Hospital Governance

  • Antonio DuránEmail author
  • Richard B. Saltman


We emphasize “governance” as setting the very ground rules within which society’s institutions, including hospitals, function—stretching across government, regulations and management. For a hospital, governance delineates the “licence to operate” of the organization. It operates at a variety of levels: micro, meso and macro. Key parameters for judging the space for governance are the technical capacity (outputs from inputs), managerial capacity (setting strategies and operational objectives) and degree of operational status. The latter in the form of degree of autonomy has led through ideas of new public management to differing corporate functional forms, but without clear criteria for assessing the result.


Autonomy Governance Government Hospitals Macro Management Managerial capacity Meso Micro New Public Management Regulations Technical capacity 


  1. Baghdadi-Sabeti, G., & Serhan, F. (2010). WHO Good Governance for Medicines Programme: An Innovative Approach to Prevent Corruption in the Pharmaceutical Sector. Geneva: World Health Organization. World Health Report, Background Paper, 25.Google Scholar
  2. Barlow, J., Roehrich, J., & Wright, S. (2013). Europe Sees Mixed Results from Public-Private Partnerships for Building and Managing Health Care Facilities and Services. Health Affairs, 32(1).
  3. Christensen, C. (2009). The Innovator’s Prescription a Disruptive Solution for Healthcare. New York: McGraw Hill.Google Scholar
  4. Deaton, A. (2003). Health, Inequality, and Economic Development. Journal of Economic Literature, 41(1), 113–158.CrossRefGoogle Scholar
  5. Duran, A., & La Forgia, J. (2016). Challenges and Lessons in Public Hospital Governance and Management in China. In China Joint Study Partnership: World Bank Group, World Health Organization, Ministry of Finance, National Health and Family Planning Commission, Ministry of Human Resources and Social Security. Deepening Health Reform in China: Building High Quality and Value-Based Service Delivery, Policy Summary. Retrieved from
  6. Duran, A., & Saltman, R. B. (2013). Innovative Strategies in Governing Public Hospitals. Eurohealth, 19(1), 3–7. Retrieved March 5, 2019, from Scholar
  7. Duran, A., Saltman, R. B., & Dubois, H. F. W. (2011). A Framework for Assessing Hospital Governance. In R. B. Saltman, A. Duran, & H. F. W. Dubois (Eds.), Governing Public Hospitals, Reform Strategies and the Movement Towards Institutional Autonomy (Observatory Studies Series No. 25) (p. 38). Brussels: European Observatory on Health Systems and Policies.Google Scholar
  8. Ezzamel, M., & Reed, M. (2008). Governance: A Code of Multiple Colours. Human Relations, 61(5), 597–615.CrossRefGoogle Scholar
  9. Gordon, J. S. (2004). An Empire of Wealth: The Epic History of American Economic Power. New York: HarperCollins.Google Scholar
  10. Hood, C. (1991). A Public Management for All Seasons? Public Administration, 69(1), 3–19.CrossRefGoogle Scholar
  11. Ikegami, N. (2014). Universal Health Coverage for Inclusive and Sustainable Development – Lessons from Japan. Washington, DC: The World Bank. Chapter 9. Retrieved August 18, 2017, from Scholar
  12. Ikegami, N., Yoo, B. K., Hashimoto, H., Matsumoto, M., Ogata, H., et al. (2011). Japanese Universal Health Coverage: Evolution, Achievements, and Challenges. Lancet, 378(9796), 1106–1115. Retrieved August 18, 2017, from Scholar
  13. Kaufmann, D., Kray, A., & Mastruzzi, M. (2010). The Worldwide Governance Indicators: Methodology and Analytical Issues. Washington, DC: The Brookings Institution.Google Scholar
  14. La Forgia, J., Harding, A., & Hawkins, L. (2000). Organizational Reform of Hospitals: Overview of Cross Country Experience. Washington, DC: The World Bank. World Bank Flagship Program in Health Sector Reform and Sustainable Financing.Google Scholar
  15. Mintzberg, H. (1996). Managing Government, Governing Management. Harvard Business Review, 74(3), 75–83.Google Scholar
  16. Nye, J., & Donahue, J. (2000). Governance in a Globalizing World. Washington, DC: Brookings Institution.Google Scholar
  17. Osborne, D., & Gaebler, T. (1992). Re-inventing Government. New York: Addison-Wesley.Google Scholar
  18. Peters, B. G. (2004). Back to the Centre? Rebuilding the State. In A. Gamble & T. Wright (Eds.), Restarting the State (pp. 130–140). London: Blackwell Publishing.Google Scholar
  19. Preker, A., & Harding, A. (Eds.). (2003). Innovations in Health Service Delivery, The Corporatization of Public Hospitals (p. 25). Washington, DC: The World Bank.Google Scholar
  20. Rhodes, R. A. W. (1996). The New Governance; Governing without Government. Political Studies, XLIV, 652–667.CrossRefGoogle Scholar
  21. Richards, D., & Smith, M. (2002). Governance and Public Policy in the UK. Oxford: Oxford University Press.Google Scholar
  22. Saltman, R. B., Duran, A., & Dubois, H. F. W. (Eds.). (2011). Governing Public Hospitals, Reform Strategies and the Movement Towards Institutional Autonomy. Brussels: European Observatory on Health Systems and Policies, Observatory Studies Series No. 25, 38.Google Scholar
  23. West, D., Villasenor, J., & Schneider, J. (2017, January 5). Spurring Private Investment in Global Health Research and Development. Washington, DC: The Brookings Institution TechTank.Google Scholar
  24. WHO – World Health Organization. (2000). World Health Report 2000. Health System Improving Performance. Geneva: World Health Organization.Google Scholar
  25. WHO – World Health Organization. (2013, April 19). Sixty-Sixth World Health Assembly Draft Twelfth General Programme of Work. Geneva: World Health Organization, A66/6, Provisional Agenda Item 12.2.Google Scholar
  26. Woods, N. (2000). The Challenge of Good Governance for the IMF and the World Bank Themselves. World Development, 28(5), 823–841.CrossRefGoogle Scholar
  27. World Bank. (2002). World Development Report 2002. Building Institutions for Markets. Washington, DC: Oxford University Press.Google Scholar

Copyright information

© The Author(s) 2020

Authors and Affiliations

  1. 1.ALLDMHEALTHSevilleSpain
  2. 2.Department of Health Policy and ManagementRollins School of Public Health, Emory UniversityAtlantaUSA

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