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Can management decentralisation resolve challenges faced by healthcare service delivery organisations? Findings for managers and researchers from a scoping review

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  • Mikael Ohrling
  • John Øvretveit
  • Mats Brommels

Abstract

Purpose Decentralisation of decision‐making from central to lower level organisation has been proposed as a way to increase innovation and make services more responsive to local needs. The purpose of this study was to discover research that can contribute to understanding decentralisation as one strategy for resolving challenges in healthcare service delivery organisations. This scoping review provides examples and research‐informed guidance for decentralisation research, planning and implementation. Findings There is limited empirical research into management decentralisation within primary and community care, but some useful frameworks for assessing and planning decentralisation. Rapid changes are being made to workforce redesign, substitution and patient co‐production. Research into such ‘micro‐decentralisation’ is not considered in the decentralisation literature. Neither is how the context of culture, systems and regulations affects implementation of this type of decentralisation. Our recent experience suggests that management decentralisation can enable fast and effective local changes to respond to the evolving Severe acute respiratory syndrome coronavirus 2 (SARS COV‐2) pandemic. Conclusions Decentralisation can create conditions that support innovation and improvement locally to develop primary and community care. Managers and policy makers can use an appropriate decentralisation strategy to address challenges in workforce retention and recruitment, rising care demands and expectations of patients. There are opportunities for researchers to provide actionable knowledge about changes in organisations and management which could address current challenges in healthcare.

Suggested Citation

  • Mikael Ohrling & John Øvretveit & Mats Brommels, 2021. "Can management decentralisation resolve challenges faced by healthcare service delivery organisations? Findings for managers and researchers from a scoping review," International Journal of Health Planning and Management, Wiley Blackwell, vol. 36(1), pages 30-41, January.
    • Handle: RePEc:bla:ijhplm:v:36:y:2021:i:1:p:30-41
    DOI: 10.1002/hpm.3058
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    References listed on IDEAS

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    1. Daniel Cobos Muñoz & Paloma Merino Amador & Laura Monzon Llamas & David Martinez Hernandez & Juana Maria Santos Sancho, 2017. "Decentralization of health systems in low and middle income countries: a systematic review," International Journal of Public Health, Springer;Swiss School of Public Health (SSPH+), vol. 62(2), pages 219-229, March.
    2. Sumah, Anthony Mwinkaara & Baatiema, Leonard & Abimbola, Seye, 2016. "The impacts of decentralisation on health-related equity: A systematic review of the evidence," Health Policy, Elsevier, vol. 120(10), pages 1183-1192.
    3. Colin Hales, 1999. "Leading Horses to Water? The Impact of Decentralization on Managerial Behaviour," Journal of Management Studies, Wiley Blackwell, vol. 36(6), pages 831-851, November.
    4. Robalino, David A. & Picazo, Oscar F. & Voetberg, Albertus, 2001. "Does fiscal decentralization improve health outcomes? - evidence from a cross-country analysis," Policy Research Working Paper Series 2565, The World Bank.
    5. Bossert, Thomas, 1998. "Analyzing the decentralization of health systems in developing countries: decision space, innovation and performance," Social Science & Medicine, Elsevier, vol. 47(10), pages 1513-1527, November.
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    1. Ilse Schoeman & James Chakwizira, 2023. "Advancing a Performance Management Tool for Service Delivery in Local Government," Administrative Sciences, MDPI, vol. 13(2), pages 1-29, January.

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