Health administration

{{Short description|Field relating to administration of hospitals}} {{For|management of health information systems, such as [[electronic health record]]s|health information management}} {{Redirect|Hospital administration|the journal|Journal of Healthcare Management{{!}}Hospital Administration (journal)}} {{Globalize|date=April 2019}} {{Use dmy dates|date=May 2025}}

[[File:'One of the wards in the hospital at Scutari'. Wellcome M0007724 - restoration, cropped.jpg|thumb|right|300px|Iconographic Collections. Keywords: E. Walker; Florence Nightingale; W.J. Simpson]]

'''Health administration''', '''healthcare administration''', '''healthcare management, health services management''' or '''hospital''' '''management''' is the field relating to leadership, management, and administration of [[public health]] systems, [[health care systems]], [[hospital]]s, and [[hospital network]]s in all the primary, secondary, and tertiary sectors.

==Terminology== Health systems management or health care systems management describes the leadership and [[general management]] of [[hospitals]], [[hospital network]]s, and/or [[health care systems]]. In international use, the term refers to management at all levels.<ref>{{cite web|url=https://www.who.int/topics/management/en|title=World Health Organization – Management|url-status=dead|archive-url=https://web.archive.org/web/20090212002640/http://www.who.int/topics/management/en/|archive-date=12 February 2009}}</ref> In the United States, management of a single institution (e.g. a hospital) is also referred to as "medical and health services management",<ref>{{cite web|url=http://www.bls.gov|title=Bureau of Labor Statistics|url-status=live|archive-url=https://web.archive.org/web/20130423042046/http://www.bls.gov/|archive-date=23 April 2013}}</ref> "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.{{cn|date=August 2023}}

==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]]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.<ref>{{cite web |url=http://www.mshealthcareers.com/careers/healthcareadmin.htm |title=Health Care Administrator |access-date=11 September 2012 |url-status=dead |archive-url=https://web.archive.org/web/20120702233306/http://www.mshealthcareers.com/careers/healthcareadmin.htm |archive-date=2 July 2012 }}</ref>

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 [[United States economy|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.<ref name="Kliff-administractive costs">{{cite web|last1=Kliff|first1=Sarah|title=$1.43 of every $100 in America goes toward hospital administration|date=15 September 2014 |url=https://www.vox.com/2014/9/15/6151861/1-43-of-every-100-in-america-towards-hospital-paperwork|publisher=Vox|access-date=16 September 2014|url-status=live|archive-url=https://web.archive.org/web/20140915211307/http://www.vox.com/2014/9/15/6151861/1-43-of-every-100-in-america-towards-hospital-paperwork|archive-date=15 September 2014}}</ref>

===Competencies=== [[National Center for Healthcare Leadership|NCHL]] competencies that require to engage with credibility, creativity, and motivation in complex and dynamic health care environments.<ref>{{cite web |url=http://www.nchl.org/documents/navlink/competency_model-summary_uid31020101024281.pdf |title=Archived copy |access-date=22 October 2016 |url-status=live |archive-url=https://web.archive.org/web/20170118094350/http://www.nchl.org/documents/navlink/competency_model-summary_uid31020101024281.pdf |archive-date=18 January 2017 }}</ref> * 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<ref name="NE">[http://www.newenglandcollegeonline.com/bachelors-degree-healthcare-administration/ "Bachelor's Degree in Healthcare Administration"] {{webarchive|url=https://web.archive.org/web/20130208031955/http://www.newenglandcollegeonline.com/bachelors-degree-healthcare-administration/ |date=8 February 2013 }} ''[[New England College]]''</ref> or healthcare management<ref>{{cite web|url=http://www.floridatechonline.com/undergraduate-ba-healthcare-management-degree/|title=Bachelor of Arts in Business Administration Healthcare Management – Online Healthcare Management Degree|website=Florida Tech Online|url-status=live|archive-url=https://web.archive.org/web/20130820105146/http://www.floridatechonline.com/undergraduate-ba-healthcare-management-degree/|archive-date=20 August 2013}}</ref> 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]] in healthcare administration or human resources,<ref name="NE" /> a [[master's degree]] is considered the "standard credential"<ref>{{cite web|url=http://www.bls.gov/oco/ocos014.htm|title=Bureau of Labor Statistics – Occupational Outlook Handbook entry|url-status=live|archive-url=https://web.archive.org/web/20090105224955/http://www.bls.gov/oco/ocos014.htm|archive-date=5 January 2009}}</ref> 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.{{cn|date=August 2023}}

The [[Commission on the Accreditation of Healthcare Management Education]] (CAHME) is the [[Educational accreditation|accrediting body]] overseeing master's-level programs in the [[United States]] and [[Canada]] on behalf of the [[United States Department of Education]]. It accredits several degree program types, including Master of Hospital Administration (MHA), [[Master of Health Administration|Master of Health Services Administration]] (MHSA), [[Master of Business Administration|Master of Business Administration in Hospital Management]] (MBA-HM), [[Master of Health Administration]] (MHA), [[Master of Public Health]] (MPH, MSPH, MSHPM), [[Master of Science]] (MS-HSM, MS-HA), and [[Master of Public Administration]] (MPA).(Master of Hospital Management) (MHM){{cn|date=August 2023}}

=== 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]] and the [[Healthcare Information and Management Systems Society]]. Institutional membership groups are joined by organizations; whereas they typically focus on organizational effectiveness, and may also include [[data sharing]] 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.{{cn|date=August 2023}}

==System processes== A career in [[Health care|healthcare]] administration consists of organizing, developing, and managing [[Medicine|medical]] and [[Health care|health services]]. These responsibilities are carried out at hospitals, clinics, managed care [[Company|companies]], [[public health]] agencies, and other comparable establishments. This job involves a lot of paperwork and minimal clinical engagement. Healthcare administrators make sure to promote excellence in patient care, [[patient satisfaction]], and relationships with their [[physician]]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.<ref name="McAlearney 2006 967–982">{{Cite journal|last=McAlearney|first=Ann Scheck|date=2006|title=Leadership Development in Healthcare: A Qualitative Study|url=https://www.jstor.org/stable/4093879|journal=Journal of Organizational Behavior|volume=27|issue=7|pages=967–982|doi=10.1002/job.417 |jstor=4093879 |issn=0894-3796}}</ref> Healthcare administrators might become overworked along with [[physician]]s feeling stressed from various protocols. However, both the parties of [[Stakeholder (corporate)|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 [[Hierarchy|hierarchies]] of professionals, on both the [[Clinical trial|clinical]] and administrative sides of the organization, generate special challenges for directing and coordinating the healthcare organization.<ref name="McAlearney 2006 967–982"/> A healthcare administrator has a long-term effect in improving the hospital's process [[Operating system|operation systems]]. They play a vital role in the sustainability of the institution.

=== Funding of hospitals === Healthcare administrators are in charge of hospital [[finance]]s and advocate various strategies to improve their facilities and resources. Hospitals provide funding for assets like [[marketing]], charity events, equipment, medicine, payroll, etc. At the same time, an institution should not be all things to people; it has its own limitations.<ref name="GODIWALLA 1991 336–351">{{Cite journal|last1=GODIWALLA|first1=YEZDI H.|last2=GODIWALLA|first2=SHIRLEY Y.|title=Strategic Management in Hospitals |date=1991|url=https://www.jstor.org/stable/25780452|journal=Journal of Health and Human Resources Administration|volume=13|issue=3|pages=336–351|jstor=25780452 |pmid=10109843 |issn=0160-4198}}</ref> The [[management]] administration carefully manages these funds due to a spending limitation. The healthcare administrators control the [[Expenditures in the United States federal budget|expenditures]] 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.<ref>{{Cite journal|last1=Pellegrini|first1=Lawrence C.|last2=Rodriguez-Monguio|first2=Rosa|last3=Qian|first3=Jing|date=2014|title=The US healthcare workforce and the labor market effect on healthcare spending and health outcomes|url=https://www.jstor.org/stable/24571845|journal=International Journal of Health Care Finance and Economics|volume=14|issue=2|pages=127–141|doi=10.1007/s10754-014-9142-0 |jstor=24571845 |pmid=24652416 |s2cid=12963343 |issn=1389-6563}}</ref> When healthcare spending reduces, [[employment]] 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]] afloat. Many hospitals host charity events and donate to them as well.{{cn|date=August 2023}}

=== 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-effectiveness analysis|cost-effective]] way possible. [[United States|The United States]] leads the world in high quality and advanced level healthcare.<ref name="GODIWALLA 1991 336–351"/> Everyone is working towards a common goal thanks to these [[mission statement]]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.{{cn|date=August 2023}}

==Research== '''Health policy and systems research''' (HPSR) is a field of inquiry that studies "how societies organize themselves in achieving collective health goals, and how different actors interact in the policy and implementation processes to contribute to policy outcomes".<ref>{{Cite web |title=What is Health Policy and Systems Research |url=https://ahpsr.who.int/what-we-do/what-is-health-policy-and-systems-research-(hpsr) |access-date=17 January 2024 |website=WHO Alliance for Health Policy & Systems Research |language=en}}</ref> HPSR is interdisciplinary and brings together expertise in a variety of biomedical and social sciences such as [[economics]], [[sociology]], [[anthropology]], [[political science]], [[public health]] and [[epidemiology]].

The [[Commission on Health Research for Development]]<ref>{{Cite journal |last1=Bennett |first1=Sara |last2=Adam |first2=Taghreed |last3=Zarowsky |first3=Christina |last4=Tangcharoensathien |first4=Viroj |last5=Ranson |first5=Kent |last6=Evans |first6=Tim |last7=Mills |first7=Anne |date=November 2008 |title=From Mexico to Mali: progress in health policy and systems research |url=https://linkinghub.elsevier.com/retrieve/pii/S014067360861658X |journal=The Lancet |language=en |volume=372 |issue=9649 |pages=1571–1578 |doi=10.1016/S0140-6736(08)61658-X|pmid=18984191 |s2cid=21065572 |url-access=subscription }}</ref> and the ''Ad Hoc Committee on Health Research''<ref>{{Cite journal |last=Lin |first=V |date=1 December 1997 |title=Resource review. Investing in health research and development: report of the ad hoc committee on health research relating to future intervention options. World Health Organization, Geneva, 1996 |url=https://academic.oup.com/heapro/article-lookup/doi/10.1093/heapro/12.4.331 |journal=Health Promotion International |volume=12 |issue=4 |pages=331–332 |doi=10.1093/heapro/12.4.331}}</ref> both highlighted the urgent need for focusing research methods, funding and practice towards addressing [[Health equity|health inequities]] and embracing [[Interdisciplinarity|inter-disciplinary]] and intersectoral thinking. These reports and other academic and activist voices linked to them argued for greater voice and participation of [[Developing country|developing countries]] in defining research priorities.<ref>{{Cite journal |last=Weisz |first=George |date=2 August 2020 |title=What Happened to the Global Forum for Health Research? |url=https://www.tandfonline.com/doi/full/10.1080/17441692.2020.1752767 |journal=Global Public Health |language=en |volume=15 |issue=8 |pages=1212–1224 |doi=10.1080/17441692.2020.1752767 |pmid=32295489 |s2cid=215793442 |issn=1744-1692|url-access=subscription }}</ref> Since then creation of the [[Alliance for Health Policy and Systems Research]] in 2000 and that of [[Health Systems Global]] in 2012 have consolidated the practice community of HPSR.

==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]] 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.<ref>Haddock, Cynthia Carter [http://www.healthmanagementcareers.org/haddock_ch01.pdf "A Brief History of Healthcare Management"] {{webarchive|url=https://web.archive.org/web/20120904050920/http://www.healthmanagementcareers.org/haddock_ch01.pdf|date=4 September 2012}}, 2002.</ref> The first modern health systems management program was established in 1934 at the University of Chicago.<ref>{{cite web|title=University of Chicago – Graduate Program in Health Administration and Policy|url=http://gphap.uchicago.edu/aboutgphap.shtml|url-status=live|archive-url=https://web.archive.org/web/20100620062442/http://gphap.uchicago.edu/aboutgphap.shtml|archive-date=20 June 2010}}</ref> 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,<ref>Stevens, R. (1999). "In sickness and in wealth: American hospitals in the twentieth century." Baltimore: The Johns Hopkins University Press.</ref> which remains the dominant structure in the United States and Canada today (see also "Academic Preparation").{{cn|date=August 2023}}

Health systems management has been described as a "hidden" health profession<ref>Haddock, C. C., & McLean, R. D. (2002). "Careers in Healthcare Management: How to Find your Path and Follow It." Chicago: Health Administration Press.</ref> 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.<ref>Organisation for Economic Co-operation and Development (2006). "Rising health costs put pressure on public finances, finds OECD." Retrieved 20 January 2009 from the OECD Web site: {{cite web|title=Rising health costs put pressure on public finances, finds OECD|url=http://www.oecd.org/document/37/0,3343,en_2649_201185_36986213_1_1_1_1,00.html|url-status=live|archive-url=https://web.archive.org/web/20080503193140/http://www.oecd.org/document/37/0,3343,en_2649_201185_36986213_1_1_1_1,00.html|archive-date=3 May 2008|access-date=27 August 2013}}</ref>

==See also== * [[Health insurance]] * [[Health Insurance Innovations]] * [[Health Advocate]] * [[Master of Health Administration]] * [[Nosokinetics]]

==References== {{Reflist|30em}} {{Reflist|group=nb}}

==Further reading== * Jill Barr & Lesley Dowding; Leadership in Health Care, 2012; Sage Publications Ltd; {{ISBN|1446207633}}.

== External links == * [http://www.hfma.org Healthcare Financial Management Association] * [http://www.himss.org Healthcare Information and Management Systems Society] * [http://www.healthcareleadershipalliance.org Healthcare Leadership Alliance] {{Webarchive|url=https://web.archive.org/web/20220402174657/http://www.healthcareleadershipalliance.org/ |date=2 April 2022 }} * [http://www.oecd.org/health/reviews Organisation for Economic Co-operation and Development – Reviews of health systems] * [https://web.archive.org/web/20090811103009/http://www.who.int/management/mhswork/en/ World Health Organization – 'Making Health Systems Work' series]

[[Category:Policy]] [[Category:Health care management| ]] [[Category:Health economics]] [[Category:Health care reform]] [[Category:Health insurance]] [[Category:Universal health care]] [[Category:Health education]] [[Category:Public health]]