About this item:

466 Views | 435 Downloads

Author Notes:

Correspondence: Patrick.Jeurissen@radboudumc.nl

PJ wrote the final manuscript. AD and RS contributed to the analysis and earlier drafts.

The authors want to thank the two anonymous reviewers for their valuable comments.

The authors declare that they have no competing interests.


Research Funding:

This publication is supported by COST.


  • European hospitals
  • Governance
  • Privatization
  • Payment reform
  • Cost-containment
  • Hospital management
  • Hospital business models

Uncomfortable realities: the challenge of creating real change in Europe’s consolidating hospital sector


Journal Title:

BMC Health Services Research


Volume 16, Number S2


Type of Work:

Article | Final Publisher PDF


Background: This article examines uncomfortable realities that the European hospital sector currently faces and the potential impact of wide-spread rationalization policies such as (hospital) payment reform and privatization. Methods: Review of relevant international literature. Results: Based on the evidence we present, rationalization policies such as (hospital) payment reform and privatization will probably fall short in delivering better quality of care and lower growth in health expenses. Reasons can be sought in a mix of evidence on the effectiveness of these rationalization policies. Nevertheless, pressures for different business models will gradually continue to increase and it seems safe to assume that more value-added process business and facilitated network models will eventually emerge. Conclusions: The overall argument of this article holds important implications for future research: how can policymakers generate adequate leverage to introduce such changes without destroying necessary hospital capacity and the ability to produce quality healthcare.

Copyright information:

© Jeurissen et al. 2016. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

This is an Open Access work distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0/).
Export to EndNote