Learning from Hospitals: AN INTRODUCTION

摘要

California Management Review published a Special Issue on health care in Fall 2000. We now follow up with a Forum on hospitals. The 2000 Special Issue addressed the business aspects of health care. These are surely critical, given that health care expenditures in the U.S. are over $1 trillion annually and the share of GDP devoted to healthcare is 14% and rising. The articles in this Forum, by contrast, focus more internally on the organizational and managerial challenges of health care organizations, notably hospitals. These issues are no less critical. There are two reasons for a focus on hospital management. First, the stakes are huge. Hospital charges are the largest single component in the trillion-dollar price of health care, accounting for about half of all third-party health care payments by government agencies and private insurers. Moreover, somewhere between 44,000 to 98,000 people die each year as a result of medical errors in hospitals. Second, hospitals hold lessons applicable to a much broader array of organizations. Hospitals represent an extreme case of three broad trends affecting a growing number of firms and industries: growing knowledge-intensity, increasingly competitive and complex environments, and intensifying accountability pressures. As an extreme case, hospitals help us understand these challenges and how organizations can respond to them.