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The fiscal crisis in the health sector: Patterns of cutback management across Europe

Ongaro, Edoardo; Ferré, Francesca and Fattore, Giovanni (2015). The fiscal crisis in the health sector: Patterns of cutback management across Europe. Health Policy, 119(7) pp. 954–963.

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DOI (Digital Object Identifier) Link: https://doi.org/10.1016/j.healthpol.2015.04.008
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Abstract

Purpose
The article investigates trends in health sector cutback management strategies occurred during the ongoing financial and fiscal crisis across Europe.

Setting
A European-wide survey to top public healthcare managers was conducted in ten different countries to understand their perception about public sector policy reactions to the financial and economic crisis; answers from 760 respondents from the healthcare sector (30.7% response rate) were analyzed.

Method
A multinomial logistic regression was used to assess the characteristics of respondents, countries’ institutional healthcare models and the trend in public health resources availability during the crisis associated to the decision to introduce unselective cuts, targeted cuts or efficiency savings measures.

Results
Differentiated responses to the fiscal crisis that buffeted public finances were reported both across and within countries. Organizational position of respondents is significant in explaining the perceived cutback management approach introduced, where decentralized positions detect a higher use of linear cuts compared to their colleagues working in central level organizations. Compared to Bismark-like systems Beveridge-like ones favour the introduction of targeted cuts. Postponing the implementation of new programmes and containing expenses through instruments like pay freezes are some of the most popular responses adopted, while outright staff layoffs or reduction of frontline services have been more selectively employed.

Conclusion
To cope with the effects of the fiscal crisis healthcare systems are undergoing important changes, possibly also affecting the scope of universal coverage.

Item Type: Journal Item
ISSN: 0168-8510
Academic Unit/School: Faculty of Business and Law (FBL) > Business > Department for Public Leadership and Social Enterprise
Faculty of Business and Law (FBL) > Business
Faculty of Business and Law (FBL)
Item ID: 51041
Depositing User: Edoardo Ongaro
Date Deposited: 20 Sep 2017 11:36
Last Modified: 20 Sep 2019 22:29
URI: http://oro.open.ac.uk/id/eprint/51041
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