A Tale of Excessive Hospital Autonomy? An Evaluation of the Hospital Reform in Senegal

Lemiè ; re, Christophe ; Turbat, Vincent ; Puret, Juliette

World Bank, Washington, DC

关键词: ABUSE;    AGED;    BEDS;    C-SECTIONS;    CAESAREAN SECTION;   

RP-ID  :  68806

学科分类：社会科学、人文和艺术（综合）

来源: World Bank Open Knowledge Repository

【 摘 要 】

This report evaluates the hospitalreform that took place in Senegal in 1998. The reform wassuccessful in granting hospitals considerable autonomy inall management areas, yet resulted in many hospitals closingto bankruptcy. After the reforms the population continued toregard hospital care as unaffordable and of inadequatequality. The very mixed results of the hospital reform aredue to a lack of efficiency and built-in accountability. Thereport concludes that it might have been possible to avoidthe current situation if in addition to empoweringhospitals, an accountability mechanism had been implemented.The priorities will be to restore some government controlover hospitals, restore the efficiency of hospitals, andcreate some progress on equity of access to hospital care.