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Health administration, healthcare administration, healthcare management, health services management or hospital management is the field relating to leadership, management, and administration of
public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the de ...
systems,
health care systems A health system, health care system or healthcare system is an organization of people, institutions, and resources that delivers health care services to meet the health needs of target populations. There is a wide variety of health systems aroun ...
,
hospital A hospital is a healthcare institution providing patient treatment with specialized Medical Science, health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically ...
s, and
hospital network A hospital network is a public, non-profit or for-profit company or organization that provides two or more hospitals and other broad healthcare facilities and services. A hospital network may include hospitals in one or more regions within one or ...
s in all the primary, secondary, and tertiary sectors.


Terminology

Health systems management or health care systems management describes the leadership and
general management A general manager (GM) is an executive who has overall responsibility for managing both the revenue and cost elements of a company's income statement, known as profit & loss (P&L) responsibility. A general manager usually oversees most or all of t ...
of
hospitals A hospital is a healthcare institution providing patient treatment with specialized health science and auxiliary healthcare staff and medical equipment. The best-known type of hospital is the general hospital, which typically has an emergency ...
,
hospital network A hospital network is a public, non-profit or for-profit company or organization that provides two or more hospitals and other broad healthcare facilities and services. A hospital network may include hospitals in one or more regions within one or ...
s, and/or
health care systems A health system, health care system or healthcare system is an organization of people, institutions, and resources that delivers health care services to meet the health needs of target populations. There is a wide variety of health systems aroun ...
. In international use, the term refers to management at all levels. In the United States, management of a single institution (e.g. a hospital) is also referred to as "medical and health services management", "healthcare management", or "health administration". Health systems management ensures that specific outcomes are attained that departments within a health facility are running smoothly that the right people are in the right jobs, that people know what is expected of them, that resources are used efficiently and that all departments are working towards a common goal for mutual development and growth.


Hospital administrators

Hospital administrators are individuals or groups of people who act as the central point of control within hospitals. These individuals may be previous or current
clinician A clinician is a health care professional typically employed at a skilled nursing facility or clinic. Clinicians work directly with patients rather than in a laboratory, community health setting or in research. A clinician may diagnose, treat a ...
s, or individuals with other healthcare backgrounds. There are two types of administrators, generalists and specialists. Generalists are individuals who are responsible for managing or helping to manage an entire facility. Specialists are individuals who are responsible for the efficient and effective operations of a specific department such as policy analysis, finance, accounting, budgeting, human resources, or marketing. It was reported in September 2014, that the United States spends roughly $218 billion per year on hospital's administration costs, which is equivalent to 1.43 percent of the total
U.S. economy The United States has a highly developed mixed economy. It is the world's largest economy by nominal GDP and second largest by purchasing power parity (PPP). As of 2025, it has the world's seventh highest nominal GDP per capita and ninth ...
. Hospital administration has grown as a percent of the U.S. economy from .9 percent in 2000 to 1.43 percent in 2012, according to ''Health Affairs''. In 11 countries, hospitals allocate approximately 12 percent of their budget toward administrative costs. In the United States, hospitals spend 25 percent on administrative costs.


Competencies

NCHL competencies that require to engage with credibility, creativity, and motivation in complex and dynamic health care environments. * Accountability * Achievement orientation * Change leadership * Collaboration * Communication skills * Financial skills * Impact and influence * Innovative thinking * Organizational awareness * Professionalism * Self-confidence * Strategic orientation * Talent development * Team leadership


Training and organizations


Associated qualifications

Health care management is usually studied through healthcare administration"Bachelor's Degree in Healthcare Administration"
''
New England College New England College (NEC) is a private liberal arts college in Henniker, New Hampshire. It is accredited by the New England Commission of Higher Education. As of fall 2020, the college enrolled 4,327 students (1,776 undergraduate and 2,551 grad ...
''
or healthcare management programs in a business school or, in some institutions, in a school of public health.


North America

Although many colleges and universities are offering a
bachelor's degree A bachelor's degree (from Medieval Latin ''baccalaureus'') or baccalaureate (from Modern Latin ''baccalaureatus'') is an undergraduate degree awarded by colleges and universities upon completion of a course of study lasting three to six years ...
in healthcare administration or human resources, a
master's degree A master's degree (from Latin ) is a postgraduate academic degree awarded by universities or colleges upon completion of a course of study demonstrating mastery or a high-order overview of a specific field of study or area of professional prac ...
is considered the "standard credential" for most health administrators in the United States. Research and academic-based doctorate level degrees, such as the Doctor of Philosophy (PhD) in Health Administration and the Doctor of Health Administration (DHA) degree, prepare health care professionals to turn their clinical or administrative experiences into opportunities to develop new knowledge and practice, teach, shape public policy and/or lead complex organizations. There are multiple recognized degree types that are considered equivalent from the perspective of professional preparation. The
Commission on the Accreditation of Healthcare Management Education The Commission on Accreditation of Healthcare Management Education (CAHME) is the accrediting body for graduate programs in healthcare management in the United States and Canada. It is based in Spring House, Pennsylvania, and is a 501(c)(3) non ...
(CAHME) is the accrediting body overseeing master's-level programs in the
United States The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
and
Canada Canada is a country in North America. Its Provinces and territories of Canada, ten provinces and three territories extend from the Atlantic Ocean to the Pacific Ocean and northward into the Arctic Ocean, making it the world's List of coun ...
on behalf of the
United States Department of Education The United States Department of Education is a cabinet-level department of the United States government, originating in 1980. The department began operating on May 4, 1980, having been created after the Department of Health, Education, and ...
. It accredits several degree program types, including Master of Hospital Administration (MHA), Master of Health Services Administration (MHSA), Master of Business Administration in Hospital Management (MBA-HM),
Master of Health Administration The Master of Health Administration, Master of Healthcare Administration (MHA), or Master of Health Management (MHM), is a master's-level professional degree granted to students who complete a course of study in the knowledge and competencies need ...
(MHA),
Master of Public Health The Master of Public Health (MPH), Master of Science in Public Health (MSPH), Master of Medical Science in Public Health (MMSPH) and the Doctor of Public Health (DrPH), International Masters for Health Leadership (IMHL) are interdisciplinary profes ...
(MPH, MSPH, MSHPM),
Master of Science A Master of Science (; abbreviated MS, M.S., MSc, M.Sc., SM, S.M., ScM or Sc.M.) is a master's degree. In contrast to the Master of Arts degree, the Master of Science degree is typically granted for studies in sciences, engineering and medici ...
(MS-HSM, MS-HA), and
Master of Public Administration A Master of Public Administration (MPA) is a specialized professional graduate degree in public administration that prepares students for leadership roles, similar or equivalent to a Master of Business Administration but with an emphasis on the ...
(MPA).(Master of Hospital Management) (MHM)


Professional organizations

There are a variety of different professional associations related to health systems management, which can be subcategorized as either personal or institutional membership groups. Personal membership groups are joined by individuals, and typically have individual skills and career development as their focus. Larger personal membership groups include the
Healthcare Financial Management Association The Healthcare Financial Management Association is a professional membership organization that helps healthcare finance management executives and professionals navigate the complexities of the healthcare industry. It is based in Downers Grove,†...
and the
Healthcare Information and Management Systems Society The Healthcare Information and Management Systems Society (HIMSS) is an American not-for-profit organization dedicated to improving health care in quality, safety, cost-effectiveness and access through the best use of information technology and ...
. Institutional membership groups are joined by organizations; whereas they typically focus on organizational effectiveness, and may also include
data sharing Data sharing is the practice of making data used for scholarly research available to other investigators. Many funding agencies, institutions, and publication venues have policies regarding data sharing because transparency and openness are consid ...
agreements and other medical related or administrative practice sharing vehicles for member organizations. Prominent examples include the
American Hospital Association The American Hospital Association (AHA) is a health care industry trade group. It includes nearly 5,000 hospitals and health care providers. The organization, which was founded in Cleveland, Ohio in 1898, with offices in Chicago, Illinois and W ...
and the University Healthsystems Consortium.


System processes

A career in
healthcare Health care, or healthcare, is the improvement or maintenance of health via the preventive healthcare, prevention, diagnosis, therapy, treatment, wikt:amelioration, amelioration or cure of disease, illness, injury, and other disability, physic ...
administration consists of organizing, developing, and managing
medical Medicine is the science and Praxis (process), practice of caring for patients, managing the Medical diagnosis, diagnosis, prognosis, Preventive medicine, prevention, therapy, treatment, Palliative care, palliation of their injury or disease, ...
and
health services Health care, or healthcare, is the improvement or maintenance of health via the preventive healthcare, prevention, diagnosis, therapy, treatment, wikt:amelioration, amelioration or cure of disease, illness, injury, and other disability, physic ...
. These responsibilities are carried out at hospitals, clinics, managed care
companies A company, abbreviated as co., is a legal entity representing an association of legal people, whether natural, juridical or a mixture of both, with a specific objective. Company members share a common purpose and unite to achieve specifi ...
,
public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the de ...
agencies, and other comparable establishments. This job involves a lot of paperwork and minimal clinical engagement. Healthcare administrators make sure to promote excellence in patient care,
patient satisfaction Patient satisfaction is a measure of the extent to which a patient is content with the health care which they received from their health care provider. In evaluations of health care quality, patient satisfaction is a performance indicator measured ...
, and relationships with their
physician A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the Medical education, study, Med ...
s. In order to do this they must make sure that their employees are willing to follow protocols and keep a positive attitude with their patients. The entire organization has a better experience when everything is organized and protocols are set into place. The dual role of physicians follows as both consumers of healthcare resources and controllers of organizational revenue with their ability to direct patients and prescribe care. This makes leader relationships with physicians fairly atypical in comparison with key stakeholder relationships in other industries. Healthcare administrators might become overworked along with
physician A physician, medical practitioner (British English), medical doctor, or simply doctor is a health professional who practices medicine, which is concerned with promoting, maintaining or restoring health through the Medical education, study, Med ...
s feeling stressed from various protocols. However, both the parties of stakeholders and patients make up the backbone of a proper healthcare administration. These administrators make sure that the doctors, insurance companies, patients, and other healthcare providers have access to the files they need to provide appropriate treatments. Multiple
hierarchies A hierarchy (from Greek: , from , 'president of sacred rites') is an arrangement of items (objects, names, values, categories, etc.) that are represented as being "above", "below", or "at the same level as" one another. Hierarchy is an importan ...
of professionals, on both the clinical and administrative sides of the organization, generate special challenges for directing and coordinating the healthcare organization. A healthcare administrator has a long-term effect in improving the hospital's process operation systems. They play a vital role in the sustainability of the institution.


Funding of hospitals

Healthcare administrators are in charge of hospital
finance Finance refers to monetary resources and to the study and Academic discipline, discipline of money, currency, assets and Liability (financial accounting), liabilities. As a subject of study, is a field of Business administration, Business Admin ...
s and advocate various strategies to improve their facilities and resources. Hospitals provide funding for assets like
marketing Marketing is the act of acquiring, satisfying and retaining customers. It is one of the primary components of Business administration, business management and commerce. Marketing is usually conducted by the seller, typically a retailer or ma ...
, charity events, equipment, medicine, payroll, etc. At the same time, an institution should not be all things to people; it has its own limitations. The
management Management (or managing) is the administration of organizations, whether businesses, nonprofit organizations, or a Government agency, government bodies through business administration, Nonprofit studies, nonprofit management, or the political s ...
administration carefully manages these funds due to a spending limitation. The healthcare administrators control the
expenditures An expense is an item requiring an outflow of money, or any form of fortune in general, to another person or group as payment for an item, service, or other category of costs. For a tenant, rent is an expense. For students or parents, tuition is ...
that the hospital allows in order to meet profits. Sometimes hospitals are limited on what they can do for patients. Administrators that run these hospitals strive to achieve goals within their financial limitations. This study examines the causes of healthcare employment growth and workforce composition in the US and evaluates the labor market's impact on healthcare spending and health outcomes. When healthcare spending reduces,
employment Employment is a relationship between two party (law), parties Regulation, regulating the provision of paid Labour (human activity), labour services. Usually based on a employment contract, contract, one party, the employer, which might be a cor ...
growth will start reducing as well. The healthcare administration is critical to the lives of the people in hospitals. It contributes to cost saving practices and making sure that the necessities are brought to the institution. Healthcare management makes sure that protocols and funds are properly organized for each department. They are responsible for keeping the
healthcare industry The healthcare industry (also called the medical industry or health economy) is an aggregation and integration of sectors within the economic system that provides goods and services to treat patients with curative, preventive, rehabilitative, ...
afloat. Many hospitals host charity events and donate to them as well.


Overall goal

The fundamental goal of a hospital administrator is to create a positive work environment where patients are treated in the most efficient and
cost-effective Cost-effectiveness analysis (CEA) is a form of economic analysis that compares the relative costs and outcomes (effects) of different courses of action. Cost-effectiveness analysis is distinct from cost–benefit analysis, which assigns a monetar ...
way possible.
The United States The United States of America (USA), also known as the United States (U.S.) or America, is a country primarily located in North America. It is a federal republic of 50 U.S. state, states and a federal capital district, Washington, D.C. The 48 ...
leads the world in high quality and advanced level healthcare. Everyone is working towards a common goal thanks to these
mission statement A mission statement is a short statement of why an organization exists, what its overall goal is, the goal of its operations: what kind of product or service it provides, its primary customers or market, and its geographical region of operation ...
s. This improves the organization's efficiency and productivity. The mission statement establishes the organization's purpose and provides employees a sense of belonging and identity. This encourages management and stakeholders to put in more effort in order to obtain success. The ultimate purpose of health care is to help individuals regain their overall health and wellbeing.


Research

Health policy and systems research (HPSR) is a field of inquiry that studies "how societies organize themselves in achieving collective health goals, and how different actors interact in the policy and implementation processes to contribute to policy outcomes". HPSR is interdisciplinary and brings together expertise in a variety of biomedical and social sciences such as
economics Economics () is a behavioral science that studies the Production (economics), production, distribution (economics), distribution, and Consumption (economics), consumption of goods and services. Economics focuses on the behaviour and interac ...
,
sociology Sociology is the scientific study of human society that focuses on society, human social behavior, patterns of Interpersonal ties, social relationships, social interaction, and aspects of culture associated with everyday life. The term sociol ...
,
anthropology Anthropology is the scientific study of humanity, concerned with human behavior, human biology, cultures, society, societies, and linguistics, in both the present and past, including archaic humans. Social anthropology studies patterns of behav ...
,
political science Political science is the scientific study of politics. It is a social science dealing with systems of governance and Power (social and political), power, and the analysis of political activities, political philosophy, political thought, polit ...
,
public health Public health is "the science and art of preventing disease, prolonging life and promoting health through the organized efforts and informed choices of society, organizations, public and private, communities and individuals". Analyzing the de ...
and
epidemiology Epidemiology is the study and analysis of the distribution (who, when, and where), patterns and Risk factor (epidemiology), determinants of health and disease conditions in a defined population, and application of this knowledge to prevent dise ...
. The Commission on Health Research for Development and the ''Ad Hoc Committee on Health Research'' both highlighted the urgent need for focusing research methods, funding and practice towards addressing
health inequities Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequit ...
and embracing
inter-disciplinary Interdisciplinarity or interdisciplinary studies involves the combination of multiple academic disciplines into one activity (e.g., a research project). It draws knowledge from several fields such as sociology, anthropology, psychology, economi ...
and intersectoral thinking. These reports and other academic and activist voices linked to them argued for greater voice and participation of
developing countries A developing country is a sovereign state with a less-developed Secondary sector of the economy, industrial base and a lower Human Development Index (HDI) relative to developed countries. However, this definition is not universally agreed upon. ...
in defining research priorities. Since then creation of the
Alliance for Health Policy and Systems Research The Alliance for Health Policy and Systems Research (the Alliance) is an international partnership hosted at World Health Organization Headquarters that works to improve the health of those in low and middle-income countries by supporting the gen ...
in 2000 and that of
Health Systems Global Health Systems Global is a membership-based society that convenes researchers, policymakers and implementers from around the world to develop the field of Health policy and systems research, health systems research. History It emerged from a ...
in 2012 have consolidated the practice community of HPSR.


History

Early hospital administrators were called patient directors or superintendents. At the time, many were nurses who had taken on administrative responsibilities. Over half of the members of the
American Hospital Association The American Hospital Association (AHA) is a health care industry trade group. It includes nearly 5,000 hospitals and health care providers. The organization, which was founded in Cleveland, Ohio in 1898, with offices in Chicago, Illinois and W ...
were graduate nurses in 1916. Other superintendents were medical doctors, laymen and members of the clergy. In the United States, the first degree granting program in the United States was established at
Marquette University Marquette University () is a Private university, private Jesuit research university in Milwaukee, Wisconsin, United States. It was established as Marquette College on August 28, 1881, by John Henni, the first Archbishop of the Roman Catholic Ar ...
in
Milwaukee, Wisconsin Milwaukee is the List of cities in Wisconsin, most populous city in the U.S. state of Wisconsin. Located on the western shore of Lake Michigan, it is the List of United States cities by population, 31st-most populous city in the United States ...
. By 1927, the first two students received their degrees. The original idea is credited to Father Moulinier, associated with the Catholic Hospital Association. The first modern health systems management program was established in 1934 at the University of Chicago. At the time, programs were completed in two years – one year of formal graduate study and one year of practicing internship. In 1958, the Sloan program at
Cornell University Cornell University is a Private university, private Ivy League research university based in Ithaca, New York, United States. The university was co-founded by American philanthropist Ezra Cornell and historian and educator Andrew Dickson W ...
began offering a special program requiring two years of formal study, which remains the dominant structure in the United States and Canada today (see also "Academic Preparation"). Health systems management has been described as a "hidden" health profession because of the relatively low-profile role managers take in health systems, in comparison to direct-care professions such as nursing and medicine. However the visibility of the management profession within healthcare has been rising in recent years, due largely to the widespread problems developed countries are having in balancing cost, access, and quality in their hospitals and health systems.Organisation for Economic Co-operation and Development (2006). "Rising health costs put pressure on public finances, finds OECD." Retrieved 20 January 2009 from the OECD Web site:


See also

*
Health insurance Health insurance or medical insurance (also known as medical aid in South Africa) is a type of insurance that covers the whole or a part of the risk of a person incurring medical expenses. As with other types of insurance, risk is shared among ma ...
* Health Insurance Innovations * Health Advocate *
Master of Health Administration The Master of Health Administration, Master of Healthcare Administration (MHA), or Master of Health Management (MHM), is a master's-level professional degree granted to students who complete a course of study in the knowledge and competencies need ...
*
Nosokinetics Nosokinetics is the science/subject of measuring and modelling the process of care in health and social care systems.'' Nosokinetics'' brings together the Greek words for ''noso'': disease and ''kinetics'': movement. Black box models are currently ...


References


Further reading

* Jill Barr & Lesley Dowding; Leadership in Health Care, 2012; Sage Publications Ltd; .


External links


Healthcare Financial Management Association

Healthcare Information and Management Systems Society

Healthcare Leadership Alliance

Organisation for Economic Co-operation and Development – Reviews of health systems

World Health Organization – 'Making Health Systems Work' series
{{Authority control Policy Health economics Health care reform Health insurance Universal health care Health education Public health