Rationalizing Mongolia’s Hospital Services: Experiences, Lessons Learned, and Future Directions

Before the 1990s, Mongolia had a health care system that largely depended on hospital-based services. The country’s hospital sector was characterized by the extensive use of an excessive number of acute beds, a large number of medically unjustified admissions, and lengthy hospital stays. In the early 1990s, the Government of Mongolia started socioeconomic reforms as part of the transition to a market economy. It requested the Asian Development Bank (ADB) to support health sector reforms in the country. This paper describes the hospital sector in Mongolia along with the reforms and results achieved, challenges that remain, and ongoing and future directions for ADB support to better respond to the needs of the people.

Estimación del costo oculto concomitante a la presencia de eventos adversos hospitalarios asociados al uso de medicamentos en un hospital federal de referencia en la ciudad de México / Estimation of the hidden cost concomitant with the presence of adverse events in the hospital sector associated with the use of medications in a federal hospital in Mexico city

Los costos ocultos se presentan a consecuencia de la aparición de disfuncionamientos, o desviaciones, presentes en la operatividad de la organización y que resultan de la interacción entre lógicas de comportamiento y aspectos de estructura. Su importancia se ejemplifica a través de análisis realizados en la Unión Europea; en donde se refiere, que equivalen entre 7.5 a 12% del costo estándar de producción o 20-30% de la nómina organizacional. En México, se reportan hallazgos de investigaciones, sobre costos ocultos, en los sectores metalmecánico, de la ropa, del trasporte... pero no en el de la salud. Objetivo.- Este análisis, corresponde a una investigación de tipo cualitativo para la identificación de los disfuncionamientos presentes en un hospital mexicano y de los costos ocultos que se generan en consecuencia; específicamente, en lo que corresponde a un tópico de interés en el Sector Salud como lo son los Eventos Adversos Hospitalarios asociados al uso de medicamentos y que para fines de esta investigación se denominan Eventos Adversos a Medicamentos y Errores Asociados al Uso de Medicamentos. Resultados.- El costo oculto tangible por fármacos corresponde al 6.53% del presupuesto hospitalario asignado en el 2013 o el 25.62% de los gastos de operación erogados para el mismo año y el intangible se asocia a la falta de creación potencial y deterioro del clima organizacional. Conclusiones.- Se sugiere la implementación de la metodología para la identificación de disfuncionamientos y costos ocultos asociados, en la unidades del Sector Salud como un área de oportunidad para la mejora organizacional.

Study on the Not-for-Profit Hospital Model in India

The “Not-for-Profit” Hospital Sector has the reputation of providing affordable and accessible healthcare for many years. This sector has done yeoman service over the years with some institutions from even before Independence. Although various institutions have been established for different purposes, this sector provides not only curative healthcare, but also preventive healthcare, and links healthcare with social reform, community engagement, and education. They utilize the resources and grants provided to them by the Government to provide cost effective healthcare to the population without being overly concerned about profits. However, this sector remains largely understudied, with a lack of awareness about its services in the public domain.

Online sustainability disclosure by Spanish hospitals: an institutionalist approach

PurposeThis paper examines the level of sustainability disclosures provided by Spanish hospitals using exclusively the information revealed in their institutional websites. Based on different levels of disclosure, the authors try to find the possible reasons why some Spanish hospitals reveal more sustainability information than others.Design/methodology/approachTo achieve this goal, the authors conducted a content analysis of the official websites of all Spanish hospitals identified by the Ministry of Health, Social Services and Equality.FindingsThe results reveal that Spanish hospitals seem to use sustainability disclosures for different legitimizing purposes. In general, the results indicate that Spanish hospitals may be driven by symbolic rather than substantive actions to achieve legitimacy from stakeholders.Originality/valueDue to the lack of empirical research on the hospital sector, more research is required to improve understanding of why hospitals disclose sustainability information or not.