Administration of Strategic Agreements in Public Hospitals: Considerations to Enhance the Quality and Sustainability of Mergers and Acquisitions.

Javier Cerezo-Espinosa De Los Monteros,Antonio Castro-Torres,Valle Coronado-Vázquez,Juan Gómez-Salgado,Javier Fagundo-Rivera,Carlos Gómez-Salgado

doi:10.3390/ijerph18084051

Abstract

Merger processes between hospitals have high benefit potential for patients, staff and managers. This integration of health centres can improve the quality and safety in patient care. Additionally, cooperative processes enhance the sustainability of the health system, by increasing team spirit, giving innovative ideas and improving staff satisfaction. In this article, the critical factors for successful hospital mergers and acquisitions in the Public Health System were considered to develop a brief guide to help with the organisation of a merger process. Five sections were designed: Strategic administration and objectives, Staff management, New hospital complex structure, Processes and Results. This guide facilitates the communication between a variety of stakeholders, thus improving the engagement between all members of the new healthcare system. This could be particularly important for countries with large regional variance in the organisation of health care and resources.

Highlights

The success factors for hospital mergers identified, after synthesising information gathered from literature review and experts’ opinions, are the following: 3.1
Our research shows the main considerations about an optimised hospital merger that coincide with the considerations of the World Health Organization [55]: (1) The costs, patient’s outcomes and satisfaction depend, among others, on the country and market; (2) Bigger hospitals are not necessarily better, the optimal hospital size depends on local healthcare needs, distance to resources, and the availability of complementary services; (3) Accurate objectives and investments need to be measured based on the achievement of better clinical results, and commonly established size indicators
Hospital competition on quality of care and resource control in these countries mainly depends on being part of a public or private healthcare system because of these proposals for cooperation that exist in the public system

Summary

Introduction

Hospital mergers have many potential benefits, such as economies of scale, greater purchasing power, more possibilities for the acquisition of expensive equipment, opportunities to share high-cost technology, the creation of hyperspecialised units for specific pathologies, and more [1]. They can impair patients’ perception of quality and satisfaction [2]. Market concentration can be a problem as, in many cases, the expected high efficiency based on economies of scales is not always achieved [4] All of these factors have made the success of hospital mergers an appealing subject of interest. As economic crisis was one important driver of mergers, it can be expected that this trend towards increasing the number of mergers will go on, something that makes finding out significant factors for its success even more relevant [13]

Methods

Results

Discussion

Conclusion