Value of Business Models for Hospitals

“places where people could die” (by isolating them from the rest of society). Well after
that – from the 19th century onwards – hospitals evolved more and more into places
where symptom-based, treatment-oriented care was administered. Important in the last
two centuries (19th and 20th century) was the development of aseptic and anti-septic
techniques, better understanding of infections and the development of effective
anesthesia. Overall, the development of the hospital in these two centuries was driven
largely by technology. But unfortunately, other roles and service line strategies on the
other hand developed with little conscious thought.
Where is the hospital today? The link with the environment of the (Dutch) hospital is
mostly determined by its “neighboring medical institutions”, such as GPs or other
hospitals. There is a structure that determines the position of the hospital based on the
complexity of care and level of specialization. We discern 5 types: general hospital, topclinical
hospital, academic hospital, specialty hospital and focus clinic. With each of these
hospitals there is a different mix of six main functions that the organization provides:
patient care, teaching, research, health system support (e.g. management of primary care),
employment role and societal role (e.g. provider of social care). Analysis shows relatively
large similarities between current hospital configurations.
What about strategic change? Hospitals have a long history of reactive behavior towards
change (coinciding with their overall organic, rather than proactive change). Hospital
reform in The Netherlands has been, especially from the 1980s, a struggle between
government, hospital management and medical specialists. Attempts to implement new
fee structures and fee cuts therefore never proved effective.
In this research we establish what possibilities for change there are according to current
decision-makers. We have conducted semi-structured... [continues]

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