Champagne F, Langley A, Denis J L, Contandriopoulos A P, Cazale L, Rivard M
Université de Montréal, Canada.
Health Serv Manage Res. 1997 Aug;10(3):146-62. doi: 10.1177/095148489701000302.
It has been suggested that strategic management in public services tends to be oriented towards preserving and perpetuating current patterns of service provision, rather than changing priorities. However, faced with severe resource constraints combined with growing demand and rapidly developing technology, public hospitals in Canada have come under increasing pressure. Based on an empirical study of strategic management and change in 32 Montreal hospitals, this paper examines the relationship between financial adversity and the extent and nature of strategic change in these organizations. Strategic change indicators considered in the study include overall product mix, product diversity, product complexity, market demographics, efficiency, and revenue diversification. Results suggest that resource constraints have indeed stimulated changes within these organizations. In particular, hospitals suffering more severe financial difficulties have reduced their size and focused on a narrower range of services. Moreover, there is evidence that greater complementarity has been achieved among the entire sample of hospitals.
有人认为，公共服务中的战略管理往往倾向于维护和延续当前的服务提供模式，而不是改变优先事项。然而，面对严重的资源限制、不断增长的需求和迅速发展的技术，加拿大的公立医院面临着越来越大的压力。基于对蒙特利尔32家医院战略管理与变革的实证研究，本文考察了财务困境与这些组织战略变革的程度和性质之间的关系。该研究中考虑的战略变革指标包括总体产品组合、产品多样性、产品复杂性、市场人口统计数据、效率和收入多元化。结果表明，资源限制确实促使这些组织发生了变革。特别是，财务困难更严重的医院缩小了规模，并专注于范围更窄的服务。此外，有证据表明，在整个医院样本中实现了更大的互补性。
