Governance of Hospitals in Central and Eastern Europe

This book presents a novel view of healthcare system transition in post-communist countries. It is the first region-wide comparative study of hospital governance in Eastern Europe. Comprehensive new material shows the evolution and significance of governance, complementing recent publications on the topic from industrialised countries. Throughout the book, governance is described and substantiated as a major component that, together with provider payment mechanisms, defines the hospital sector’s operations. This view subscribes to the economists’ growing appreciation of extra-financial aspects in the discussion of incentives and regulation of healthcare markets. In particular, the book explains how governance arrangements may affect the outcomes of healthcare financing reforms, and should thus be seen as a critical determinant of their success or failure. This new model of thinking about healthcare system transition emerges from an analysis of 22 countries over the course of two decades. While the primary focus of the study is on developing the hospital sector, an extensive background chapter provides a standalone introduction to the dynamically changing landscape of healthcare in Eastern Europe and an overview of the various problems and challenges the region is facing. Practitioners, policy-makers, academics and students interested in Eastern European healthcare systems, their origins, current status and ways forward, will appreciate the book’s reflections on the problem complexity, the clarity of its concepts, and its accessible style of presentation.

Przemyslaw Marcin Sowa is a health economist whose primary research interests revolve around health care reforms in the countries of Eastern Europe, governance and ownership of hospitals, financing of health care and long term care, health insurance, and health technology assessment. He received a PhD in health economics at the Australian National University, and in the course of his candidature collaborated with experts from the London School of Economics and the London School of Hygiene and Tropical Medicine. He authored papers, articles and reports, as well as conference and seminar presentations, on a range of topics in health economics and health policy including the health care system transition in post-communist countries, hospital reform, private health insurance, risk adjustment, and disability policy. His academic activity also involved the teaching of health economics and health technology assessment, and providing policy assessments and commentaries. He currently holds a position of a Research Fellow in Health Technology Assessment at Griffith University and is an Adjunct Research Fellow in Health Economics at the Australian National University.