness and access through the best use of information technology and ...
. Institutional membership groups are joined by organizations; whereas they typically focus on organizational effectiveness, and may also include
data sharing Data sharing is the practice of making data used for scholarly research available to other investigators. Many funding agencies, institutions, and publication venues have policies regarding data sharing because transparency and openness are consid ...
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.


System Processes

A career in
healthcare Health care or healthcare is the improvement of health via the prevention, diagnosis, treatment, amelioration or cure of disease, illness, injury, and other physical and mental impairments in people. Health care is delivered by health profe ...
administration consists of organizing, developing, and managing
medical Medicine is the science and practice of caring for a patient, managing the diagnosis, prognosis, prevention, treatment, palliation of their injury or disease, and promoting their health. Medicine encompasses a variety of health care practic ...
and
health services Health care or healthcare is the improvement of health via the preventive healthcare, prevention, diagnosis, therapy, treatment, wiktionary:amelioration, amelioration or cure of disease, illness, injury, and other disability, physical and menta ...
. These responsibilities are carried out at hospitals, clinics, managed care
companies A company, abbreviated as co., is a legal entity representing an association of people, whether natural, legal or a mixture of both, with a specific objective. Company members share a common purpose and unite to achieve specific, declared go ...
,
public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the det ...
agencies, and other comparable establishments. This job involves a lot of paperwork and minimal patient engagement. Healthcare administrators make sure to promote excellence in patient care,
patient satisfaction Patient satisfaction is a measure of the extent to which a patient is content with the health care which they received from their health care provider. In evaluations of health care quality, patient satisfaction is a performance indicator measured ...
, and relationships with their
physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
s. In order to do this they must make sure that their employees are willing to follow protocols and keep a positive attitude with their patients. The entire organization has a better experience when everything is organized and protocols are set into place. The dual role of physicians follows as both consumers of healthcare resources and controllers of organizational revenue with their ability to direct patients and prescribe care. This makes leader relationships with physicians fairly atypical in comparison with key stakeholder relationships in other industries. Healthcare administrators might become overworked along with
physician A physician (American English), medical practitioner (Commonwealth English), medical doctor, or simply doctor, is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through th ...
s feeling stressed from various protocols. However, both the parties of stakeholders and patients make up the backbone of a proper healthcare administration. These administrators make sure that the doctors, insurance companies, patients, and other healthcare providers have access to the files they need to provide appropriate treatments. Multiple
hierarchies A hierarchy (from Greek: , from , 'president of sacred rites') is an arrangement of items (objects, names, values, categories, etc.) that are represented as being "above", "below", or "at the same level as" one another. Hierarchy is an important ...
of professionals, on both the clinical and administrative sides of the organization, generate special challenges for directing and coordinating the healthcare organization. A healthcare administrator has a long-term effect in improving the hospital's process operation systems. They play a vital role in the sustainability of the institution.


Funding of Hospitals

Healthcare administrators are in charge of hospital
finance Finance is the study and discipline of money, currency and capital assets. It is related to, but not synonymous with economics, the study of production, distribution, and consumption of money, assets, goods and services (the discipline of fina ...
s and advocate various strategies to improve their facilities and resources. Hospitals provide funding for assets like
marketing Marketing is the process of exploring, creating, and delivering value to meet the needs of a target market in terms of goods and services; potentially including selection of a target audience; selection of certain attributes or themes to emph ...
, charity events, equipment, medicine, payroll, etc. At the same time, an institution should not be all things to people; it has its own limitations. The
management Management (or managing) is the administration of an organization, whether it is a business, a nonprofit organization, or a government body. It is the art and science of managing resources of the business. Management includes the activities o ...
administration carefully manages these funds due to a spending limitation. The healthcare administrators control the
expenditures An expense is an item requiring an outflow of money, or any form of Wealth, fortune in general, to another person or group as payment for an item, service, or other category of costs. For a leasehold estate, tenant, renting, rent is an expense. Fo ...
that the hospital allows in order to meet profits. Sometimes hospitals are limited on what they can do for patients. Administrators that run these hospitals strive to achieve goals within their financial limitations. This study examines the causes of healthcare employment growth and workforce composition in the US and evaluates the labor market's impact on healthcare spending and health outcomes. When healthcare spending reduces,
employment Employment is a relationship between two parties regulating the provision of paid labour services. Usually based on a contract, one party, the employer, which might be a corporation, a not-for-profit organization, a co-operative, or any othe ...
growth will start reducing as well. The healthcare administration is critical to the lives of the people in hospitals. It contributes to cost saving practices and making sure that the necessities are brought to the institution. Healthcare management makes sure that protocols and funds are properly organized for each department. They are responsible for keeping the
healthcare industry The healthcare industry (also called the medical industry or health economy) is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, a ...
afloat. Many hospitals host charity events and donate to them as well.


Overall Goal

The fundamental goal of a hospital administrator is to create a positive work environment where patients are treated in the most efficient and
cost-effective Cost-effectiveness analysis (CEA) is a form of economic analysis that compares the relative costs and outcomes (effects) of different courses of action. Cost-effectiveness analysis is distinct from cost–benefit analysis, which assigns a monetar ...
way possible.
The United States The United States of America (U.S.A. or USA), commonly known as the United States (U.S. or US) or America, is a country primarily located in North America. It consists of 50 states, a federal district, five major unincorporated territorie ...
leads the world in high quality and advanced level healthcare. Everyone is working towards a common goal thanks to these
mission statement A mission statement is a short statement of why an organization exists, what its overall goal is, the goal of its operations: what kind of product or service it provides, its primary customers or market, and its geographical region of operation ...
s. This improves the organization's efficiency and productivity. The mission statement establishes the organization's purpose and provides employees a sense of belonging and identity. This encourages management and stakeholders to put in more effort in order to obtain success. The ultimate purpose of health care is to help individuals regain their overall health and wellbeing.


History

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 Marquette University () is a Private university, private Society of Jesus, Jesuit research university in Milwaukee, Wisconsin. Established by the Society of Jesus as Marquette College on August 28, 1881, it was founded by John Henni, John Martin ...
in
Milwaukee, Wisconsin Milwaukee ( ), officially the City of Milwaukee, is both the most populous and most densely populated city in the U.S. state of Wisconsin and the county seat of Milwaukee County, Wisconsin, Milwaukee County. With a population of 577,222 at th ...
. 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 Cornell University is a private statutory land-grant research university based in Ithaca, New York. It is a member of the Ivy League. Founded in 1865 by Ezra Cornell and Andrew Dickson White, Cornell was founded with the intention to teach an ...
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.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:


See also

*
Master of Health Administration The Master of Health Administration, Master of Healthcare Administration (MHA), or Master of Health Management (MHM), is a Master's degree, master's-level professional degree granted to students who complete a course of study in the knowledge and c ...
*
Nosokinetics Nosokinetics is the science/subject of measuring and modelling the process of care in health care, health and social care systems.'' Nosokinetics'' brings together the Greek language, Greek words for ''noso'': disease and ''kinetics'': movement. Bl ...


References


Further reading

* Jill Barr & Lesley Dowding; Leadership in Health Care, 2012; Sage Publications Ltd; .


External links


Healthcare Financial Management Association

Healthcare Information and Management Systems Society

Healthcare Leadership Alliance

Organisation for Economic Co-operation and Development - Reviews of health systems

World Health Organization - 'Making Health Systems Work' series
{{Authority control Policy Health economics