The reform of Portuguese public hospitals can be described as an evolution by “waves”. A first “wave” took place in 2002, when 34 public hospitals were transformed into State-owned hospital enterprises (SA hospitals). Subsequently, in January 2006, the SA hospitals and some of the traditional public administration hospitals (SPA hospitals) were changed into public business enterprises (EPE hospitals). That was the second “wave” that is the stage we are at pre- sent. A possible third “wave” can be related with the possibility of conversion of the EPE hospitals into State Hospital Foundations (SHF). This paper tries to identify if this new management model has more capacity to influence positively values such as efficiency, equity, quality, governance, empowerment and accountability than the previous existing model. For this purpose it was developed a strategic analysis including an evaluation of some internationals experi- ences, and also a SWOT analysis was performed. The authors conclude that the introduction of SHF model is a very plausible alternative. The model of governance can make the difference and promote its implementation. Due to the participative management model, the process of accountability can be more “visible” and the regulatory process of this management model seems to be more effective.
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