Health administration

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.[1] In the United States, management of a single institution (e.g. a hospital) is also referred to as "medical and health services management",[2] "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 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 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.[3]

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 countries, hospitals allocate approximately 12 percent of their budget toward administrative costs. In the United States, hospitals spend 25 percent on administrative costs.[4]

A career in healthcare administration consists of organizing, developing, and managing medical and health services. These responsibilities are carried out at hospitals, clinics, managed care companies, public health 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, and relationships with their physicians. 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.[9] Healthcare administrators might become overworked along with physicians 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 of professionals, on both the clinical and administrative sides of the organization, generate special challenges for directing and coordinating the healthcare organization.[9] 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.

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.[12] The first modern health systems management program was established in 1934 at the University of Chicago.[13] 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,[14] 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[15] 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.[16]

• Master of Health Administration
• Nosokinetics

• Jill Barr & Lesley Dowding; Leadership in Health Care, 2012; Sage Publications Ltd; ISBN 1446207633.

• 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