Hvordan fungerte innføringen av bestiller-utfører modell ved St. Olavs hospital, og hvordan fremstår modellen i dag?

Content Provider	Semantic Scholar
Author	Sørlie, Håvard Tetlien, John Sigurd Hansen, Morten Damgaard
Copyright Year	2010
Abstract	The development of the public sector in Norway has, over the past decades, been increasingly influenced by the ideas of New Public management. During the 80's there was a broad consensus that traditional bureaucratic organization of the public sector, neither were consistent nor suitable for the many new challenges and demands. The political ideology of the mid 80`s was the idea for the public sector to become more effective through reorganization, competition, individualization and the benefit of the market. The 1990`s modernization and conversion reforms were gathered in the collective term, New Public Management (NPM). In Hospital administration the purchaser/provider was one of the models who was initialized as a consequence of the national health reform in 2002. The main idea was to adjust to the principals of the market to become more effective for non medical goods and services. This model (among other tactical moves) would become a tool for the hospital management to control rapidly increasing costs. In this work we have studied the model of purchaser/provider in St. Olavs Hospital in Trondheim. We have analyzed documents and conducted interviews of leaders and economic advisers in both the purchaser (clinics) and provider (STOD) field, all in all 8 respondents. The theoretical foundation of our analyze is mainly the conceptual enterprise model by Busch, Johnsen and Vanebo (2005). In addition we have also focused on new institutional economic and structural theory. In this framework we have analyzed the implementation process and how the model works today. We were studying the model in relation to how it affected economic and management processes, and the legitimacy of the model inside the hospital. All three of us work in the hospital, and we are in many ways affected by the model in our field of activity. Main findings. • STOD became the leading part in the implementation process. We have identified that the imbalance, between provider (STOD) and the purchaser (clinics), led to a concentration of power in the hands of the provider. As a consequence of this imbalance the leadership of the hospital choose to reverse the model, and began to report economic results without taking into consideration internal spending. The consequence of this imbalance was the managerial choice of reversing the model. The consequence of the managerial decision to report results before internal trade in the clinics from 2005, and managing STOD by controlling the costs from 2006, breached the goals for the implementation of the model. As we see it, this indicates a measurement structure similar to the "old" administration model. The lack of involvement from the leadership of the hospital, could as well be a main factor for the reduced effect of the model.
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Alternate Webpage(s)	https://brage.bibsys.no/xmlui/bitstream/handle/11250/147318/Hansen,%20S%C3%B8rlie%20og%20Tetlien.pdf?isAllowed=y&sequence=1
Language	English
Access Restriction	Open
Content Type	Text
Resource Type	Article