Yalda Mousazadeh1, Ali Jannati2, Hossein Jabbari Beiramy3, Mohammad Asgharijafarabadi4, Ali Ebadi5. 1. Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran. 2. Tabriz Healthcare Management Research Center,Tabriz University of Medical Sciences, Tabriz, Iran. 3. Tabriz Health Services Management Research Center, Tabriz University of medical sciences, Tabriz, Iran. 4. Road Traffic Injury Research Centre, Tabriz University of Medical Sciences, Tabriz, Iran. 5. Deputy of Health, Tabriz University of Medical Sciences, Tabriz, Iran.
Abstract
BACKGROUND: Hospitals as key actors in health systems face growing pres-sures especially cost cutting and search for costeffective ways to resources management. Downsizing is one of these ways. This study was conducted to identify advantages and disadvantages of different methods of hospital' downsizing. METHODS: The search was conducted in databases of Medlib, SID, Pub Med, Science Direct and Google Scholar Meta search engine by keywords of Downsizing, Hospital Downsizing, Hospital Rightsizing, Hospital Restructuring, Staff Downsizing, Hospital Merging, Hospital Reorganization and the Persian equivalents. Resulted 815 articles were studied and refined step by step. Finally, 27 articles were selected for analysis. RESULTS: Five hospital downsizing methods were identified during searching. These methods were reducing the number of employees and beds, outsourcing, integration of hospital units, and the combination of these methods. The most important benefits were cost reduction, increasing patient satisfaction, increasing home care and outpatient services. The most important disadvantage included reducing access, reducing the rate of hospital admissions and increasing employees' workload and dissatisfaction. CONCLUSION: Each downsizing method has strengths and weaknesses. Using different methods of downsizing, according to circumstances and applying appropriate interventions after implementation, is necessary for promotion.
BACKGROUND: Hospitals as key actors in health systems face growing pres-sures especially cost cutting and search for costeffective ways to resources management. Downsizing is one of these ways. This study was conducted to identify advantages and disadvantages of different methods of hospital' downsizing. METHODS: The search was conducted in databases of Medlib, SID, Pub Med, Science Direct and Google Scholar Meta search engine by keywords of Downsizing, Hospital Downsizing, Hospital Rightsizing, Hospital Restructuring, Staff Downsizing, Hospital Merging, Hospital Reorganization and the Persian equivalents. Resulted 815 articles were studied and refined step by step. Finally, 27 articles were selected for analysis. RESULTS: Five hospital downsizing methods were identified during searching. These methods were reducing the number of employees and beds, outsourcing, integration of hospital units, and the combination of these methods. The most important benefits were cost reduction, increasing patient satisfaction, increasing home care and outpatient services. The most important disadvantage included reducing access, reducing the rate of hospital admissions and increasing employees' workload and dissatisfaction. CONCLUSION: Each downsizing method has strengths and weaknesses. Using different methods of downsizing, according to circumstances and applying appropriate interventions after implementation, is necessary for promotion.
Authors: Jussi Vahtera; Mika Kivimäki; Pauli Forma; Juhani Wikström; Tuomo Halmeenmäki; Anne Linna; Jaana Pentti Journal: J Epidemiol Community Health Date: 2005-03 Impact factor: 3.710