Investing in hospitals of the future
Bernd Rechel, Stephen Wright, Nigel Edwards,
World Health Organization 2009, on behalf of the European Observatory on Health Systems and Policies
Available online as PDF file [304p.] at: http://www.euro.who.int/Document/E92354.pdf
“……..Over the years, the hospital has evolved into the institution and buildings that we know and trust, through the advance of scientifi c medicine. Th ere have been revolutions in surgery (anaesthesia and asepsis), imaging (X-rays and magnetic resonance imaging (MRI)) and laboratory medicine (bacteriology and haematology), among many other fields. The locus of all these developments was the hospital, leading to its enormous significance today, although some activities are increasingly able to be carried out in other settings.
Hospitals are not only sites to provide health care: they carry out extensive programmes relating to research and development, education and training, and in their own right they are critical components of the urban fabric. Thus, although there are sure to be major evolutions in the nature and role of hospitals, the institutions themselves are unlikely to be displaced soon.
If only as a result of its importance as the place where scientific health care is focused, the hospital sector typically absorbs up to 50% of national expenditure on the health care system. This highlights the critical nature of the decision to invest capital in the construction of a hospital, given that this action commits society to a stream of future running costs which dwarf the original – already considerable – capital cost…..”
“…..Running through this book is the leitmotif of the critical nature of the model of care, explicit or perhaps even implicit, as a structure for the role of the hospital. “Form follows function”, and thus the shape and size of the hospital are determined by the services it tries to deliver. In planning a hospital, it is naturally the future demands that are most important, futures that are always uncertain because of unpredictable trends and technological developments.
Decision-makers should be aware that capacity is not usefully indexed simply by the number of beds, and space should be as “loose-fit” and flexible as can be designed and built. We can surmise that the more the underlying care processes can be systematized, the more efficiently and effectively flows of patients can be managed.
Perhaps inevitably, this volume raises more questions than it answers, and thus indicates a research agenda to come. ….”Philippe Maystadt President European Investment Bank
CONTENT
Part one: The changing context of capital investment
Chapter 1 Introduction: hospitals within a changing context Bernd Rechel, Stephen Wright, Nigel Edwards,
Chapter 2 New models of long-term care and implications for service redesign Pieter Degeling, Jonathan Erskine
Part two: Influencing capital investment
Chapter 3 Planning health care capacity: whose responsibility? Stefanie Ettelt, Martin McKee, Ellen Nolte, Nicholas Mays, Sarah Thomson
Chapter 4 Concept planning: getting capital investment right Knut Samset,
Chapter 5 Capital investment and the health care workforce Bernd Rechel, James Buchan, Martin McKee
Part three: Economic aspects of capital investment
Chapter 6 Market competition in European hospital care Hans Maarse, Charles Normand
Chapter 7 Capital financing models, procurement strategies and decision-making Geert Dewulf, Stephen Wright
Chapter 8 Life-cycle economics: cost, functionality and adaptability Svein Bjørberg, Marinus Verweij
Chapter 9 Facility management of hospitals Kunibert Lennerts
Chapter 10 The economic and community impact of health capital investment Jonathan Watson, Simona Agger
Part four: Design issues
Chapter 11 Translating hospital services into capital asset solutions Bernd Rechel, Stephen Wright, Martin McKee
Chapter 12 Sustainable design for health Rosemary Glanville, Phil Nedin
Part five: Conclusions
Chapter 13 Conclusions and critical success factors Bernd Rechel, Stephen Wright, Nigel Edwards,
The European Observatory on Health Systems and Policies is a partnership between the World Health Organization Regional Offi ce for Europe, the Governments of Belgium,
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