The future management of nephrology: budget elements and organization planning.

Like many specialized branches of medicine, the future of nephrology will be entrusted to organizational models that are able to withstand the impact of both the new and increasing demand for assistance and the rationalization of resources. Therefore, it is necessary to clearly understand that the model must integrate and unify many aspects that regulate the activities in the health care service. Budget means "who does what and with material and what human resources" with respect to the constraints imposed by the decisions of the controlling entities, and it is mainly a system of planning and control. Management control utilizes a combined and coordinated synthesis of various company techniques including an auditing system, analytical accounting (or per cents of cost), a reporting system able to change the data gathered into measures of syntheses that can be used to carry out sound evaluations. The health system needs a type of organization--typical of professional organizations--that is an absolute prerogative of the technical/professional component which is the only one able to discern, understand and propose new diagnostic and therapeutic trends and approaches. At the end an evaluation of quality system is depicted. ISO 9004 norms, for example, provide principles on which an organization must be based, in order to reach high levels of quality and that must be used by the top management to lead the organization towards improved performance.