Bocconi University and SDA Bocconi School of Management, Department of Policy Analysis and Public Management.
J Healthc Manag. 2012 Jan-Feb;57(1):17-33; discussion 33-4.
Over the last 20 years, hospitals have revised their organizational structures in response to new environmental pressures. Today, demographic and epidemiologic trends and recent technological advances call for new strategies to cope with ultra-elderly frail patients characterized by chronic conditions, high-severity health problems, and complex social situations. The main areas of change surround new ways of managing emerging clusters of patients whose needs are not efficiently or effectively met within traditional hospital organizations. Following the practitioner and academic literature, we first identify the most relevant clusters of new kinds of patients who represent an increasingly larger share of the hospital population in developed countries. Second, we propose a framework that synthesizes the major organizational innovations adopted by successful organizations around the world. We conclude by substantiating the trends of and the reasoning behind the prospective pattern of hospital organizational development.
在过去的 20 年中，医院为应对新的环境压力，对组织结构进行了调整。如今，人口和流行病学趋势以及最近的技术进步要求采取新策略来应对极度老龄化的脆弱患者，这些患者具有慢性疾病、严重健康问题和复杂的社会状况。变化的主要领域围绕着管理新出现的患者群体的新方法展开，这些患者的需求在传统医院组织中不能得到有效满足。我们首先参考从业者和学术文献，确定了最相关的新类型患者群体，这些患者在发达国家的医院人口中所占比例越来越大。其次，我们提出了一个框架，综合了世界各地成功组织所采用的主要组织创新。最后，我们对医院组织发展的未来模式的趋势和背后的推理进行了论证。
