A Tale of Excessive Hospital Autonomy? An Evaluation of the Hospital Reform in Senegal

This report evaluates the hospital reform that took place in Senegal in 1998. The reform was successful in granting hospitals considerable autonomy in all management areas, yet resulted in many hospitals closing to bankruptcy. After the reforms the...

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Main Authors:	Lemière, Christophe, Turbat, Vincent, Puret, Juliette
Format:	Other Health Study
Language:	English
Published:	World Bank, Washington, DC 2012
Subjects:	ABUSE AGED BEDS C-SECTIONS CAESAREAN SECTION CAESAREAN SECTIONS CHILD CARE CLINICAL SERVICES CLINICIANS COST OF SERVICES DEBT DEVELOPING COUNTRIES DIAGNOSIS DIAGNOSIS RELATED GROUPS DIAGNOSTIC PROCEDURES DISEASES DISSEMINATION DOCTORS DRUGS ECONOMIC STATUS ELDERLY ELDERLY PEOPLE ELDERLY PERSONS ENTREPRENEURIAL INITIATIVES EPIDEMIOLOGICAL PROFILE EQUITY IN ACCESS EXPENDITURES FACT SHEET FAMILIES FINANCIAL MANAGEMENT FREE CARE HEALTH CARE HEALTH CARE CENTERS HEALTH CARE DEMAND HEALTH CARE EXPENDITURES HEALTH CARE FACILITIES HEALTH CARE SERVICES HEALTH CENTERS HEALTH COMMITTEES HEALTH COVERAGE HEALTH FACILITIES HEALTH FINANCING HEALTH INDICATORS HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH PLANS HEALTH POLICY HEALTH PROMOTION HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SYSTEM HEALTH SYSTEM PERFORMANCE HEALTH WORKERS HOSPITAL HOSPITAL AUTONOMY HOSPITAL CARE HOSPITAL COST HOSPITAL DELIVERIES HOSPITAL MANAGEMENT HOSPITAL MANAGERS HOSPITAL PATIENTS HOSPITAL RATES HOSPITAL SERVICES HOSPITAL STAFF HOSPITALIZATION HOSPITALIZATIONS HOSPITALS HOUSEHOLD SURVEYS HUMAN RESOURCES IMPACT ON HEALTH INCOME INDEXES INDUCED DEMAND INFECTIONS INFORMATION SYSTEM INFORMATION SYSTEMS INPATIENT CARE INTEGRATION JOB SECURITY LAB TESTS LEGAL STATUS LIABILITY LOW-INCOME COUNTRIES MEDICAL SERVICES MEDICAL SPECIALISTS MEDICINES MIDWIVES MINISTRY OF HEALTH MINORITY MORBIDITY MOTHER NATIONAL PLANS NATIONAL POLICY NUMBER OF BIRTHS NURSE NURSES NURSING OUTPATIENT CARE PARAMEDICS PATHOLOGY PATIENT PATIENT SATISFACTION PATIENTS PENSIONS PERSONALITY PHYSICIANS POPULATION DENSITY POPULATION GROWTH POPULATION INCREASE PREGNANCIES PROGRESS PUBLIC HOSPITALS QUALITY ASSURANCE QUALITY OF CARE REGIONAL HOSPITAL REHABILITATION REMEDIES RESPECT RURAL AREAS SKILLED STAFF SKILLED WORKERS SOCIAL SECURITY SPILLOVER SURGERY TECHNICAL CAPACITY TRANSPORTATION UNFPA UNIONS UNITED NATIONS POPULATION FUND USER FEES VIOLENCE VISITS WORKERS WORKFORCE WORLD HEALTH ORGANIZATION
Online Access:	http://documents.worldbank.org/curated/en/2012/05/16279763/senegal-tale-excessive-hospital-autonomy-evaluation-hospital-reform-senegal http://hdl.handle.net/10986/11880

id	okr-10986-11880
recordtype	oai_dc
spelling	okr-10986-118802021-04-23T14:02:58Z A Tale of Excessive Hospital Autonomy? An Evaluation of the Hospital Reform in Senegal Lemière, Christophe Turbat, Vincent Puret, Juliette ABUSE AGED BEDS C-SECTIONS CAESAREAN SECTION CAESAREAN SECTIONS CHILD CARE CLINICAL SERVICES CLINICIANS COST OF SERVICES DEBT DEVELOPING COUNTRIES DIAGNOSIS DIAGNOSIS RELATED GROUPS DIAGNOSTIC PROCEDURES DISEASES DISSEMINATION DOCTORS DRUGS ECONOMIC STATUS ELDERLY ELDERLY PEOPLE ELDERLY PERSONS ENTREPRENEURIAL INITIATIVES EPIDEMIOLOGICAL PROFILE EQUITY IN ACCESS EXPENDITURES FACT SHEET FAMILIES FINANCIAL MANAGEMENT FREE CARE HEALTH CARE HEALTH CARE CENTERS HEALTH CARE DEMAND HEALTH CARE EXPENDITURES HEALTH CARE FACILITIES HEALTH CARE SERVICES HEALTH CENTERS HEALTH COMMITTEES HEALTH COVERAGE HEALTH FACILITIES HEALTH FINANCING HEALTH INDICATORS HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH PLANS HEALTH POLICY HEALTH PROMOTION HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SYSTEM HEALTH SYSTEM PERFORMANCE HEALTH WORKERS HOSPITAL HOSPITAL AUTONOMY HOSPITAL CARE HOSPITAL COST HOSPITAL DELIVERIES HOSPITAL MANAGEMENT HOSPITAL MANAGERS HOSPITAL PATIENTS HOSPITAL RATES HOSPITAL SERVICES HOSPITAL STAFF HOSPITALIZATION HOSPITALIZATIONS HOSPITALS HOUSEHOLD SURVEYS HUMAN RESOURCES IMPACT ON HEALTH INCOME INDEXES INDUCED DEMAND INFECTIONS INFORMATION SYSTEM INFORMATION SYSTEMS INPATIENT CARE INTEGRATION JOB SECURITY LAB TESTS LEGAL STATUS LIABILITY LOW-INCOME COUNTRIES MEDICAL SERVICES MEDICAL SPECIALISTS MEDICINES MIDWIVES MINISTRY OF HEALTH MINORITY MORBIDITY MOTHER NATIONAL PLANS NATIONAL POLICY NUMBER OF BIRTHS NURSE NURSES NURSING OUTPATIENT CARE PARAMEDICS PATHOLOGY PATIENT PATIENT SATISFACTION PATIENTS PENSIONS PERSONALITY PHYSICIANS POPULATION DENSITY POPULATION GROWTH POPULATION INCREASE PREGNANCIES PROGRESS PUBLIC HOSPITALS QUALITY ASSURANCE QUALITY OF CARE REGIONAL HOSPITAL REHABILITATION REMEDIES RESPECT RURAL AREAS SKILLED STAFF SKILLED WORKERS SOCIAL SECURITY SPILLOVER SURGERY TECHNICAL CAPACITY TRANSPORTATION UNFPA UNIONS UNITED NATIONS POPULATION FUND USER FEES VIOLENCE VISITS WORKERS WORKFORCE WORLD HEALTH ORGANIZATION This report evaluates the hospital reform that took place in Senegal in 1998. The reform was successful in granting hospitals considerable autonomy in all management areas, yet resulted in many hospitals closing to bankruptcy. After the reforms the population continued to regard hospital care as unaffordable and of inadequate quality. The very mixed results of the hospital reform are due to a lack of efficiency and built-in accountability. The report concludes that it might have been possible to avoid the current situation if in addition to empowering hospitals, an accountability mechanism had been implemented. The priorities will be to restore some government control over hospitals, restore the efficiency of hospitals, and create some progress on equity of access to hospital care. 2012-12-04T19:54:39Z 2012-12-04T19:54:39Z 2012-05 http://documents.worldbank.org/curated/en/2012/05/16279763/senegal-tale-excessive-hospital-autonomy-evaluation-hospital-reform-senegal http://hdl.handle.net/10986/11880 English CC BY 3.0 IGO http://creativecommons.org/licenses/by/3.0/igo World Bank World Bank, Washington, DC Economic & Sector Work :: Other Health Study Economic & Sector Work Africa Senegal
repository_type	Digital Repository
institution_category	Foreign Institution
institution	Digital Repositories
building	World Bank Open Knowledge Repository
collection	World Bank
language	English
topic	ABUSE AGED BEDS C-SECTIONS CAESAREAN SECTION CAESAREAN SECTIONS CHILD CARE CLINICAL SERVICES CLINICIANS COST OF SERVICES DEBT DEVELOPING COUNTRIES DIAGNOSIS DIAGNOSIS RELATED GROUPS DIAGNOSTIC PROCEDURES DISEASES DISSEMINATION DOCTORS DRUGS ECONOMIC STATUS ELDERLY ELDERLY PEOPLE ELDERLY PERSONS ENTREPRENEURIAL INITIATIVES EPIDEMIOLOGICAL PROFILE EQUITY IN ACCESS EXPENDITURES FACT SHEET FAMILIES FINANCIAL MANAGEMENT FREE CARE HEALTH CARE HEALTH CARE CENTERS HEALTH CARE DEMAND HEALTH CARE EXPENDITURES HEALTH CARE FACILITIES HEALTH CARE SERVICES HEALTH CENTERS HEALTH COMMITTEES HEALTH COVERAGE HEALTH FACILITIES HEALTH FINANCING HEALTH INDICATORS HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH PLANS HEALTH POLICY HEALTH PROMOTION HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SYSTEM HEALTH SYSTEM PERFORMANCE HEALTH WORKERS HOSPITAL HOSPITAL AUTONOMY HOSPITAL CARE HOSPITAL COST HOSPITAL DELIVERIES HOSPITAL MANAGEMENT HOSPITAL MANAGERS HOSPITAL PATIENTS HOSPITAL RATES HOSPITAL SERVICES HOSPITAL STAFF HOSPITALIZATION HOSPITALIZATIONS HOSPITALS HOUSEHOLD SURVEYS HUMAN RESOURCES IMPACT ON HEALTH INCOME INDEXES INDUCED DEMAND INFECTIONS INFORMATION SYSTEM INFORMATION SYSTEMS INPATIENT CARE INTEGRATION JOB SECURITY LAB TESTS LEGAL STATUS LIABILITY LOW-INCOME COUNTRIES MEDICAL SERVICES MEDICAL SPECIALISTS MEDICINES MIDWIVES MINISTRY OF HEALTH MINORITY MORBIDITY MOTHER NATIONAL PLANS NATIONAL POLICY NUMBER OF BIRTHS NURSE NURSES NURSING OUTPATIENT CARE PARAMEDICS PATHOLOGY PATIENT PATIENT SATISFACTION PATIENTS PENSIONS PERSONALITY PHYSICIANS POPULATION DENSITY POPULATION GROWTH POPULATION INCREASE PREGNANCIES PROGRESS PUBLIC HOSPITALS QUALITY ASSURANCE QUALITY OF CARE REGIONAL HOSPITAL REHABILITATION REMEDIES RESPECT RURAL AREAS SKILLED STAFF SKILLED WORKERS SOCIAL SECURITY SPILLOVER SURGERY TECHNICAL CAPACITY TRANSPORTATION UNFPA UNIONS UNITED NATIONS POPULATION FUND USER FEES VIOLENCE VISITS WORKERS WORKFORCE WORLD HEALTH ORGANIZATION
spellingShingle	ABUSE AGED BEDS C-SECTIONS CAESAREAN SECTION CAESAREAN SECTIONS CHILD CARE CLINICAL SERVICES CLINICIANS COST OF SERVICES DEBT DEVELOPING COUNTRIES DIAGNOSIS DIAGNOSIS RELATED GROUPS DIAGNOSTIC PROCEDURES DISEASES DISSEMINATION DOCTORS DRUGS ECONOMIC STATUS ELDERLY ELDERLY PEOPLE ELDERLY PERSONS ENTREPRENEURIAL INITIATIVES EPIDEMIOLOGICAL PROFILE EQUITY IN ACCESS EXPENDITURES FACT SHEET FAMILIES FINANCIAL MANAGEMENT FREE CARE HEALTH CARE HEALTH CARE CENTERS HEALTH CARE DEMAND HEALTH CARE EXPENDITURES HEALTH CARE FACILITIES HEALTH CARE SERVICES HEALTH CENTERS HEALTH COMMITTEES HEALTH COVERAGE HEALTH FACILITIES HEALTH FINANCING HEALTH INDICATORS HEALTH INSURANCE HEALTH INSURANCE COVERAGE HEALTH ORGANIZATION HEALTH OUTCOMES HEALTH PLANS HEALTH POLICY HEALTH PROMOTION HEALTH SERVICE HEALTH SERVICE DELIVERY HEALTH SYSTEM HEALTH SYSTEM PERFORMANCE HEALTH WORKERS HOSPITAL HOSPITAL AUTONOMY HOSPITAL CARE HOSPITAL COST HOSPITAL DELIVERIES HOSPITAL MANAGEMENT HOSPITAL MANAGERS HOSPITAL PATIENTS HOSPITAL RATES HOSPITAL SERVICES HOSPITAL STAFF HOSPITALIZATION HOSPITALIZATIONS HOSPITALS HOUSEHOLD SURVEYS HUMAN RESOURCES IMPACT ON HEALTH INCOME INDEXES INDUCED DEMAND INFECTIONS INFORMATION SYSTEM INFORMATION SYSTEMS INPATIENT CARE INTEGRATION JOB SECURITY LAB TESTS LEGAL STATUS LIABILITY LOW-INCOME COUNTRIES MEDICAL SERVICES MEDICAL SPECIALISTS MEDICINES MIDWIVES MINISTRY OF HEALTH MINORITY MORBIDITY MOTHER NATIONAL PLANS NATIONAL POLICY NUMBER OF BIRTHS NURSE NURSES NURSING OUTPATIENT CARE PARAMEDICS PATHOLOGY PATIENT PATIENT SATISFACTION PATIENTS PENSIONS PERSONALITY PHYSICIANS POPULATION DENSITY POPULATION GROWTH POPULATION INCREASE PREGNANCIES PROGRESS PUBLIC HOSPITALS QUALITY ASSURANCE QUALITY OF CARE REGIONAL HOSPITAL REHABILITATION REMEDIES RESPECT RURAL AREAS SKILLED STAFF SKILLED WORKERS SOCIAL SECURITY SPILLOVER SURGERY TECHNICAL CAPACITY TRANSPORTATION UNFPA UNIONS UNITED NATIONS POPULATION FUND USER FEES VIOLENCE VISITS WORKERS WORKFORCE WORLD HEALTH ORGANIZATION Lemière, Christophe Turbat, Vincent Puret, Juliette A Tale of Excessive Hospital Autonomy? An Evaluation of the Hospital Reform in Senegal
geographic_facet	Africa Senegal
description	This report evaluates the hospital reform that took place in Senegal in 1998. The reform was successful in granting hospitals considerable autonomy in all management areas, yet resulted in many hospitals closing to bankruptcy. After the reforms the population continued to regard hospital care as unaffordable and of inadequate quality. The very mixed results of the hospital reform are due to a lack of efficiency and built-in accountability. The report concludes that it might have been possible to avoid the current situation if in addition to empowering hospitals, an accountability mechanism had been implemented. The priorities will be to restore some government control over hospitals, restore the efficiency of hospitals, and create some progress on equity of access to hospital care.
format	Economic & Sector Work :: Other Health Study
author	Lemière, Christophe Turbat, Vincent Puret, Juliette
author_facet	Lemière, Christophe Turbat, Vincent Puret, Juliette
author_sort	Lemière, Christophe
title	A Tale of Excessive Hospital Autonomy? An Evaluation of the Hospital Reform in Senegal
title_short	A Tale of Excessive Hospital Autonomy? An Evaluation of the Hospital Reform in Senegal
title_full	A Tale of Excessive Hospital Autonomy? An Evaluation of the Hospital Reform in Senegal
title_fullStr	A Tale of Excessive Hospital Autonomy? An Evaluation of the Hospital Reform in Senegal
title_full_unstemmed	A Tale of Excessive Hospital Autonomy? An Evaluation of the Hospital Reform in Senegal
title_sort	tale of excessive hospital autonomy? an evaluation of the hospital reform in senegal
publisher	World Bank, Washington, DC
publishDate	2012
url	http://documents.worldbank.org/curated/en/2012/05/16279763/senegal-tale-excessive-hospital-autonomy-evaluation-hospital-reform-senegal http://hdl.handle.net/10986/11880
_version_	1764418264888246272

A Tale of Excessive Hospital Autonomy? An Evaluation of the Hospital Reform in Senegal

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