In order for delivery to be effective, the structure of healthcare organisation must reflect the strategies of that organisation. Lex Donaldson (2000) advocates that organisations should adopt structures that assist in the attainment of goals thus ensuring organisational effectiveness. Organisations that deliver healthcare (both government and non-government) have four essential characteristics that govern their efficiency: mix; the division or provision of activities; internal administrative, management structures and processes.
Most countries structure the delivery of
healthcare services in a hierarchal model: small sub-centres to larger clinics, small hospital sites to large hospital sites both in government or non-government models. Whilst in most cases the smaller decentralised health provider would be the most convenient and cost effective, they are also limited in the delivery. In contrast the large health providers are the least accessible and overall more costly, but offer a wider scope of health delivery.
Healthcare delivered from smaller health providers
to the larger providers should be by way of referral in order to connect the mix in service provision between the two organisations.
It is the state that ultimately affects delivery of service through policies that determine the type of organisations that can exist, how resources are applied to that organisation and by implementing policies that change the behaviour of providers and patients in order to improve organisational performance. For example, government can finance new or additional services and introduce incentives to promote the development by implementing policy change however; it is the organisation that affects the delivery of healthcare by access, quality and efficiency. Access, quality and efficiency are the performance indicators by which we judge the organisation. The organisational structure is crucial to the distribution and equality of healthcare delivery. William...
References: Katz, R (2004) The human side of managing technological innovation. 2nd ed. New
York : Oxford University Press Ch
deliberations in nonroutine work”, pp. 497 - 507
Daft, Richard L (2010) Organisation theory and design
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